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A Comparison of Plasma Efavirenz and Tenofovir, Dried Blood Spot Tenofovir-Diphosphate, and Self-Reported Adherence to Predict Virologic Suppression Among South African Women
| Content Provider | Scilit |
|---|---|
| Author | Phillips, Tamsin K. Sinxadi, Phumla Abrams, Elaine J. Zerbe, Allison Orrell, Catherine Hu, Nai-Chung Brittain, Kirsty Gomba, Yolanda Norman, Jennifer Wiesner, Lubbe Myer, Landon Maartens, Gary |
| Copyright Year | 2019 |
| Description | Journal: JAIDS Journal of Acquired Immune Deficiency Syndromes Background: Tenofovir-diphosphate (TFV-DP) in dried blood spots (DBS) is an objective long-term adherence measure, but data are limited on its ability to predict virologic suppression (VS) in people on antiretroviral (ARV) treatment. There are also no data comparing DBS TFV-DP with plasma ARV concentrations as predictors of VS. Methods: Women who were on a first-line regimen of tenofovir, emtricitabine, and efavirenz (EFV) were enrolled in a cross-sectional study. Plasma EFV and tenofovir (TFV), DBS TFV-DP assays, and 30-day self-reported adherence were evaluated as predictors of VS (<50 copies/mL) with the area under the curve of receiver operating characteristics and logistic regression. Results: We enrolled 137 women; mean age of 33 years; median 4 years on antiretroviral therapy; 88 (64%) had VS. In receiver operating characteristics analyses: DBS TFV-DP [0.926 (95% CI: 0.876 to 0.976)] had a higher area under the curve than plasma TFV [0.864 (0.797 to 0.932); P = 0.006], whereas plasma EFV [0.903 (0.839–0.967)] was not significantly different from DBS TFV-DP (P = 0.138) or plasma TFV (P = 0.140); all ARV assays performed better than self-report. The association of TFV-DP in DBS with VS strengthened with increasing concentrations [reference <350 fmol/punch: 350–699 fmol/punch aOR 37 (8–178); 700–1249 fmol/punch aOR 47 (13–175); ≥1250 fmol/punch aOR 175 (20–1539)]. “White coat adherence” (defined as DBS TFV-DP <350 fmol/punch with detectable plasma TFV) was only detected in 4 women. Conclusions: Plasma EFV, TFV, and DBS TFV-DP were all strong predictors of VS. EFV or TFV assays have potential for development as point-of-care assays for use as objective adherence measures in resource-limited settings. |
| Related Links | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6565450/pdf |
| Ending Page | 318 |
| Page Count | 8 |
| Starting Page | 311 |
| ISSN | 15254135 |
| e-ISSN | 10779450 |
| DOI | 10.1097/qai.0000000000002032 |
| Journal | JAIDS Journal of Acquired Immune Deficiency Syndromes |
| Issue Number | 3 |
| Volume Number | 81 |
| Language | English |
| Publisher | Ovid Technologies (Wolters Kluwer Health) |
| Publisher Date | 2019-07-01 |
| Access Restriction | Open |
| Subject Keyword | Journal: JAIDS Journal of Acquired Immune Deficiency Syndromes Womens Studies Antiretroviral Therapy, Adherence, Efavirenz, Tenofovir, Tenofovir-diphosphate in Dried Blood Spots, Virologic Suppression |
| Content Type | Text |
| Resource Type | Article |
| Subject | Infectious Diseases Pharmacology (medical) |
