Using Lopinavir Concentrations in Hair Samples to Assess Treatment Outcomes on Second-Line Regimens Among Asian Children
We conducted a prospective monitoring study to determine whether antiretroviral (ARV) levels in hair of Asian children on second-line protease inhibitor-based ARV therapy (ART) are associated with virologic failure (VF), compared to plasma drug levels and self-reported adherence. HIV-infected Asian children on second-line ART regimens were enrolled into a longitudinal cohort. Traditional adherence measures, plasma, and hair samples were collected 24 weeks after study enrollment. Hair ARV levels were determined via liquid chromatography/tandem mass spectrometry. Among 149 children on lopinavir/ritonavir-based regimens, 47% were female; the median [interquartile range (IQR)] age was 10.3 (7.9-13.3) years. The median CD4% was 26% (IQR 21.7-32.1%) and the median CD4 cell count 754 (IQR 596-1,013) cells/mm(3). The median duration of lopinavir-based ART prior to week 24 of the study was 2.9 (IQR 1.6-4.2) years. Adherence was >95% in 91% (135/148) by visual analogue scale and 89% (129/145) by pill count. The median lopinavir hair concentrations were 5.43 (IQR 3.21-9.01) ng/mg in children with HIV RNA >1,000 copies/ml and 9.96 (IQR 6.51-12.31) ng/mg in children with HIV RNA <1,000 copies/ml (p = 0.003). Plasma trough and lopinavir hair concentrations were not statistically significantly correlated (Pearson's correlation coefficient 0.20; p = 0.13). Increasing lopinavir hair concentrations in quartiles were strongly associated with virologic success (odds ratios ≥4.0, overall p = 0.02), while self-reported adherence, pill count, and plasma lopinavir levels were not. Based on this first report of hair ARV concentrations and virologic outcomes in children, ARV hair concentrations, representing longer-term adherence, may be useful to identify children at risk for VF.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2015 |
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| Erschienen: |
2015 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:31 |
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| Enthalten in: |
AIDS research and human retroviruses - 31(2015), 10 vom: 04. Okt., Seite 1009-14 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Prasitsuebsai, Wasana [VerfasserIn] |
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| Links: |
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| Themen: |
2494G1JF75 |
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| Anmerkungen: |
Date Completed 20.06.2016 Date Revised 26.10.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1089/AID.2015.0111 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM251132838 |
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| 520 | |a We conducted a prospective monitoring study to determine whether antiretroviral (ARV) levels in hair of Asian children on second-line protease inhibitor-based ARV therapy (ART) are associated with virologic failure (VF), compared to plasma drug levels and self-reported adherence. HIV-infected Asian children on second-line ART regimens were enrolled into a longitudinal cohort. Traditional adherence measures, plasma, and hair samples were collected 24 weeks after study enrollment. Hair ARV levels were determined via liquid chromatography/tandem mass spectrometry. Among 149 children on lopinavir/ritonavir-based regimens, 47% were female; the median [interquartile range (IQR)] age was 10.3 (7.9-13.3) years. The median CD4% was 26% (IQR 21.7-32.1%) and the median CD4 cell count 754 (IQR 596-1,013) cells/mm(3). The median duration of lopinavir-based ART prior to week 24 of the study was 2.9 (IQR 1.6-4.2) years. Adherence was >95% in 91% (135/148) by visual analogue scale and 89% (129/145) by pill count. The median lopinavir hair concentrations were 5.43 (IQR 3.21-9.01) ng/mg in children with HIV RNA >1,000 copies/ml and 9.96 (IQR 6.51-12.31) ng/mg in children with HIV RNA <1,000 copies/ml (p = 0.003). Plasma trough and lopinavir hair concentrations were not statistically significantly correlated (Pearson's correlation coefficient 0.20; p = 0.13). Increasing lopinavir hair concentrations in quartiles were strongly associated with virologic success (odds ratios ≥4.0, overall p = 0.02), while self-reported adherence, pill count, and plasma lopinavir levels were not. Based on this first report of hair ARV concentrations and virologic outcomes in children, ARV hair concentrations, representing longer-term adherence, may be useful to identify children at risk for VF | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, N.I.H., Extramural | |
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| 700 | 1 | |a Kerr, Stephen J |e verfasserin |4 aut | |
| 700 | 1 | |a Truong, Khanh Huu |e verfasserin |4 aut | |
| 700 | 1 | |a Ananworanich, Jintanat |e verfasserin |4 aut | |
| 700 | 1 | |a Do, Viet Chau |e verfasserin |4 aut | |
| 700 | 1 | |a Nguyen, Lam Van |e verfasserin |4 aut | |
| 700 | 1 | |a Kurniati, Nia |e verfasserin |4 aut | |
| 700 | 1 | |a Kosalaraksa, Pope |e verfasserin |4 aut | |
| 700 | 1 | |a Sudjaritruk, Tavitiya |e verfasserin |4 aut | |
| 700 | 1 | |a Chokephaibulkit, Kulkanya |e verfasserin |4 aut | |
| 700 | 1 | |a Thammajaruk, Narukjaporn |e verfasserin |4 aut | |
| 700 | 1 | |a Singtoroj, Thida |e verfasserin |4 aut | |
| 700 | 1 | |a Teeraananchai, Sirinya |e verfasserin |4 aut | |
| 700 | 1 | |a Horng, Howard |e verfasserin |4 aut | |
| 700 | 1 | |a Bacchetti, Peter |e verfasserin |4 aut | |
| 700 | 1 | |a Gandhi, Monica |e verfasserin |4 aut | |
| 700 | 1 | |a Sohn, Annette H |e verfasserin |4 aut | |
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