The Connection Between PrEP And Your Kidney Health
People may become infected with the human immunodeficiency virus (HIV) in a variety of ways, according to the U.S. Centers for Disease Control and Prevention (CDC). This can include sexual contact and the sharing of needles or drug equipment.
However, an important tool that we can use to help prevent transmission of the virus is a medication called PrEP (pre-exposure prophylaxis). This medication, says HIV.gov, can prevent the virus from getting a foothold inside your body and replicating. If taken as prescribed by HIV-negative people who may be at risk for exposure to the virus, it may reduce the risk of contracting HIV from sexual contact by 99%. In addition, it can reduce the risk of infection by 74% for people who inject drugs.
While PrEP does not seem to have any serious side effects, it is generally only recommended for people at high risk, according to Immunopaedia. They cite two major studies pointing to issues with kidney function, especially in older adults.
Studies link PrEP to decline in kidney function
There are currently two medications that are FDA-approved for PrEP, says the CDC: Truvada and Descovy. Truvada is composed of emtricitabine and tenofovir disoproxil fumarate, according to its manufacturer Gilead Sciences. Gilead Sciences further states that its drug Descovy contains emtricitabine and a different form of tenofovir, tenofovir alafenamide.
Immunopaedia explains that the tenofovir contained in these medications might be problematic when it comes to kidney function. Two studies found that high levels of this drug were linked to a slight decline in kidney function as measured by glomerular filtration rate. Over about 18 months, an average of a 2.5% decline in function was seen in these studies. In addition, people over 50 were more greatly affected. Their kidney function decreased in the range of six to 24% during this time frame.
Immunopaedia's conclusion based on this data is that, although the effect is typically mild, people who have risk factors for kidney disease should keep an eye on kidney function while using PrEP.