The Truvada Disaster made the New York Times.

After years of flying (mostly) under the radar in the legacy media, Gilead’s dirty tricks have made the New York Times, in a piece written by Rebecca Robbins and Sheryl Gay Stolberg.

The timing of this article is interesting; moreover, recall the attempts on the parts of AIDS activists to censor the advertisements for the Truvada lawsuits—effectively, intentionally hiding the dangers of Truvada from patients, and attempting to steer them away from any idea that they might be entitled to compensation for their pain and suffering. From The Body:

These ads are really undermining our efforts to mitigate the concerns and fears that people have about the potential side effects of taking Truvada for PrEP," Mena said. "They are undoing work done in the HIV community to educate people at risk and improve access to PrEP."

Mena says it's hard to gauge whether the ads have influenced people to discontinue their PrEP regimen. He said many people who stop taking PrEP don't return to his clinic, making follow-up difficult. However, he added, side effects are one of the main concerns potential PrEP users raise prior to taking the drug. These ads play into those worries.

This piece in the NYT is an interesting development in light of these mostly successful censorship attempts.

Consider the following excerpts:

In 2004, Gilead Sciences decided to stop pursuing a new H.I.V. drug. The public explanation was that it wasn’t sufficiently different from an existing treatment to warrant further development.

In private, though, something else was at play. Gilead had devised a plan to delay the new drug’s release to maximize profits, even though executives had reason to believe it might turn out to be safer for patients, according to a trove of internal documents made public in litigation against the company.

The delayed release of the new treatment is now the subject of state and federal lawsuits in which some 26,000 patients who took Gilead’s older H.I.V. drugs claim that the company unnecessarily exposed them to kidney and bone problems.

Just a few months ago, the number was 23,000.

Today, a generation of expensive Gilead drugs containing the new iteration of tenofovir account for half of the market for H.I.V. treatment and prevention, according to IQVIA, an industry data provider. One widely used product, Descovy, has a sticker price of $26,000 annually. Generic versions of its predecessor, Truvada, whose patents have expired, now cost less than $400 a year.

Here is just one story of a man who was harmed by TDF:

David Swisher, who lives in Central Florida, is one of the plaintiffs suing Gilead in federal court. He took Truvada for 12 years, starting in 2004, and developed kidney disease and osteoporosis. Four years ago, when he was 62, he said, his doctor told him he had “the bones of a 90-year-old woman.”

It was not until 2016, when Descovy was finally on the market, that Mr. Swisher switched off Truvada, which he believed was harming him. By that time, he said, he had grown too sick to work and had retired from his job as an airline operations manager.

“I feel like that whole time was taken away from me,” he said.

In 2001, the Food and Drug Administration for the first time approved a product containing Gilead’s first iteration of tenofovir. Four more would follow. The drugs prevent the replication of H.I.V., the virus that causes AIDS.

Those became game-changers in the fight against AIDS, credited with saving millions of lives worldwide. The drugs came to be used not only as a treatment but also as a prophylactic for those at risk of getting infected.

But a small percentage of patients who were taking the drug to treat H.I.V. developed kidney and bone problems. It proved especially risky when combined with booster drugs to enhance its effectiveness — a practice that was once common but has since fallen out of favor. The World Health Organization and the U.S. National Institutes of Health discourage the use of the original version of tenofovir in people with brittle bones or kidney disease.

The newer version doesn’t cause those problems, but it can cause weight gain and elevated cholesterol levels. For most people, experts say, the two tenofovir-based drugs — the first known as T.D.F., the second called T.A.F. — offer roughly equal risks and benefits.

A “small percentage of patients”? 26,000 plaintiffs represent 2.1% of the US HIV positive population, and those are only the victims we know about.

Gilead moved to resurrect the newer formulation in 2010, putting it on track for its 2015 release. John Milligan, Gilead’s president and future chief executive, told investors that it would be a “kinder, gentler version” of tenofovir.

A “kinder, gentler” version of a toxic drug? Where have we seen this before?

Furthermore, weight gain and elevated cholesterol levels are not the only adverse effects of TAF, according to the law firm Shouse Law, who is involved in litigation regarding Genvoya, a TAF based drug, alleging that it causes “bone loss, osteoporosis, kidney failure, and lactic acidosis”—the exact same adverse effects reported for TDF.

Here are a few Twitter reactions to the NYT piece:

From Toxic poz-itivity:

I actually know people who had to get off of the Truvada iteration of PrEP because of liver damage. There was one guy I know who had bone damage from it. It's maddening to know there was a safer alternative the whole time but capitalism...

From Mike:

I developed Stage 3 kidney disease after taking #Truvada from 2008-14 so was surprised when it became popular for Prep. The graph of my declining kidney function pointed to, and was the reason I was taken off, Truvada. Now I’ve gone from 6’-0” to 5’-10” in 2 years. What’s next?

From LIVE WORK PLAY DANCE

My husband had kidney failure taking Truvada for just a couple of weeks and ended up on dialysis for over a year in 2005. No lawyer would take the case and this just infuriates me to no end. Now, the truth comes out. Remember, these drugs were developed with federal dollars.

Finally, consider the Twitter reaction by AIDS activist Peter Staley:

We may have lost the generic Truvada pay-for-delay case against @GileadSciences, but our discovery process proved we were right that Gilead harmed thousands of people with HIV just to patent hop.

In light of the attempts to censor any advertisements for the Truvada lawsuits, this smells like damage control to me, and an awareness that this story is too big to bury.

This is only the beginning. This story is enormous, and is likely to explode sooner than later. Stay tuned.

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