Emtricitabine/tenofovir

Last updated

Emtricitabine/tenofovir
Tenofovir disoproxil and emtricitabine.svg
Truvada.JPG
Combination of
Emtricitabine Nucleoside reverse transcriptase inhibitor
Tenofovir disoproxil Nucleotide analogue reverse transcriptase inhibitor
Clinical data
Trade names Truvada, others
Other namesEmtricitabine/tenofovir disoproxil fumarate
AHFS/Drugs.com Monograph
MedlinePlus a612036
License data
Pregnancy
category
Routes of
administration 		By mouth
ATC code
Legal status
Legal status
Identifiers
CAS Number
PubChem CID
KEGG
NIAID ChemDB
   (verify)

Emtricitabine/tenofovir, sold under the brand name Truvada among others, is a fixed-dose combination antiretroviral medication used to treat and prevent HIV/AIDS. [5] [6] It contains the antiretroviral medications emtricitabine and tenofovir disoproxil. [7] For treatment, it must be used in combination with other antiretroviral medications. [7] [8] For prevention before exposure, in those who are at high risk, it is recommended along with safer sex practices. [7] It does not cure HIV/AIDS. [5] Emtricitabine/tenofovir is taken by mouth. [7]

Contents

Common side effects include headache, tiredness, trouble sleeping, abdominal pain, weight loss, and rash. [5] Serious side effects may include high blood lactate levels and enlargement of the liver. [7] Use of this medication during pregnancy does not appear to harm the fetus, but this has not been well studied. [1]

Emtricitabine/tenofovir was approved for medical use in the United States in 2004. [5] It is on the World Health Organization's List of Essential Medicines. [9] In the United States, emtricitabine/tenofovir was under patent by Gilead until 2020, but is now available as a generic worldwide. [10] In 2020, it was the 278th most commonly prescribed medication in the United States, with more than 1 million prescriptions. [11] [12]

Medical uses

Emtricitabine/tenofovir is used both to treat and to prevent HIV/AIDS. [5] The U.S. National Institutes of Health (NIH) recommends antiretroviral therapy (ART) for all people with HIV/AIDS. [13]

HIV prevention

The Centers for Disease Control and Prevention (CDC) recommends the use of emtricitabine/tenofovir for pre-exposure prophylaxis (PrEP) for uninfected, HIV-1 negative individuals that may be at risk for HIV-1 infection. [14] [7] A Cochrane systematic review found a 51% relative risk reduction of contracting HIV with both tenofovir alone and the tenofovir/emtricitabine combination. [15] A JAMA systematic review found a similar relative risk reduction of 54% on average and greater reduction with greater adherence. [16] It was approved for PrEP against HIV infection in the United States in 2012. [17]

The CDC recommends PrEP be considered for the following high-risk groups: [18]

The consideration of utilizing emtricitabine/tenofovir as a reduction strategy involves discussion with a health professional who can help the patient navigate the benefits and risks. Patients are advised to discuss any history of bone issues, kidney issues, or hepatitis B infection with their healthcare provider. [19] Effectiveness of PrEP for prevention of infection is reliant on an individual's ability to take the medication consistently. [20]

Emtricitabine/tenofovir is also used for HIV post-exposure prophylaxis. People who start taking emtricitabine/tenofovir see HIV reduction benefits up to 72 hours after starting, but the medicine must be taken for thirty days after a high-risk sexual event to ensure HIV transmission levels are optimally reduced. [21] [22]

Emtricitabine/tenofovir as PrEP should not be used for individuals who are positive for HIV-1. [7]

HIV treatment

Emtricitabine/tenofovir has been approved in the United States as part of antiretroviral combination therapy for the treatment of HIV-1. [7] The combination therapy is suggested as one of the options for adults who have not received any prior treatment for HIV infection. [23]

Hepatitis B

Both emtricitabine and tenofovir are indicated for the treatment of hepatitis B, with the added benefit that they can target HIV for those with co-infection. [24] Emtricitabine/tenofovir may also be considered for some antiviral resistant hepatitis B infections. [25]

Pregnancy and breastfeeding

In the United States, it is recommended that all pregnant HIV-infected women start antiretroviral therapy (ART) as early in pregnancy as possible to reduce the risk of transmission. ART generally does not increase risk of birth defects with exception of dolutegravir, which is not recommended during first trimester of pregnancy only due to potential risk of neural tube defects. [26]

