Antiretroviral hair levels, self-reported adherence, and virologic failure in second-line regimen patients in resource-limited settings
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved..
OBJECTIVE: To evaluate associations between hair antiretroviral hair concentrations as an objective, cumulative adherence metric, with self-reported adherence and virologic outcomes.
DESIGN: Analysis of cohort A of the ACTG-A5288 study. These patients in resource-limited settings were failing second-line protease inhibitor-based antiretroviral therapy (ART) but were susceptible to at least one nucleoside reverse transcriptase inhibitor (NRTI) and their protease inhibitor, and continued taking their protease inhibitor-based regimen.
METHODS: Antiretroviral hair concentrations in participants taking two NRTIs with boosted atazanavir (n = 69) or lopinavir (n = 112) were analyzed at weeks 12, 24, 36 and 48 using liquid-chromatography--tandem-mass-spectrometry assays. Participants' self-reported percentage of doses taken in the previous month; virologic failure was confirmed HIV-1 RNA at least 1000 copies/ml at week 24 or 48.
RESULTS: From 181 participants with hair samples (61% women, median age: 39 years; CD4+ cell count: 167 cells/μl; HIV-1 RNA: 18 648 copies/ml), 91 (50%) experienced virologic failure at either visit. At 24 weeks, median hair concentrations were 2.95 [interquartile range (IQR) 0.49-4.60] ng/mg for atazanavir, 2.64 (IQR 0.73--7.16) for lopinavir, and 0.44 (IQR 0.11--0.76) for ritonavir. Plasma HIV-1 RNA demonstrated inverse correlations with hair levels (rs -0.46 to -0.74) at weeks 24 and 48. Weaker associations were seen with self-reported adherence (rs -0.03 to -0.24). Decreasing hair concentrations were significantly associated with virologic failure, the hazard ratio (95% CI) for ATV, LPV, and RTV were 0.69 (0.56-0.86), 0.77 (0.68-0.87), and 0.12 (0.06-0.27), respectively.
CONCLUSION: Protease inhibitor hair concentrations showed stronger associations with subsequent virologic outcomes than self-reported adherence in this cohort. Hair adherence measures could identify individuals at risk of second-line treatment failure in need of interventions.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2021 |
|---|---|
| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:35 |
|---|---|
| Enthalten in: |
AIDS (London, England) - 35(2021), 9 vom: 15. Juli, Seite 1439-1449 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Apornpong, Tanakorn [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
2494G1JF75 |
|---|
| Anmerkungen: |
Date Completed 06.08.2021 Date Revised 17.12.2023 published: Print Citation Status MEDLINE |
|---|
| doi: |
10.1097/QAD.0000000000002901 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM323870732 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM323870732 | ||
| 003 | DE-627 | ||
| 005 | 20231227132828.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2021 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1097/QAD.0000000000002901 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1230.xml |
| 035 | |a (DE-627)NLM323870732 | ||
| 035 | |a (NLM)33831905 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Apornpong, Tanakorn |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Antiretroviral hair levels, self-reported adherence, and virologic failure in second-line regimen patients in resource-limited settings |
| 264 | 1 | |c 2021 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 06.08.2021 | ||
| 500 | |a Date Revised 17.12.2023 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved. | ||
| 520 | |a OBJECTIVE: To evaluate associations between hair antiretroviral hair concentrations as an objective, cumulative adherence metric, with self-reported adherence and virologic outcomes | ||
