HIV Drugs

HIV drugs can help slow the progression of the disease, allowing HIV-positive people to live longer, healthier lives. However, HIV drugs containing tenofovir disoproxil fumarate (TDF) may cause severe kidney, bone, and liver damage. Tenofovir alafenamide fumarate (TAF) is a safer alternative to TDF. Gilead discovered TAF to be safer before they started selling TDF drugs, but it was not released until several years after TDF drugs had already harmed many users.

What are HIV Drugs?

HIV drugs treat human immunodeficiency virus (HIV) by preventing the virus from reproducing.

While these drugs cannot cure HIV or AIDS, HIV-positive people who take them consistently can live near-average lifespans — and drastically reduce their risk of spreading HIV to others.

In 2017, the Centers for Disease Control and Prevention (CDC) estimated that 49% of the 1.1 million U.S. citizens living with HIV were successfully managing their condition through drug treatment, called antiretroviral therapy or ART.

However, some HIV drugs may cause severe or even life-threatening side-effects. TDF drugs, in particular, may cause serious damage to the kidneys, bones, and liver.

What are TDF Drugs?

TDF drugs are part of a class of HIV medications known as nucleoside reverse transcriptase inhibitors (NRTI). These NRTI drugs use tenofovir to block an enzyme that HIV needs to make copies of itself — effectively stopping the virus from spreading through the body.

In addition to treating HIV, TDF drugs are used to treat Hepatitis B and to help protect HIV-negative people from contracting the disease.

Quick Facts

  • Roughly half of all HIV-positive people in the U.S. successfully manage HIV with medication.
  • HIV drugs cannot cure HIV or AIDS, but they can help people live longer healthy lives.
  • TDF drugs may cause serious health problems with the bones and kidneys.
  • TAF is a safer alternative to TDF — one many claim should have been available sooner.

Types of HIV Drugs

HIV drugs have six main classes, each one disrupting a different phase in the virus’s lifecycle. The most effective HIV treatment involves taking multiple drugs from different classes.

The main types of HIV drugs are:

  • Nucleoside reverse transcriptase inhibitors
  • Non-nucleoside reverse transcriptase inhibitors
  • Protease inhibitors
  • Integrase inhibitors
  • Fusion inhibitors
  • Chemokine receptor antagonists

Within each class, there are dozens of HIV drugs. These drugs are essential to keeping HIV suppressed, but some, like TDF drugs, may cause long-term health issues.

Some well-known HIV drugs containing TDF are:

All of these drugs were created by the company Gilead Sciences, which also developed tenofovir alafenamide fumarate (TAF) — another NRTI that is more effective and safer than TDF.

Side Effects of HIV Drugs

While HIV drugs have become safer over the years, they still come with many potential health risks.

Side effects of HIV drugs include:

  • Abnormal cholesterol levels
  • Blood sugar increase
  • Diabetes
  • Diarrhea
  • Heart disease
  • Muscle tissue breakdown
  • Nausea
  • Vomiting
  • Weakened bones or bone loss

In addition, those who take TDF drugs may suffer from serious side effects that harm the bones, kidneys, and liver.

HIV Drugs and Bone Issues

According to a 2016 literature review published in the journal Current Opinion in HIV and AIDS, several studies showed that patients on TDF lost 1-3% more bone mineral density than those on other HIV drugs.

Bone density loss occurs when the body absorbs bone more quickly than it makes new bone. It typically has no symptoms but may lead to osteoporosis.

Bone health issues associated with TDF drugs include:

  • Bone fractures: Decreased bone density increases the risk of broken bones.
  • Osteoporosis: Osteoporosis causes fragile bones that break easily.
  • Tooth loss: A weakened jawbone may cause teeth to loosen and fall out.

HIV Drugs and Kidney Problems

A 2018 literature review published in the Southern African Journal of HIV Medicine stated that TDF is the HIV drug most commonly linked to toxicity in the kidneys.

TDF drugs may cause kidney problems such as:

  • Acute kidney injury (AKI): AKI is sudden kidney failure or damage that develops between a few hours and a few days.
  • Chronic kidney disease (CKD): CKD is the loss of kidney function over a gradual period of time.
  • End-stage renal disease (ESRD): The last stage of chronic kidney disease, ESRD is fatal unless the patient receives dialysis or a kidney transplant.
  • Renal insufficiency: Renal insufficiency is poor kidney function. It is often caused by narrowed kidney arteries.
  • Renal failure: When kidneys no longer function, it is called renal failure. It causes waste products to build up in the body.

HIV Drugs and Liver Issues

In addition to bone and kidney problems, the U.S. Department of Health and Human Services (HHS) warns that TDF may cause lactic acidosis and severe liver problems.