Emtricitabine/tenofovir is secreted in breast milk. [27] In developed countries, HIV-infected mothers are generally recommended to not breastfeed due to slight risk of mother-to-children HIV transmission. [28] [29] In developing countries, where avoiding breastfeeding may not be an option, the World Health Organization recommends a triple drug regimen of tenofovir, efavirenz, and either lamivudine or emtricitabine. [29]

Side effects

Emtricitabine/tenofovir is generally well tolerated. Some of its side effects include: [7]

Fat redistribution and accumulation (lipodystrophy) has been observed in people receiving antiretroviral therapy, including fat reductions in the face, limbs, and buttocks and increases in visceral fat of the abdomen and accumulations in the upper back. [7] When used as pre-exposure prophylaxis (PrEP) this effect may not be present. [30] Weight changes have however been linked to the medication. [31]

Drug interactions

Drug-drug interactions [7]
Drug-drug InteractionCoadministration
Tenofovir Didanosine
  • May increase didanosine concentration and risk of didanosine toxicity (e.g. pancreatitis, neuropathy).
  • Discontinue didanosine if patient develops didanosine-associated adverse events.
  • For patients who weigh more than 60 kg, didanosine dose should be reduced to 250 mg; there is no available data to recommend didanosine dose adjustments in patients who weigh less than 60 kg.
Atazanavir
  • May decrease atazanavir and increase tenofovir concentrations.
  • Atazanavir should only be taken together with emtricitabine/tenofovir with ritonavir.
  • Monitor for tenofovir toxicity.
Lopinavir/ritonavir, atazanavir coadministered with ritonavir & darunavir coadministered with ritonavir
  • May increase tenofovir concentrations.
Ledipasvir/sofosbuvir
  • May increase tenofovir concentrations.
  • Consider alternative Hepatitis C antiviral or antiretroviral therapy.
  • Monitor for tenofovir toxicity.
Emtricitabine/tenofovir P-glycoprotein and breast cancer resistance protein (BCRP) transporters inhibitors
  • May increase absorption of emtricitabine/tenofovir.
Drugs may decrease renal function (e.g. acyclovir, adefovir, dipivoxil, cidofovir, ganciclovir, valacyclovir, valganciclovir, aminoglycosides, etc.)
  • May increase emtricitabine and/or tenofovir concentrations.
High-dose or multiple NSAIDs
Orlistat
  • May inhibit the absorption of emtricitabine/tenofovir and result in loss of viral control. [32]
  • Monitor HIV viral load frequently while the patient is taking orlistat.
  • Discontinue orlistat if HIV viral load increases.

Other drugs with adverse reactions include dabigatran etexilate, lamivudine, and vincristine. Dabigatran etexilate used with p-glycoprotein inducers requires monitoring of decreased levels and effects of dabigatran. Lamivudine may increase the adverse or toxic effect of emtricitabine. Vincristine used with P-glycoprotein/ABCB1 inducers can decrease the serum concentration of vincristine. [33]

Society and culture

The patent for the drug combination is owned by Gilead Sciences in some regions. The European patent EP0915894B1 [34] expired in July 2018, Gilead Sciences wished the patent to be extended, however "four rival labs—Teva, Accord Healthcare, Lupin and Mylan—had sought to have that overturned in the courts in Britain", the High Court of England and Wales invalidated Gilead's patent, [35] however the company appealed [36] and the UK referred the case to the European Court of Justice who refused to extend the patent. [37] An Irish court rejected an injunction request to prevent the launch of generic Emtricitabine/tenofovir prior to the resolution of the case. [38] [39] Despite the expiration of the Gilead Sciences patent, as of 2021, there are still widespread challenges to the availability and uptake of generic PrEP throughout Europe. [40]

In 2019, Gilead Sciences challenged the validity of patents granted to the United States after 2015 for using the drug combination for HIV PrEP and post-exposure prophylaxis (PEP). [41] [42] [43] In July 2024, The Biden administration appealed the jury finding that ruled in favor of Gilead Sciences verdict that the U.S. government's patents are invalid. [44]

In the United States, most healthcare plans are required to cover PrEP without any copay or other cost sharing. This is due to a United States Preventive Services Task Force recommendation that gave PrEP a grade A rating. Under the Affordable Care Act, this recommendation requires all non-grandfathered private health plans to cover PrEP without cost sharing. [45] [46]

In the United Kingdom, PrEP is widely available to all at-risk groups following the Department for Health and Social Care's decision to make it available across England in 2020. Wales, Scotland, and Northern Ireland made it available in 2017 and 2018. [47] [48]

Related Research Articles

Reverse-transcriptase inhibitors (RTIs) are a class of antiretroviral drugs used to treat HIV infection or AIDS, and in some cases hepatitis B. RTIs inhibit activity of reverse transcriptase, a viral DNA polymerase that is required for replication of HIV and other retroviruses.