| 520 | |a DESIGN: Analysis of cohort A of the ACTG-A5288 study. These patients in resource-limited settings were failing second-line protease inhibitor-based antiretroviral therapy (ART) but were susceptible to at least one nucleoside reverse transcriptase inhibitor (NRTI) and their protease inhibitor, and continued taking their protease inhibitor-based regimen | ||
| 520 | |a METHODS: Antiretroviral hair concentrations in participants taking two NRTIs with boosted atazanavir (n = 69) or lopinavir (n = 112) were analyzed at weeks 12, 24, 36 and 48 using liquid-chromatography--tandem-mass-spectrometry assays. Participants' self-reported percentage of doses taken in the previous month; virologic failure was confirmed HIV-1 RNA at least 1000 copies/ml at week 24 or 48 | ||
| 520 | |a RESULTS: From 181 participants with hair samples (61% women, median age: 39 years; CD4+ cell count: 167 cells/μl; HIV-1 RNA: 18 648 copies/ml), 91 (50%) experienced virologic failure at either visit. At 24 weeks, median hair concentrations were 2.95 [interquartile range (IQR) 0.49-4.60] ng/mg for atazanavir, 2.64 (IQR 0.73--7.16) for lopinavir, and 0.44 (IQR 0.11--0.76) for ritonavir. Plasma HIV-1 RNA demonstrated inverse correlations with hair levels (rs -0.46 to -0.74) at weeks 24 and 48. Weaker associations were seen with self-reported adherence (rs -0.03 to -0.24). Decreasing hair concentrations were significantly associated with virologic failure, the hazard ratio (95% CI) for ATV, LPV, and RTV were 0.69 (0.56-0.86), 0.77 (0.68-0.87), and 0.12 (0.06-0.27), respectively | ||
| 520 | |a CONCLUSION: Protease inhibitor hair concentrations showed stronger associations with subsequent virologic outcomes than self-reported adherence in this cohort. Hair adherence measures could identify individuals at risk of second-line treatment failure in need of interventions | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, N.I.H., Extramural | |
| 650 | 7 | |a Anti-HIV Agents |2 NLM | |
| 650 | 7 | |a HIV Protease Inhibitors |2 NLM | |
| 650 | 7 | |a Lopinavir |2 NLM | |
| 650 | 7 | |a 2494G1JF75 |2 NLM | |
| 650 | 7 | |a Ritonavir |2 NLM | |
| 650 | 7 | |a O3J8G9O825 |2 NLM | |
| 700 | 1 | |a Grinsztejn, Beatriz |e verfasserin |4 aut | |
| 700 | 1 | |a Hughes, Michael |e verfasserin |4 aut | |
| 700 | 1 | |a Ritz, Justin |e verfasserin |4 aut | |
| 700 | 1 | |a Kerr, Stephen J |e verfasserin |4 aut | |
| 700 | 1 | |a Fletcher, Courtney V |e verfasserin |4 aut | |
| 700 | 1 | |a Ruxrungtham, Kiat |e verfasserin |4 aut | |
| 700 | 1 | |a Godfrey, Catherine |e verfasserin |4 aut | |
| 700 | 1 | |a Gross, Robert |e verfasserin |4 aut | |
| 700 | 1 | |a Hogg, Evelyn |e verfasserin |4 aut | |
| 700 | 1 | |a Wallis, Carole L |e verfasserin |4 aut | |
| 700 | 1 | |a Badal-Faesen, Sharlaa |e verfasserin |4 aut | |
| 700 | 1 | |a Hosseinipour, Mina C |e verfasserin |4 aut | |
| 700 | 1 | |a Mngqbisa, Rosie |e verfasserin |4 aut | |
| 700 | 1 | |a Santos, Breno R |e verfasserin |4 aut | |
| 700 | 1 | |a Shah, Sarita |e verfasserin |4 aut | |
| 700 | 1 | |a Hovind, Laura J |e verfasserin |4 aut | |
| 700 | 1 | |a Mawlana, Sajeeda |e verfasserin |4 aut | |
| 700 | 1 | |a Van Schalkwyk, Marije |e verfasserin |4 aut | |
| 700 | 1 | |a Chotirosniramit, Nuntisa |e verfasserin |4 aut | |
| 700 | 1 | |a Kanyama, Cecilia |e verfasserin |4 aut | |
| 700 | 1 | |a Kumarasamy, Nagalingeswaran |e verfasserin |4 aut | |
| 700 | 1 | |a Salata, Robert |e verfasserin |4 aut | |
| 700 | 1 | |a Collier, Ann C |e verfasserin |4 aut | |
| 700 | 1 | |a Gandhi, Monica |e verfasserin |4 aut | |
| 700 | 0 | |a for A5288 study team |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t AIDS (London, England) |d 1988 |g 35(2021), 9 vom: 15. Juli, Seite 1439-1449 |w (DE-627)NLM012619280 |x 1473-5571 |7 nnns |
| 773 | 1 | 8 | |g volume:35 |g year:2021 |g number:9 |g day:15 |g month:07 |g pages:1439-1449 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1097/QAD.0000000000002901 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 35 |j 2021 |e 9 |b 15 |c 07 |h 1439-1449 | ||