New Medications For HIV Treatment

Human Immunodeficiency Virus (HIV) attacks the body’s immune system by destroying human CD4 T cells (T helper Cells). The continuous destruction of these cells weakens the immune system, reducing the body’s ability to fight infections and diseases.

There is no cure for HIV. However, it can be controlled by proper use of antiretroviral therapy (ART). ART can significantly increase the lifespan of infected people and improve their quality of life. Three drug regimens are used for maximal suppression of HIV replication. The combination of three antiretroviral agents inhibits HIV replication to undetectable levels, prevents and reverses immune system deficiency, and decrease morbidity and mortality. Here is an overview of some new combination-HIV drugs.

Evotaz (atazanavir and cobicistat)

Evotaz is a combination drug that contains atazanavir (a protease inhibitor) and cobicistat (a CYP3A inhibitor). HIV cleaves larger proteins into smaller functional proteins necessary for the production of mature and infectious virus copies. Atazanavir prevents HIV from cleaving larger proteins into smaller proteins. Cobicistat increases the blood concentration of atazanavir by blocking its breakdown in the liver. Evotaz was approved by the FDA in January, 2015.

Some Facts About Evotaz

• One tablet is taken once daily by mouth, and it needs to be taken with food.
• Always used in combination with other antiretroviral drugs.
• Accumulation of body fat may occur.
• It can cause insulin resistance.
• Evotaz is a tablet that contains 300 mg of atazanavir and 150 mg of cobicistat.

The average wholesale price of each tablet is $64.22 and a 30 tablet package size costs $1926.56

Side Effects of Evotaz

• Jaundice
• Scleral icterus – yellow coloration of eyes
• Rash
• Nausea/Vomiting
• Cardiovascular problems such as heart block
• Liver and kidney dysfunction
• Kidney stones
• Gallstones

Prezcobix (darunavir and cobicistat)

It is a combination drug that contains darunavir (a protease inhibitor) and cobicistat (a CYP3A inhibitor). Darunavir is similar to atazanavir and cobicistat increases the blood levels of darunavir. Prezcobix was approved by the FDA in January, 2015.

Some Facts About Prezcobix

• Use with caution in people who have a sulfa allergy.
• The dose is one tablet taken once daily by mouth, and it needs to be taken with food.
• It is always used in combination with other antiretroviral drugs
• Accumulation of body fat may occur.
• It can cause insulin resistance.

Prezcobix is a tablet that contains 800 mg of darunavir and 150 mg of cobicistat.

The average wholesale price of each tablet is $66.97 and 30 tablets package size costs $2009.23.

Side Effects of Prezcobix

• Liver damage
• Severe skin reactions such as rash and anaphylaxis
• Nausea, vomiting
• Kidney dysfunction
• Increased cholesterol
• Jaundice
• Ocular Icterus

Genvoya (elvitegravir, cobicistat, emtricitabine, and tenofovir alafenamide)

Genvoya is a four-drug combination of elvitegravir (an HIV integrase strand transfer inhibitor), cobicistat (a CYP3A inhibitor), emtricitabine, and tenofovir alafenamide which are HIV nucleoside analog reverse transcriptase inhibitors. Elvitegravir works by inhibiting HIV integrase, which is an enzyme that is needed for the HIV virus to multiply. Emtricitabine and tenofovir block the action of reverse transcriptase, an enzyme that HIV virus uses to produce viral DNA and for viral replication. Genvoya was approved by the FDA in November, 2015.

Side Effects of Genvoya

• Lactic acidosis and severe liver enlargement with steatosis
• Severe and sudden worsening of hepatitis B infection
• Severe infections
• Liver dysfunction
• Kidney dysfunction
• A headache and fatigue
• Nausea and diarrhea
• High cholesterol
• Bone loss

Some Facts About Genvoya

• One tablet should be taken once daily by mouth with food.
• It requires good kidney function (creatinine clearance of at least 30 ml/min)
• Patients need to be tested for hepatitis B virus infection.
• It can be used as a single tablet for antiretroviral therapy.
• Needs to be taken at least 2 hours before or after taking any antacids.
• Changes in body fat can occur especially in upper back, neck, breast, and trunk.

Genvoya comes in a tablet form that contains 150 mg of elvitegravir, 150 mg of cobicistat, 200 mg of emtricitabine, and 10 mg of tenofovir alafenamide. The average wholesale price of each tablet is $110.22 and 30 tablets package size costs $3306.62.

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