<span class="mw-page-title-main">Emtricitabine</span> Antiretroviral drug used to treat HIV infection

Emtricitabine, with trade name Emtriva, is a nucleoside reverse-transcriptase inhibitor (NRTI) for the prevention and treatment of HIV infection in adults and children. In 2019, it was the 494th most commonly prescribed medication in the United States, with more than 3 thousand prescriptions.

Post-exposure prophylaxis, also known as post-exposure prevention (PEP), is any preventive medical treatment started after exposure to a pathogen in order to prevent the infection from occurring.

<span class="mw-page-title-main">Gilead Sciences</span> American pharmaceutical company

Gilead Sciences, Inc. is an American biopharmaceutical company headquartered in Foster City, California, that focuses on researching and developing antiviral drugs used in the treatment of HIV/AIDS, hepatitis B, hepatitis C, influenza, and COVID-19, including ledipasvir/sofosbuvir and sofosbuvir. Gilead is a member of the Nasdaq-100 and the S&P 100.

<span class="mw-page-title-main">Tenofovir disoproxil</span> Antiviral drug used to treat or prevent HIV and hepatitis infections

Tenofovir disoproxil, sold under the brand name Viread among others, is a medication used to treat chronic hepatitis B and to prevent and treat HIV/AIDS. It is generally recommended for use with other antiretrovirals. It may be used for prevention of HIV/AIDS among those at high risk before exposure, and after a needlestick injury or other potential exposure. It is sold both by itself and together in combinations such as emtricitabine/tenofovir, efavirenz/emtricitabine/tenofovir, and elvitegravir/cobicistat/emtricitabine/tenofovir. It does not cure HIV/AIDS or hepatitis B. It is available by mouth as a tablet or powder.

<span class="mw-page-title-main">Efavirenz</span> Antiretroviral medication

Efavirenz (EFV), sold under the brand names Sustiva among others, is an antiretroviral medication used to treat and prevent HIV/AIDS. It is generally recommended for use with other antiretrovirals. It may be used for prevention after a needlestick injury or other potential exposure. It is sold both by itself and in combination as efavirenz/emtricitabine/tenofovir. It is taken by mouth.

<span class="mw-page-title-main">Pre-exposure prophylaxis for HIV prevention</span> HIV prevention strategy using preventative medication for HIV-negative individuals

Pre-exposure prophylaxis for HIV prevention, commonly known as PrEP, is the use of antiviral drugs as a strategy for the prevention of HIV/AIDS by people that do not yet have HIV/AIDS. PrEP is one of a number of HIV prevention strategies for people who are HIV-negative but who have a higher risk of acquiring HIV, including sexually-active adults who are at increased risk of contracting HIV, people who engage in intravenous drug use, and serodiscordant sexually-active couples.

<span class="mw-page-title-main">Efavirenz/emtricitabine/tenofovir</span> Combination drug for HIV

Efavirenz/emtricitabine/tenofovir, sold under the brand name Atripla among others, is a fixed-dose combination antiretroviral medication used to treat HIV/AIDS. It contains efavirenz, emtricitabine, and tenofovir disoproxil. It can be used by itself or together with other antiretroviral medications. It is taken by mouth.

<span class="mw-page-title-main">HIV Prevention Trials Network</span>

The HIV Prevention Trials Network (HPTN) is a worldwide collaborative clinical trials network that brings together investigators, ethicists, community and other partners to develop and test the safety and efficacy of interventions designed to prevent the acquisition and transmission of HIV. HPTN studies evaluate new HIV prevention interventions and strategies in populations and geographical regions that bear a disproportionate burden of infection. The HPTN is committed to the highest ethical standards for its clinical trials and recognizes the importance of community engagement in all phases of the research process.

iPrEx

iPrEx was a phase III clinical trial to determine whether the antiretroviral medication emtricitabine/tenofovir could safely and effectively prevent HIV acquisition through sex in men who have sex with men and transgender women. iPrEx was the first human study of an HIV prevention strategy known as pre-exposure prophylaxis, or PrEP.

