Question
Long term side effects from PEP.
24 January 2022. Related: All topics, PEP/PEPSE, Side effects.
I took PEP (Truvada and Isentress) five times in the last 10 years for 21 to 28 days each time. My doctor treated them as very safe and I suffer from anxiety, so it was prescribed after every situation of low risk with someone of unknown status. I’m a heterosexual male in my 40s, I have read the side effects which include bone density loss, kidney problems and even cancer from Isentress. Do you see those side effects could present in my case? Will these drugs affect my genetic material if I want to have kids? My kidneys are filtering 10% under average for my age but can’t prove that it wasn’t like that before taking these meds. Thank you for your help!
Answer
Hi, how are you doing?
The side effects you have mentioned are associated with these medications when on long-term use. Having 5 courses of 10 years is not going to lead to these complications. Your doctor was right to treat the course of PEP as safe.
During PEP side-effects are often noted to be short term and resolve when the course ends. There will have been no long-term effect to your genetic material. You are safe to have children.
Truvada is linked to kidney function loss. However, this is assessed long term and can present within 6 months of starting. In your case you were not on it longer than 28 days at a time. Are you aware of of any kidney problems you had before starting PEP? Filtering 10% under average does not indicate loss of function. As it’s an average many people will fall into the same bracket as you are are very healthy.
Josh.
Hi Ajayi, have you been on any other treatment/under other investigations since the last test results?
You still have an eGFR within a healthy range. It is good that your nephrologist has recommended that you come back.
An elevation in liver enzymes can be quite common and in most cases is transient, meaning that after you stop treatment your liver enzymes should soon return to normal.
Have you spoken to your GP about this and if you can be investigated for any other possible causes of these changes to your health?
And was this elevated blood sugar reading a one-off or have you had repeatedly high blood sugars?
Hi
I am from Nigeria
I completed PEP truvada and dolutegravir for 28days, in March 5 this year.
I had a baseline Egfr of above 120.
Now, my Egfr is 106 with elevated cholesterol level, and blood sugar.
I also experience elevated liver enzymes.
I am also experiencing muscle cramps, body weakness
UACR tests have also discovered slightly elevated protein in my urine.
My Nephrologist has advised me to come back in 6months.
I am so perplexed right now and wish I didn’t have to start the course.
Hi Nenc, I am sorry to hear about the symptoms you have been experiencing.
PEP is not associated with what you have mentioned. PEP has a short half life meaning the medication leaves your body within hours after stopping. PEP does not have long term side effects.
It is important to always evaluate HIV risk before starting PEP, as risk should be assessed before starting any treatment.
Gall bladder sludge and GERD can be related to similar causes but they are not directly linked. Is your doctor managing these conditions?
Back in November 2023 I was put on PEP (Aluvia + Truvada) after a broken condom. Bad side effects started two days after (mostly pain under right ribs, belatedness), but dr said it couldn’t be due to PEP so I (and I’ll be sorry for that for the rest of my life) continued the therapy. Most people say you get used to the pills after a week or two and I to some extent also did. Pain would come and go but I ignored it. I expected the side effects to go away after the 28 days of therapy, but they stayed with me on/off for 3 and a half months when they became worse. Back in November my abdominal ultrasound came back clear, today I have sludge in my gallbladder and the symptoms developed into GERD.
Just wanted to warn people to be careful, evaluate the risk of contracting HIV more than once before starting PEP. Looking back, I know that my risk wasn’t huge, but I wanted to do what I thought was the right thing for my health and boy was I wrong. For the rest of my life I now have to live with GERD and my gallbladder will most probably have to be removed soon.