What is Genvoya? Explained
What is Genvoya?
Genvoya is an FDA approved antiretroviral treatment (ART) for HIV-1 infection in adults and children 12 years of age and older who weigh at least 35 kilograms. It consists of a combination of 4 drugs: elvitegravir, cobicistat, emtricitabine, and tenofovir alafenamide. Genvoya is a complete medication in 1 pill, which is indicated for “treatment naïve” patients or those who have not received any HIV medications before, as well as those with suppressed viral load.
While antiretroviral drugs can’t cure HIV, it can reduce viral replication considerably, restoring immune function to safe levels in most patients and reducing the risk of disease progression and death. ART paved the way in turning a previously fatal syndrome into a manageable chronic condition, where it is possible for patients to enjoy a quality of life comparable to that of uninfected individuals.
- Elvitegravir – blocks the action of the viral enzyme integrase
- Cobicistat – a pharmacokinetic enhancer that boosts the effects of integrase inhibitor elvitegravir
- Emtricitabine – known as nucleoside reverse transcriptase inhibitor (NRTI), a type of drug that blocks the HIV enzyme reverse transcriptase from converting RNA into DNA
- Tenofovir alafenamide (TAF) – a new formulation of the old drug tenofovir disoproxil fumarate
Genvoya comes in a green film-coated tablet, debossed with GSI on 1 side and the number 510 on the other side. Each tablet contains 150mg of elvitegravir, 150mg of cobicistat, 200mg of emtricitabine, and 10mg of tenofovir alafenamide. HIV-infected patients should take 1 tablet daily with food. Since Genvoya is already a complete regimen, containing a fixed dose combination of drugs, it should not be taken alongside other antiretroviral products.
How does Genvoya work?
The single-tablet combo pill contains 3 anti-HIV medication and 1 booster. Elvitegravir is an integrate strand transfer inhibitor (INSTI). It works by blocking the action of integrase, an HIV-1 enzyme that is essential for viral replication. Cobicistat inhibits cytochrome P450 enzymes and enhances elvitegravir, which has limited bioavailability and shortened half-life due to CYP3A-dependent metabolism. Emtricitabine is a nucleoside analogue of 2'-deoxycytidine and works as a nucleoside reverse transcriptase inhibitor (NRTI). Through phosphorylation by cellular enzymes, emtricitabine forms emtricitabine triphosphate. This active form terminates viral DNA chain by inhibiting HIV replication. Tenofovir alafenamide or TAF is a nucleotide reverse transcriptase inhibitor (NtRTI). TAF is said to be more efficient than TDF (tenofovir disoproxil fumarate) with increased cell permeability and plasma stability. Both Emtricitabine and Tenofovir work against HIV-1, HIV-2, and HBV.