Emtricitabine/rilpivirine/tenofovir, sold under the brand name Complera among others, is a fixed-dose combination of antiretroviral drugs for the treatment of HIV/AIDS. The drug was co-developed by Gilead Sciences and Johnson & Johnson's Tibotec division and was approved by the US Food and Drug Administration (FDA) in August 2011, and by the European Medicines Agency in November 2011, for patients who have not previously been treated for HIV. It is available as a once-a-day single tablet.

<span class="mw-page-title-main">Tenofovir alafenamide</span> Chemical compound

Tenofovir alafenamide, sold under the brand name Vemlidy, is an antiviral medication used against hepatitis B and HIV. It is used for the treatment of chronic hepatitis B virus (HBV) infection in adults with compensated liver disease and is given in combination with other medications for the prevention and treatment of HIV. It is taken by mouth.

Elvitegravir/cobicistat/emtricitabine/tenofovir, sold under the brand name Stribild, also known as the Quadpill, is a fixed-dose combination antiretroviral medication for the treatment of HIV/AIDS. Elvitegravir, emtricitabine and tenofovir disoproxil directly suppress viral reproduction. Cobicistat increases the effectiveness of the combination by inhibiting the liver and gut wall enzymes that metabolize elvitegravir. It is taken by mouth. It is manufactured by Gilead Sciences.

<span class="mw-page-title-main">John C. Martin (businessman)</span> American billionaire businessman

John Charles Martin was an American billionaire businessman, and the former executive chairman (2016–2018) and CEO (1996–2016) of the American biotechnology company Gilead Sciences. He joined Gilead Sciences in 1990 as vice president for research and development. Gilead is known for developing drugs such as Atripla and commercializing Sovaldi (sofosbuvir) for the treatment of the liver virus hepatitis C. Martin is the recipient of a number of awards, including the Biotechnology Heritage Award (2017).

<span class="mw-page-title-main">Cabotegravir</span> Medication for HIV/AIDS

Cabotegravir, sold under the brand name Vocabria among others, is a antiretroviral medication used for the treatment of HIV/AIDS. It is available in the form of tablets and as an intramuscular injection, as well as in an injectable combination with rilpivirine under the brand name Cabenuva.

<span class="mw-page-title-main">Elioda Tumwesigye</span> Ugandan politician

Elioda Tumwesigye is a Ugandan politician, physician, and epidemiologist who has served as minister of science, technology and innovation in the cabinet of Uganda since June 2016. From March 2015 until June 2016, he served as the minister of health.

HPTN 083 is a 2016 clinical trial which compares cabotegravir injections with oral use of Emtricitabine/tenofovir as pre-exposure prophylaxis ("PrEP") for prevention of HIV/AIDS.

Efavirenz/lamivudine/tenofovir (EFV/3TC/TDF), sold under the brand name Symfi among others, is a fixed-dose combination antiretroviral medication for the treatment of HIV/AIDS. It combines efavirenz, lamivudine, and tenofovir disoproxil. As of 2019, it is listed by the World Health Organization as an alternative first line option to dolutegravir/lamivudine/tenofovir. It is taken by mouth.

<span class="mw-page-title-main">Bictegravir/emtricitabine/tenofovir alafenamide</span> Fixed dose combination HIV drug

Bictegravir/emtricitabine/tenofovir alafenamide, sold under the brand name Biktarvy, is a fixed-dose combination antiretroviral medication for the treatment of HIV/AIDS. It contains bictegravir, a human immunodeficiency virus type 1 (HIV-1) integrase strand transfer inhibitor; emtricitabine, an HIV-1 nucleoside analog reverse transcriptase inhibitor; and tenofovir alafenamide, an HIV-1 nucleoside analog reverse transcriptase inhibitor.

In January 2018, the provincial government of British Columbia (BC) began providing individuals at high risk of HIV infection with pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) at no cost. High risk individuals include men and trans women who have sex with men, people who inject drugs, and people who have sex with people living with HIV. One year following this policy change, which is delivered as part of the British Columbia Centre for Excellence in HIV/AIDS (BC-CfE)'s Drug Treatment Program, almost 3,300 people have been prescribed with PrEP or PEP.

