Tenofovir Alafenamide for HIV Preexposure Prophylaxis
Authors: Diana Brainard, Scott McCallister
Journal: Annals of Internal Medicine (2020)

Letters7 July 2020Tenofovir Alafenamide for HIV Preexposure ProphylaxisDiana Brainard, MD and Scott McCallister, MDDiana Brainard, MDGilead Sciences, Foster City, California (D.B., S.M.)Search for more papers by this author and Scott McCallister, MDGilead Sciences, Foster City, California (D.B., S.M.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L20-0300 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Krakower and colleagues' commentary (1) discussed the phase 3 DISCOVER trial, which compared the safety and efficacy of tenofovir alafenamide with emtricitabine (TAF–FTC) versus tenofovir disoproxil fumarate with emtricitabine (TDF–FTC) for HIV preexposure prophylaxis (PrEP) (2). The authors suggested that the renal and bone safety advantages of TAF–FTC observed in DISCOVER were not clinically meaningful. We agree that both drugs are generally safe and well tolerated; however, published data have consistently shown that use of TDF has a substantial effect on renal and bone safety in both HIV treatment and prevention clinical studies.A recent meta-analysis in ...References1. Krakower DS, Daskalakis DC, Feinberg J, et al. Tenofovir alafenamide for HIV preexposure prophylaxis: what can we DISCOVER about its true value? Ann Intern Med. 2020;172:281-282. [PMID: 31931525]. doi:10.7326/M19-3337 LinkGoogle Scholar2. Hare CB, Coll J, Ruane P, et al. The phase 3 DISCOVER study: daily F/TAF or F/TDF for HIV preexposure prophylaxis [Abstract]. In: Abstract eBook for Conference on Retroviruses and Opportunistic Infections, Seattle, Washington, 4–7 March 2019. CROI Foundation/IAS–USA. 2019:41. Google Scholar3. Chou R, Evans C, Hoverman A, et al. Preexposure prophylaxis for the prevention of HIV infection: evidence report and systematic review for the US Preventive Services Task Force. JAMA. 2019;321:2214-2230. [PMID: 31184746] doi:10.1001/jama.2019.2591 CrossrefMedlineGoogle Scholar4. Havens PL, Perumean-Chaney SE, Patki A, et al. Changes in bone mass after discontinuation of preexposure prophylaxis with tenofovir disoproxil fumarate/emtricitabine in young men who have sex with men: extension phase results of Adolescent Trials Network protocols 110 and 113. Clin Infect Dis. 2020;70:687-691. [PMID: 31179503] doi:10.1093/cid/ciz486 CrossrefMedlineGoogle Scholar5. Gupta SK, Post FA, Arribas JR; et al;. Renal safety of tenofovir alafenamide vs. tenofovir disoproxil fumarate: a pooled analysis of 26 clinical trials. AIDS. 2019;33:1455-1465. [PMID: 30932951] doi:10.1097/QAD.0000000000002223 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Gilead Sciences, Foster City, California (D.B., S.M.)Note: Drs. Brainard and McCallister are employees and shareholders of Gilead Sciences.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L20-0300. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoTenofovir Alafenamide for HIV Preexposure Prophylaxis: What Can We DISCOVER About Its True Value? Douglas S. Krakower , Demetre C. Daskalakis , Judith Feinberg , and Julia L. Marcus Tenofovir Alafenamide for HIV Preexposure Prophylaxis Douglas S. Krakower , Demetre C. Daskalakis , Judith Feinberg , and Julia L. Marcus Metrics Cited byMind the Gap: HIV Prevention Among Young Black Men Who Have Sex with Men 7 July 2020Volume 173, Issue 1Page: 77-78KeywordsBoneDisclosureHIVHIV preventionHypertensionOsteoporosisPopulation statisticsPreexposure prophylaxisSafetySafety studies ePublished: 7 July 2020 Issue Published: 7 July 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...