Author | Apornpong, Tanakorn | |
Author | Grinsztejn, Beatriz | |
Author | Hughes, Michael | |
Author | Ritz, Justin | |
Author | Kerr, Stephen J. | |
Author | Fletcher, Courtney V. | |
Author | Ruxrungtham, Kiat | |
Author | Godfrey, Catherine | |
Author | Gross, Robert | |
Author | Hogg, Evelyn | |
Author | Wallis, Carole L. | |
Author | Badal-Faesen, Sharlaa | |
Author | Hosseinipour, Mina C. | |
Author | Mngqbisa, Rosie | |
Author | Santos, Breno R. | |
Author | Shah, Sarita | |
Author | Hovind, Laura J. | |
Author | Mawlana, Sajeeda | |
Author | Schalkwyk, Marije Van | |
Author | Chotirosniramit, Nuntisa | |
Author | Kanyama, Cecilia | |
Author | Kumarasamy, Nagalingeswaran | |
Author | Salata, Robert | |
Author | Collier, Ann C. | |
Author | Gandhi, Monica | |
Access date | 2021-12-13T17:28:11Z | |
Available date | 2021-12-13T17:28:11Z | |
Document date | 2021 | |
Citation | APORNPONG, Tanakorn et al. Antiretroviral hair levels, self-reported adherence, and virologic failure in second-line regimen patients in resource-limited settings. AIDS, v. 35, n. 9, p. 1439-1449, 2021. | pt_BR |
ISSN | 0269-9370 | pt_BR |
URI | https://www.arca.fiocruz.br/handle/icict/50344 | |
Language | eng | pt_BR |
Publisher | Wolters Kluwer Health | pt_BR |
Rights | restricted access | pt_BR |
Title | Antiretroviral hair levels, self-reported adherence, and virologic failure in second-line regimen patients in resource-limited settings | pt_BR |
Type | Article | pt_BR |
DOI | 10.1097/QAD.0000000000002901 | |
Abstract | 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. | pt_BR |
Affilliation | TRCARC. HIV-NAT. Bangkok, Thailand. | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil. | pt_BR |
Affilliation | Harvard T.H. Chan School of Public Health. Boston, Maryland, USA. | pt_BR |
Affilliation | Harvard T.H. Chan School of Public Health. Boston, Maryland, USA. | pt_BR |
Affilliation | TRCARC. HIV-NAT. Bangkok, Thailand / Biostatistics Excellence Centre. Bangkok, Thailand / UNSW. The Kirby Institute. Sydney, Australia. | pt_BR |
Affilliation | University of Nebraska Medical Center. Omaha, Nebraska, USA. | pt_BR |
Affilliation | TRCARC. HIV-NAT. Bangkok, Thailand / Chulalongkorn University. Bangkok, Thailand. | pt_BR |
Affilliation | NIH. Division of AIDS NIAID. Bethesda, Maryland. | pt_BR |
Affilliation | University of Pennsylvania. Pennsylvania, USA. | pt_BR |
Affilliation | Social & Scientific Systems. Silver Spring, Maryland, USA. | pt_BR |
Affilliation | BARC-SA and Lancet Laboratories. Johannesburg, South Africa. | pt_BR |
Affilliation | University of the Witwatersrand. Helen Joseph Hospital. Clinical HIV Research Unit. Johannesburg, South Africa. | pt_BR |
Affilliation | Kamuzu Central Hospital. Lilongwe, Malawi. | pt_BR |
Affilliation | Durban International CRS. Durban, South Africa. | pt_BR |
Affilliation | Hospital Nossa Senhora da Conceicao CRS. Porto Alegre, RS, Brasil. | pt_BR |
Affilliation | Emory University. Atlanta, Georgia, USA. | pt_BR |
Affilliation | Frontier Science & Technology Research Foundation. Amherst, Massachusetts, USA. | pt_BR |
Affilliation | Hospital Nossa Senhora da Conceicao CRS. Porto Alegre, RS, Brasil. | pt_BR |
Affilliation | Stellenbosch University. Family Centre for Research with Ubuntu (FAMCRU). Cape Town, South Africa. | pt_BR |
Affilliation | Research Institute for Health Sciences. Chiang Mai, Thailand. | pt_BR |
Affilliation | Kamuzu Central Hospital. Lilongwe, Malawi. | pt_BR |
Affilliation | VHS Infection Disease Medical Centre. Clinical Research Site. CART. Chennai, India. | pt_BR |
Affilliation | Case Western Reserve University. Cleveland, Ohio, USA. | pt_BR |
Affilliation | University of Washington. Seattle, Washington, USA. | pt_BR |
Affilliation | University of California. San Francisco, California, USA. | pt_BR |
Subject | Hair concentrations | pt_BR |
Subject | Protease inhibitors | pt_BR |
Subject | Resource-limited settings | pt_BR |
Subject | Second-line failure | pt_BR |
Subject | Virological failure | pt_BR |