Tenofovir concentrations in hair strongly predict virologic suppression in breastfeeding women

Murnane, Pamela M.; Bacchetti, Peter; Currier, Judith S.; Brummel, Sean; Okochi, Hideaki; Phung, Nhi; Louie, Alan K.; Kuncze, Karen; Hoffman, Risa M.; Nematadzira, Teacler; Soko, Dean; Owor, Maxensia; Saidi, Friday; Flynn, Patricia M.; Fowler, Mary Glenn; Gandhi, Monica

doi:10.1097/qad.0000000000002237

Cited by 12 publications

(17 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our results regarding PLHIV with virologic suppression had higher hair concentrations of 3TC, AZT, and EFV than those with virologic failure were in line with previous studies employing hair concentrations of 3TC, 13 EFV, 12 , 43 TFV, 33 NVP, 12 LPV, 12 , 29 , 31 , 34 , 43 RTV, 12 , 29 , 34 ATV 34 , 44 and indinavir. 25–27 Interestingly, our study revealed that hair concentrations of 3TC and EFV, but not AZT, are the strongest independent predictor of virologic suppression.…”

Section: Discussionsupporting

confidence: 92%

“… 25–27 Interestingly, our study revealed that hair concentrations of 3TC and EFV, but not AZT, are the strongest independent predictor of virologic suppression. Our findings of hair concentrations of 3TC and EFV added evidence to existing studies that reported that hair concentrations of antiretrovirals (eg, TFV, 33 EFV, 43 , 45 NVP, 30 LPV, 31 , 32 , 34 ATV 28 , 34 ) were the strongest independent predictor of virologic suppression. Regarding the nonsignificant finding of hair AZT concentrations, the small sample size and lower hair AZT concentrations could contribute to this finding.…”

Section: Discussionsupporting

confidence: 81%

“…Furthermore, the simultaneous determination of hair concentrations of antiretrovirals in multiple classes is technically possible. [21][22][23][24] However, major of the previous studies only investigated the association of hair concentrations of a single antiretroviral 13,[25][26][27][28][29][30][31][32][33] or antiretrovirals in a single class 34 with virologic outcomes. Limited data are available on the association of hair concentrations of antiretrovirals in multiple classes with virologic outcomes.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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

Zhang¹,

Li²,

Qiao³

et al. 2021

PPA

View full text Add to dashboard Cite

Background: Hair concentrations of antiretrovirals are an innovative and non-invasive method for measuring cumulative antiretroviral exposure and assessing long-term antiretroviral adherence. This study aimed to examine hair concentrations of antiretrovirals in relation to virologic outcomes among PLHIV in Guangxi, China. Methods: Cross-sectional data of hair concentrations of antiretrovirals and HIV viral load were collected from 215 PLHIV in Guangxi, China. Multivariate logistic regression analyses were used to examine the association of hair concentrations of antiretrovirals with virologic outcomes. Results: Of the 215 participants, 215, 67, and 163 PLHIV are receiving lamivudine, zidovudine, and efavirenz, respectively. Multivariate analysis revealed that hair concentrations of lamivudine [odds ratio = 16.52, 95% CI 2.51-108.60, p = 0.004] and efavirenz [odds ratio = 14.26, 95% CI 1.18-172.01, p = 0.036], but not zidovudine [odds ratio = 1.77, 95% CI 0.06-56.14, p = 0.747], were the strongest independent predictor of virologic suppression when controlling for sociodemographic and other HIV-related characteristics. Conclusion:Hair concentrations of lamivudine and efavirenz were the strongest independent predictor of virologic suppression among Chinese PLHIV. Hair analysis of antiretrovirals may provide a non-invasive, cost-effective tool that predicts virologic suppression among PLHIV in China.

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 81%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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

Zhang¹,

Li²,

Qiao³

et al. 2021

PPA

View full text Add to dashboard Cite

show abstract

“…women on ART. 41 However, we have not described this validated analytical method in a publication prior to this report. .…”

Section: Stabilitymentioning

confidence: 99%

“…The University of California San Francisco‐Hair Analytical Laboratory (UCSF‐HAL) has quantified a number of ARVs in hair (e.g., atazanavir, 19 lopinavir, 20 ritonavir, 20 efavirenz, 20 nevirapine, 21 darunavir, raltegravir, dolutegravir, TFV/FTC, 22–29 ) for research projects over the past 15 years. Hair concentrations of ARVs have been shown to be strong predictors of virologic response for a variety of ARVs, including TFV/FTC 30–41 …”

Section: Introductionmentioning

confidence: 99%

Tenofovir and emtricitabine concentrations in hair are comparable between individuals on tenofovir disoproxil fumarate versus tenofovir alafenamide‐based ART