Lactic acidosis is the buildup of lactic acid in the blood, which may damage the liver and kidneys.

A study involving 45,544 HIV-positive participants found that, between 2004 and 2014, 319 of them developed chronic liver failure and liver cancer. The study also noted that TDF was one of the drugs most strongly associated with these issues.

Options for Those Harmed by HIV Drugs

HIV drugs containing TDF may lead to serious side effects involving the bones, kidneys, or liver.

Gilead, the company that developed these drugs, allegedly discovered a much safer alternative, TAF, before it even began selling TDF drugs. This has led to several lawsuits from victims who claim that their health problems could have been avoided if Gilead hadn’t chosen to withhold the safer TAF medication.

Such lawsuits can provide compensation vital for covering the medical costs of the damage these drugs have caused.

If you or a loved one has taken a TDF drug and suffered bone or kidney damage, you have options.

To learn more, start a free case review now.

Author:HIV Drug Justice Editorial Team
HIV Drug Justice Editorial Team

HIV Drug Justice educates people about the risks of HIV drugs, which can cause kidney failure and bone damage. Our site is managed by the HIV Drug Justice Editorial Team, a group of concerned writers, editors, journalists, and illustrators. Our team helps readers understand what medical and legal options are available if they used dangerous HIV drugs and developed serious health problems as a result.

Last modified: September 17, 2019

View 15 References
  1. Centers for Disease Control and Prevention. (2017, July 27). More people with HIV have the virus under control. Retrieved September 5, 2019, from https://www.cdc.gov/nchhstp/newsroom/2017/2017-HIV-Continuum-Press-Release.html

  2. Centers for Disease Control and Prevention. (2018, November). HIV Surveillance Report, 2017, vol. 29 [PDF file]. Retrieved September 5, 2019, from http://www.cdc.gov/hiv/library/reports/hiv-surveillance.html

  3. National Center for Biotechnology Information. (n.d.). Tenofovir, CID=464205. Retrieved September 5, 2019, from https://pubchem.ncbi.nlm.nih.gov/compound/Tenofovir

  4. U.S. Department of Health and Human Services. (2019, April 11). Tenofovir Disoproxil Fumarate. Retrieved September 5, 2019, from https://aidsinfo.nih.gov/drugs/290/tenofovir-disoproxil-fumarate/0/patient

  5. MD Magazine. (2018, May 18). TDF versus TAF-Based Regimens in HIV Infection [Video file]. Retrieved September 5, 2019, from https://www.youtube.com/watch?v=-6NTMhdhnx4

  6. National Institutes of Health. (2018, November). Oral Health and Bone Disease. Retrieved September 5, 2019, from https://www.bones.nih.gov/health-info/bone/bone-health/oral-health/oral-health-and-bone-disease

  7. National Kidney Foundation. (n.d.). Acute Kidney Injury. Retrieved September 5, 2019, from https://www.kidney.org/atoz/content/AcuteKidneyInjury

  8. National Kidney Foundation. (n.d.). About Chronic Kidney Disease. Retrieved September 5, 2019, from https://www.kidney.org/atoz/content/about-chronic-kidney-disease

  9. UC Davis Health Vascular Center. (n.d.). Renal insufficiency. Retrieved September 5, 2019, from https://health.ucdavis.edu/vascular/diseases/renal_insufficiency.html

  10. Urology Care Foundation. (n.d.). What is Kidney (Renal) Failure? Retrieved September 5, 2019, from https://www.urologyhealth.org/urologic-conditions/kidney-(renal)-failure

  11. Tourret, J., Deray, G., & Isnard-Bagnis, C. (2013, October). Tenofovir Effect on the Kidneys of HIV-Infected Patients: A Double-Edged Sword?. Journal of the American Society of Nephrology, 24(10). Retrieved September 5, 2019, from https://jasn.asnjournals.org/content/24/10/1519

  12. Mayo Clinic. (2018, January 19). HIV/AIDS Diagnosis. Retrieved September 5, 2019, from https://www.mayoclinic.org/diseases-conditions/hiv-aids/diagnosis-treatment/drc-20373531

  13. Grant, P., & Cotter, A. (2016, May). Tenofovir and bone health. Current Opinion in HIV and AIDS, 11(3). Retrieved September 5, 2019. doi:10.1097/COH.0000000000000248

  14. Venter, W. D.F., Fabian, J., & Feldman, C. An overview of tenofovir and renal disease for the HIV-treating clinician. Retrieved September 5, 2019. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6111387/

  15. Hosein, S. R. Does tenofovir (TDF) cause liver injury? (2016, February 10). Retrieved September 5, 2019, from https://www.catie.ca/en/catienews/2016-02-10/does-tenofovir-cause-liver-injury