Association of Hair Concentrations of Antiretrovirals with Virologic Outcomes Among People Living with HIV in Guangxi, China

Zhang, Quan; Li, Xiaoming; Qiao, Shan; Liu, Shuaifeng; Shen, Zhiyong; Zhou, Yuejiao

doi:10.2147/ppa.s277965

Cited by 2 publications

(6 citation statements)

References 46 publications

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“…This study found that hair zidovudine concentrations are closely associated with virologic suppression as indicated by the significant intergroup difference and correlations between them. The intergroup difference was also observed in our previous study, 24 illustrating that PLWH showing high hair zidovudine concentrations due to adequate ARV adherence may have more access to virologic suppression. Furthermore, hair zidovudine concentrations gave prediction power matching with, but slightly weaker than hair lamivudine concentrations.…”

Section: Discussionsupporting

confidence: 83%

“…In the present study, we reported that hair zidovudine concentrations had a similar effect on predicting virologic suppression as hair lamivudine concentrations did and were much better than self-reported measures. To the best of our knowledge, while no association between hair zidovudine concentrations and virologic outcomes was reported in our previous study with small-size participants, 24 we further characterized the strong prediction of hair zidovudine concentrations on virologic outcomes among a large-scale cohort of Chinese PLWH. The results indicated that hair zidovudine concentrations might be an alternative biomarker of virologic outcomes consistent with the verified hair lamivudine concentrations.…”

Section: Discussionmentioning

confidence: 68%

“…Additionally, hair zidovudine concentrations in this study presented stronger predictive utility (with optimal threshold at 58 pg/mg) on virologic suppression than that in our previous study. 24 This may be as a result of a larger sample size in the current study (n = 564 vs n = 67), which improved the statistical power and reliability of the result.…”

Section: Discussionmentioning

confidence: 85%

“…All participants reported their sociodemographic characteristics by completing a questionnaire, 24 including age, body mass index (BMI) calculated from weight and height, gender, ethnicity, education level, marital status, employment status, and average monthly income.…”

Section: Methodsmentioning

confidence: 99%

“…Overall frequency of adherence behaviors (how strictly did you take your medication following doctor’s advice in the last one month?) has been validated by Lu et al 47 The response is a 5-point option (none of the time, few of the time, some of the time, most of the time, and all of the time) 47 and then quantified in 25% increments for frequency estimation (eg, none of the time = 0% and all of the time = 100%), 24 , 48 , 49 which showed good performances in predicting viral loads and CD4 cell counts. 50 Percentage adherence (percent of 30 days taken; how many days they took all needed antiretrovirals during the last 30 days) validated by Da et al 51 was also determined in the present study.…”

Section: Methodsmentioning

confidence: 99%

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Hair Zidovudine Concentrations Predict Virologic Outcomes Among People Living with HIV/AIDS in China

Wu¹,

Liu²,

Chu³

et al. 2022

PPA

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Background Hair antiretroviral concentrations are an objective and non-invasive measure of adherence to long-term antiretroviral therapy (ART) and can further predict virologic outcomes among people living with HIV/AIDS (PLWH). Zidovudine, one of the mainstream antiretrovirals in China, has been verified to have high reliability in adherence assessment, especially for its hair concentrations. However, data are limited in its predicting virologic outcomes. Therefore, this study aimed to characterize whether hair zidovudine concentrations can predict virologic suppression among Chinese PLWH compared with hair lamivudine concentrations and two self-reported measures, the overall frequency of adherence behaviors and percentage adherence. Methods This cross-sectional study randomly recruited 564 PLWH currently treated with zidovudine, lamivudine, and other ART agents (efavirenz, nevirapine, or lopinavir/ritonavir) in Guangxi, China. Hair antiretroviral concentrations were determined using the LC-ESI + -MS/MS method. Receiver operating characteristic (ROC) curves were used to estimate the optimal classification thresholds of hair concentrations of zidovudine and lamivudine, and the two self-reported measures. Based on those optimal classification thresholds, logistic regression was used to examine whether those four adherence measures can predict virologic suppression (HIV-1 RNA <200 copies/mL). Results ROC curves demonstrated good classification performance for association with virologic suppression of zidovudine with the optimal threshold at 58 pg/mg and lamivudine at 255 pg/mg but no self-reported measures. PLWH with hair zidovudine concentrations >58 pg/mg had an adjusted odds ratio (aOR) of 43.191 (95% confidence interval (CI) = 10.171‒183.418, p < 0.001) for virologic suppression. Hair lamivudine concentrations were also associated with virologic suppression (aOR = 10.656, 95% CI = 3.670‒30.943, p < 0.001). However, two self-reported measures did not predict virologic suppression (aORs = 1.157 and 2.488, p s >0.149). Conclusion Hair zidovudine concentrations can be served as an alternative tool for clinically predicting virologic suppression among PLWH in China.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 85%

Section: Methodsmentioning

confidence: 99%