A medical expert said that the HIV medication Truvada may be tested against COVID-19 if remdesivir is shown to work against the disease in clinical trials. Truvada is a combination of emtricitabine and tenofovir disoproxil, both of which are nucleotide analogs. The experimental medication remdesivir is also a nucleotide analog.
“If Remdesivir works, because it falls into the same class of medication as Truvada, then Truvada may be able to be tried as well,” said David Hardy of the Johns Hopkins University School of Medicine.
Remdesivir and Truvada function via the same “mechanism of action,” attacking SARS-CoV-2, the coronavirus responsible for COVID-19, in a vulnerable point in the replication cycle of the virus, Hardy said.
“It basically stops the production of the virus,” said Dr. Gregory Poland of the Mayo Clinic’s Vaccine Research Group.
“I would wager to say that if the clinical studies that are studying remdesivir in China and then in the U.S. now show some promise, then there’s gonna be a very quick look at Truvada to see if it works,” Hardy said.
Hardy noted an important distinction between remdesivir and Truvada: remdesivir must be injected intravenously whereas Truvada can be taken orally.
“[Injection] can be much more complicated for treating large numbers of people than pills are,” Hardy said.”
Remdesivir has been shown to interfere with the ability for the SARS and MERS viruses to replicate. SARS-CoV-2 is closely related to those viruses. There have been numerous anecdotal reports of remdesivir successfully treating COVID-19 patients, including patients from the Diamond Princess cruise ship. The medication seemed to reduce the need for ventilator support for Diamond Princess patients. Remdesivir is currently undergoing multiple clinical trials studying its effectiveness against COVID-19.
Truvada was recently in the news cycle when Facebook decided to delete misleading Truvada ads which implied that the risk of serious Truvada side effects was the same for treatment of HIV and pre-exposure prophylaxis (PrEP) use. A study in 2010 linked osteoporosis and decreased bone density to tenofovir disoproxil fumarate (TDF) drugs such as Truvada. A study in 2018 linked kidney damage and renal failure to TDF drugs. However, both studies investigated TDF drugs being used to treat existing HIV infection rather than being used as PrEP. A study from 2017 found that bone density loss and kidney damage were more likely to result from HIV treatment with TDF drugs than TDF drugs being used as PrEP.