References

  1. 1 2 "Emtricitabine / tenofovir Pregnancy and Breastfeeding Warnings". Drugs.com. 1 August 2018. Archived from the original on 10 October 2019. Retrieved 10 October 2019.
  2. ↑ "Prescription medicines: registration of new generic medicines and biosimilar medicines, 2017". Therapeutic Goods Administration (TGA). 21 June 2022. Retrieved 30 March 2024.
  3. ↑ "FDA-sourced list of all drugs with black box warnings (Use Download Full Results and View Query links.)". nctr-crs.fda.gov. FDA . Retrieved 22 October 2023.
  4. ↑ "Truvada EPAR". European Medicines Agency. 21 February 2005. Retrieved 13 June 2024.
  5. 1 2 3 4 5 "Truvada". Drugs.com. Archived from the original on 20 December 2016. Retrieved 12 December 2016.
  6. ↑ "UK label Truvada film-coated tablets". Electronic Medicines Compendium. August 2016. Archived from the original on 20 December 2016.
  7. 1 2 3 4 5 6 7 8 9 10 11 "Truvada- emtricitabine and tenofovir disoproxil fumarate tablet, film coated label". DailyMed. 18 May 2018. Archived from the original on 31 October 2019. Retrieved 31 October 2019.
  8. ↑ World Health Organization (2009). Stuart MC, Kouimtzi M, Hill SR (eds.). WHO Model Formulary 2008. World Health Organization. p. 160. hdl:10665/44053. ISBN   9789241547659.
  9. ↑ World Health Organization (2019). World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization. hdl: 10665/325771 . WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
  10. ↑ "AOC asks pharma CEO why $2,000 HIV drug costs just $8 in Australia". The Independent. 17 May 2019. Retrieved 15 November 2019.
  11. ↑ "The Top 300 of 2020". ClinCalc. Retrieved 7 October 2022.
  12. ↑ "Emtricitabine; Tenofovir Disoproxil - Drug Usage Statistics". ClinCalc. Retrieved 7 October 2022.
  13. ↑ "Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents with HIV" (PDF). AIDSinfo Clinical Guidelines. July 2019. Archived from the original (PDF) on 4 December 2016. Retrieved 30 October 2019.
  14. ↑ "PrEP". Centers for Disease Control and Prevention (CDC). 17 October 2019. Archived from the original on 31 October 2019. Retrieved 31 October 2019.PD-icon.svg This article incorporates text from this source, which is in the public domain .
  15. ↑ Okwundu CI, Uthman OA, Okoromah CA (2012). "Antiretroviral pre-exposure prophylaxis (PrEP) for preventing HIV in high-risk individuals". Cochrane Database Syst Rev. 7 (7): CD007189. doi:10.1002/14651858.CD007189.pub3. PMC   11324012 . PMID   22786505. S2CID   35672491.
  16. ↑ Chou R, Evans C, Hoverman A, Sun C, Dana T, Bougatsos C, et al. (11 June 2019). "Preexposure Prophylaxis for the Prevention of HIV Infection: Evidence Report and Systematic Review for the US Preventive Services Task Force". JAMA. 321 (22): 2214–2230. doi: 10.1001/jama.2019.2591 . ISSN   0098-7484. PMID   31184746. S2CID   184485546.
  17. ↑ Perrone M (16 July 2012). "FDA approves first pill to help prevent HIV". The Seattle Times . Associated Press. Archived from the original on 19 July 2012.
  18. ↑ "Pre-Exposure Prophylaxis (PrEP)". Archived from the original on 5 June 2015. Retrieved 4 June 2015.PD-icon.svg This article incorporates text from this source, which is in the public domain .
  19. ↑ "Administration of pre-exposure prophylaxis against HIV infection". UpToDate. Archived from the original on 1 November 2019. Retrieved 31 October 2019.
  20. ↑ "Pre-exposure prophylaxis of HIV in adults at high risk: Truvada (emtricitabine/tenofovir disoproxil)". 5 October 2016.
  21. ↑ Panlilio AL, Cardo DM, Grohskopf LA, Heneine W, Ross CS (September 2005). "Updated U.S. Public Health Service guidelines for the management of occupational exposures to HIV and recommendations for postexposure prophylaxis" (PDF). MMWR Recomm Rep. 54 (RR-9): 1–17. PMID   16195697.
  22. ↑ Kuhar DT, Henderson DK, Struble KA, Heneine W, Thomas V, Cheever LW, et al. (September 2013). "Updated US Public Health Service guidelines for the management of occupational exposures to human immunodeficiency virus and recommendations for postexposure prophylaxis" (PDF). Infection Control and Hospital Epidemiology. 34 (9): 875–92. doi:10.1086/672271. PMID   23917901. S2CID   17032413. 20711.PD-icon.svg This article incorporates text from this source, which is in the public domain .
