Hep C Drug Sovaldi May Interact Harmfully With HIV Drug Viread

What is Sovaldi?

Sovaldi is the name brand for sofosbuvir. It is a drug that is commonly included in some of the most commonly prescribed hepatitis C medications, including Harvoni (ledipasvir/sofosbuvir), Epclusa (sofosbuvir/velpatasvir), Dakinza (daclatasvir), and Olysio (simeprevir). These drugs are part of drug therapy regimens that are often prescribed to people who test positive for hepatitis C. Most often, the drugs are taken for a 12 week period in order to rid the body of the virus.

What is Viread?

Viread is the brand name for tenofovir disoproxil fumarate (also called TDF). It is often included in drugs that are prescribed for people who are on a protocol to manage their HIV diagnosis. TDF is found in Truvada (TDF/emtricitabline), Atripla (efavirenz/TDF/emtricitabine), Stribild (elvitegravir/cobicistat/emtricitabine/TDF) and Complera (rilpivirine/TDF/emtricitabine). These drugs are often provided to people who are managing their HIV and working to maintain a low to undetectable viral load. Taking the drug is required to maintain the person’s health and to keep the virus from replicating inside the body.

Why Would A Person Need To Take Both Simultaneously?

When the body is interacting with a virus, its immune system can become compromised. Often, this makes the body more susceptible to becoming infected with other illnesses if the person becomes exposed. When a person has HIV or AIDS, their body is strongly fighting itself and its own immune system is often working against itself. This can create an internal environment that makes it easier for a person to become sick or for an illness to become stronger in their bodies than in the bodies of those who are not already fighting.

The most common transmission for HIV is through unprotected sex or through interaction with infected blood or bodily fluids. The most common transmission for hepatitis C is through interaction with blood, typically on needles being used for tattoos and piercings at an unlicensed facility or during IV drug use. In many cases, IV drug users are known to engage in unsafe sex practices either because they are under the influence at the time of the sexual encounter or because they are attempting to trade sexual activities for access to drugs. This lifestyle can lead to a person becoming infected with both HIV and hepatitis C. Often, there can be a long period of time after the infections when the person’s body shows no obvious symptoms of illness. In addition, some who are using IV drugs may experience symptoms but may attribute them to their drug use. This can create a situation where a person is very ill by the time they see a physician and become properly diagnosed with both viruses. As either virus can create permanent internal damage which can lead to death, physicians often do not want to wait to begin treatment. This can lead to a patient being prescribed Sovaldi or a Sovaldi-based drug to treat their hepatitis C infection at the same time that they are prescribed Viread or a Viread-based drug to treat and manage their HIV or AIDS infection. This has been seen as the proper course of treatment for many years, as it addresses both viruses immediately upon positive test results, rather than treating one virus at a time and giving the one not being treated time to continue to cause damage within the body. In addition, for patients with low income levels, treating both issues simultaneously means only having to pay for one office visit to assess the progress of the medications or to discuss drug and side effect management.

Why Is Interaction A Problem?

New research suggests that these two drugs are creating problems within the kidney. When taken together, the Sovaldi-based drug stops the production of an enzyme that is needed to prevent kidney toxicity in patients who take Viread or a Viread-based drug.

What Should I Do If I Take Sovaldi or Viread?

Never stop or change any drug regimens without first discussing your concerns and problems with your doctors. Choosing to change or stop any type of medication without being supervised by a physician can create side effects within the body and it can cause problems in continuing the previously prescribed treatment plan. Currently, tests continue to be run to find out whether there are any long-term effects in people who have used both drugs simultaneously. In the meantime, researchers are recommending that people who are taking both drugs do so at different times in the day. They are hopeful that doing this means there is a lesser chance of drug interaction since the body is absorbing the drugs at different times. In addition, if you are able to access the drugs through different methods (oral vs. injection, for example), that can also be an option to minimize risks.1-3

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View References
  1. Bad combination: Hepatitis C and HIV medications can interact adversely when used together. (2016). ScienceDaily. Retrieved 1 April 2017, from https://www.sciencedaily.com/releases/2016/12/161213174950.htm
  2. Puoti, M., Panzeri, C., Rossotti, R., & Baiguera, C. (2014). Efficacy of sofosbuvir-based therapies in HIV/HCV infected patients and persons who inject drugs. Digestive And Liver Disease, 46, S206-S211. http://dx.doi.org/10.1016/j.dld.2014.09.027
  3. Shen, Y., & Yan, B. (2017). Covalent inhibition of carboxylesterase-2 by sofosbuvir and its effect on the hydrolytic activation of tenofovir disoproxil. Journal Of Hepatology, 66(3), 660-661. http://dx.doi.org/10.1016/j.jhep.2016.11.025