Does PrEP prevent COVID?
There have been recent news reports about different medicines being tested to treat or prevent COVID-19. Many different drugs are being tested, including ones that are used for HIV treatment. At this stage there are no drugs that have gone through sufficient clinic research trials for us to be certain that they work for sure against COVID-19. In fact, some of the drugs being tested might cause more harm than good.
Some of these news reports provide hope about possible medicines to treat or prevent COVID-19 in the future. And some misunderstand or misinterpret the trial data. In some cases people have been harmed, or have died, from taking drugs used for other health conditions, because they have read news stories (or listened to politicians who should know better) that suggest that the drugs might stop COVID-19.
At the start of April 2020, a new clinical trial was announced that proposes to use TDF/FTC. This is the same drug most commonly used for HIV PrEP (and is the formulation used in Truvada). The trial is being conducted in Spain amongst health workers and will explore if TDF/FTC prevents COVID-19 and/or reduces the severity of illness if someone becomes infected. Information about the trial is available here.
Conducting a drug trial does not mean that the drugs used in HIV PrEP prevent COVID-19. It means that this is being explored as a possibility. At this stage there is not sufficient evidence to suggest that TDF/FTC protects against COVID-19 (and that’s why a trial is being conducted).
We know that some PrEP users have decided to continue using PrEP, or have considered re-starting, because they have heard about this trial. There is more information about re-starting PrEP here.
Some people who have not used PrEP before might consider starting TDF/FTC because they’ve read about the trial. In those circumstances, it is essential to follow guidance on starting PrEP, even if an individual is considering taking the drug for possible COVID-19 prevention, and not for HIV prevention.
Not everyone with HIV uses TDF/FTC for HIV treatment and, after learning about this trial, might want to start using TDF/FTC for COVID-19 prevention. We strongly, strongly discourage this unless this decision is made in consultation with an HIV specialist health worker. Switching or changing drugs that are also used for HIV treatment could significantly impact on HIV treatment and health.
If someone decides to take, or to continue to take TDF/FTC, because of possible COVID-19 prevention, it is strongly, strongly recommended to continue to practice all the currently recommended COVID-19 prevention methods including physical distancing, hand washing, and avoiding casual hook-ups.
If deciding to start or resume TDF/FTC for possible COVID-19 prevention it is strongly advised NOT to take more than the usual recommended dosing (one pill a day unless double dosing to start event based PrEP). Taking additional dosing on an on-going basis could lead to more side effects.
To reiterate: there is currently no clinical evidence that TDF/FTC provides protection against COVID-19.
The trial mentioned above is not testing TAF/FTC (Descovy).