A new anti-HIV drug that could drastically reduce long-term side effects was given European Commission approval on Monday, allowing 28 countries in the EU to give it to HIV-positive patients.

Although trials show Genvoya is similar – or marginally superior – in efficacy to the best existing treatments, HIV specialists say it is the reduced side effects, particularly bone and kidney problems, that are the most promising.

Current anti-retroviral drugs become active in the bloodstream before reaching the infected CD4 cells – the white blood cells that govern the immune system – where they are needed. However, Genvoya, a single dose, once-daily regimen, only becomes active once it reaches the inside of CD4 cells.

"Because it's more targeted in the place it's needed, you don't have to give as big a dosage," Dr Tristan Barber, a consultant in HIV and sexual health at the Chelsea and Westminster Hospital, told BuzzFeed News. "With previous drugs – tenofivir for example – a lot of it was removed [by the body] from the bloodstream before it had reached the target, so you had to give more of it to make sure you got enough to the target cells."

Genvoya, which combines four different drugs (elvitegravir, cobicistat, emtricitabine, and tenofovir) and received US approval earlier this month, contains a fraction of the dose of existing treatments, and a 10th of the previous dose of its central active ingredient, tenofovir. Tenofovir has been widely prescribed since 2001, and, like Genvoya, is owned by Gilead, the pharmaceutical company.



In the long term, Barber said, such a reduction in dosage could offer "significant safety benefits" as slashed doses offer reductions in toxicity – in particular by helping to reduce chronic bone and kidney problems.

A 2009 study of HIV-positive patients across North America, China, and Europe found that between 1 in 11 and 1 in 20 suffered moderate to severe kidney problems. And in a small minority of patients, tenofovir can cause acute renal failure, as it is removed from the body through the kidneys. For the minority who suffer long-term, said Barber, "this new drug clearly offers an advantage".