Okochi

Louie

Phung

et al. 2021

Drug Testing and Analysis

Self Cite

View full text Add to dashboard Cite

Tenofovir disoproxil fumarate (TDF) in combination with emtricitabine (FTC) is the backbone for both human immunodeficiency virus (HIV) treatment and pre-exposure prophylaxis (PrEP) worldwide. Tenofovir alafenamide (TAF) with FTC is increasingly used in HIV treatment and was recently approved for PrEP among menwho-have-sex-with-men. TDF and TAF are both metabolized into tenofovir (TFV).Antiretrovirals in plasma are taken up into hair over time, with hair levels providing a long-term measure of adherence. Here, we report a simple, robust, highly sensitive, and validated high-performance liquid chromatography coupled with tandem mass spectrometry (LC/MS/MS)-based analytical method for analyzing TFV and FTC from individuals on either TDF/FTC or TAF/FTC in small hair samples. TFV/FTC are extracted from $5 mg hair and separated on a column using a gradient elution. The lower quantification limits are 0.00200 (TFV) and 0.0200 (FTC) ng/mg hair; the assay is linear up to 0.400 (TFV) and 4.00 (FTC) ng/mg hair. The intra-day and inter-day coefficients of variance (CVs) are 5.39-12.6% and 6.40-13.5% for TFV and 0.571-2.45% and 2.45-5.16% for FTC. TFV concentrations from participants on TDF/FTC-based regimens with undetectable plasma HIV RNA were 0.0525 ± 0.0295 ng/mg, whereas those from individuals on TAF/FTC-based regimens were 0.0426 ± 0.0246 ng/mg. Despite the dose of TFV in TDF being 10 times that of TAF, hair concentrations of TFV were not significantly different for those on TDF versus TAF regimens. Pharmacological enhancers (ritonavir and cobicistat) did not boost TFV concentrations in hair. In summary, we developed and validated a sensitive analytical method to analyze TFV and FTC in hair and found that hair concentrations of TFV were essentially equivalent among those on TDF and TAF.

show abstract

Measuring patient engagement with HIV care in sub‐Saharan Africa: a scoping study

et al. 2022

View full text Add to dashboard Cite

Introduction:Engagement with HIV care is a multi-dimensional, dynamic process, critical to maintaining successful treatment outcomes. However, measures of engagement are not standardized nor comprehensive. This undermines our understanding of the scope of challenges with engagement and whether interventions have an impact, complicating patient and programmelevel decision-making. This study identified and characterized measures of engagement to support more consistent and comprehensive evaluation. Methods: We conducted a scoping study to systematically categorize measures the health system could use to evaluate engagement with HIV care for those on antiretroviral treatment. Key terms were used to search literature databases (Embase, PsychINFO, Ovid Global-Health, PubMed, Scopus, CINAHL, Cochrane and the World Health Organization Index Medicus), Google Scholar and stakeholder-identified manuscripts, ultimately including English evidence published from sub-Saharan Africa from 2014 to 2021. Measures were extracted, organized, then reviewed with key stakeholders. Results and discussion: We screened 14,885 titles/abstracts, included 118 full-texts and identified 110 measures of engagement, categorized into three engagement dimensions ("retention," "adherence" and "active self-management"), a combination category ("multi-dimensional engagement") and "treatment outcomes" category (e.g. viral load as an end-result reflecting that engagement occurred). Retention reflected status in care, continuity of attendance and visit timing. Adherence was assessed by a variety of measures categorized into primary (prescription not filled) and secondary measures (medication not taken as directed). Active self-management reflected involvement in care and self-management. Three overarching use cases were identified: research to make recommendations, routine monitoring for quality improvement and strategic decision-making and assessment of individual patients. Conclusions: Heterogeneity in conceptualizing engagement with HIV care is reflected by the broad range of measures identified and the lack of consensus on "gold-standard" indicators. This review organized metrics into five categories based on the dimensions of engagement; further work could identify a standardized, minimum set of measures useful for comprehensive evaluation of engagement for different use cases. In the interim, measurement of engagement could be advanced through the assessment of multiple categories for a more thorough evaluation, conducting sensitivity analyses with commonly used measures for more comparable outputs and using longitudinal measures to evaluate engagement patterns. This could improve research, programme evaluation and nuanced assessment of individual patient engagement in HIV care.

show abstract

Tenofovir concentrations in hair strongly predict virologic suppression in breastfeeding women

Cited by 12 publications

References 35 publications

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

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

Tenofovir and emtricitabine concentrations in hair are comparable between individuals on tenofovir disoproxil fumarate versus tenofovir alafenamide‐based ART

Measuring patient engagement with HIV care in sub‐Saharan Africa: a scoping study

Contact Info

Product

Resources

About