  23. ↑ "Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents with HIV" (PDF). Archived from the original (PDF) on 4 December 2016. Retrieved 30 October 2019.
  24. ↑ "Update on Prevention, Diagnosis, and Treatment of Chronic Hepatitis B: AASLD 2018 Hepatitis B Guidance" (PDF). Archived from the original (PDF) on 25 January 2020. Retrieved 20 November 2019.
  25. ↑ "Emtricitabine and Tenofovir Disoproxil Fumarate (Professional Patient Advice)". Drugs.com. Retrieved 31 October 2019.
  26. ↑ "Brief What's New in the Guidelines Perinatal". AIDSinfo. Archived from the original on 23 October 2019. Retrieved 23 October 2019.
  27. ↑ "Recommendations for use of antiretroviral drugs in pregnant HIV-1-infected women for maternal health and interventions to reduce perinatal HIV transmission in the United States" (PDF). National Institutes of Health (NIH). Archived (PDF) from the original on 12 April 2014. Retrieved 21 October 2014.
  28. ↑ "Emtricitabine / tenofovir Use During Pregnancy". Drugs.com. Retrieved 23 October 2019.
  29. 1 2 "Tenofovir". Drugs and Lactation Database (LactMed). National Library of Medicine (US). 2006. PMID   30000609 . Retrieved 23 October 2019.
  30. ↑ "PrEP does not raise lipids or alter body fat, safety study finds" . Retrieved 16 February 2018.
  31. ↑ Glidden DV, Mulligan K, McMahan V, Anderson PL, Guanira J, Chariyalertsak S, et al. (July 2018). "Metabolic Effects of Preexposure Prophylaxis With Coformulated Tenofovir Disoproxil Fumarate and Emtricitabine". Clin. Infect. Dis. 67 (3): 411–419. doi:10.1093/cid/ciy083. PMC   6051460 . PMID   29415175.
  32. ↑ "DailyMed - XENICAL- orlistat capsule". dailymed.nlm.nih.gov. Retrieved 30 October 2019.
  33. ↑ Ramanathan S, Shen G, Cheng A, Kearney BP (July 2007). "Pharmacokinetics of emtricitabine, tenofovir, and GS-9137 following coadministration of emtricitabine/tenofovir disoproxil fumarate and ritonavir-boosted GS-9137". J. Acquir. Immune Defic. Syndr. 45 (3): 274–9. doi: 10.1097/QAI.0b013e318050d88c . PMID   17414929. S2CID   31756102.
  34. ↑ "EP0915894B1 - NUCLEOTIDE ANALOGS". Espacenet. Retrieved 13 December 2017.
  35. ↑ "U.K. Court invalidates Gilead's Truvada patent extension, allowing PrEP generics". 19 September 2018.
  36. ↑ "Truvada ruling could allow cheap HIV prevention in the UK -". 19 September 2018.
  37. ↑ "EU door opens for generic version of AIDS medicine Truvada".
  38. ↑ "Gilead loss of generic HIV drug battle a boost for gay community". The Irish Times . Retrieved 18 May 2018.
  39. ↑ "Gilead in row with generics manufacturers over HIV drug in Ireland". The Irish Times . Retrieved 30 October 2017.
  40. ↑ "European PrEP programs face two big issues: How to get more people coming forward, and how to serve them if they do". 27 January 2021.
  41. ↑ Rowland C (24 April 2019). "Gilead defied a government HIV patent. The Justice Department has opened a review". The Washington Post . Archived from the original on 1 November 2019. Retrieved 31 October 2019.
  42. ↑ Rowland C (21 August 2019). "Gilead files challenge to government patents for HIV prevention pill". The Washington Post . Archived from the original on 1 November 2019. Retrieved 29 October 2019.
  43. ↑ "Petitions to US Patent and Trademark Office on HIV PrEP Patents". Gilead Sciences (Press release). 21 August 2019. Archived from the original on 30 October 2019. Retrieved 29 October 2019.
  44. ↑ Silverman E (8 July 2024). "Biden administration appeals jury finding in battle over patents for HIV prevention pills". STAT News. Retrieved 8 July 2024.
  45. ↑ Keith K (2021). "New Guidance On PrEP: Support Services Must Be Covered Without Cost-Sharing | Health Affairs Forefront". Health Affairs Forefront. doi:10.1377/forefront.20210728.333084 . Retrieved 4 August 2022.
  46. ↑ "FAQS ABOUT AFFORDABLE CARE ACT IMPLEMENTATION PART 47" (PDF). Centers for Medicare & Medicaid Services. 19 July 2021. Retrieved 4 August 2022.
  47. ↑ "HIV drug PrEP to be available across England".
  48. ↑ "Free PrEP on the NHS".
This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.