Urine tenofovir and dried blood spot tenofovir diphosphate concentrations and viraemia in people taking efavirenz and dolutegravir-based antiretroviral therapy.
AIDS
; 38(5): 697-702, 2024 04 01.
Article
en En
| MEDLINE
| ID: mdl-38126342
ABSTRACT
OBJECTIVE:
We aimed to determine whether urine tenofovir (TFV) and dried blood spot (DBS) tenofovir diphosphate (TFV-DP) concentrations are associated with concurrent HIV viraemia.DESIGN:
Cross-sectional study among people with HIV (PWH) receiving tenofovir disoproxil fumarate (TDF)-based antiretroviral therapy (ART).METHODS:
We used dual tandem liquid chromatography and mass spectrometry to measure urine TFV and DBS TFV-DP concentrations, and evaluated their associations with concurrent viraemia at least 1000âcopies/ml using logistic regression models. In exploratory analyses, we used receiver operating curves (ROCs) to estimate optimal urine TFV and DBS TFV-DP thresholds to predict concurrent viraemia.RESULTS:
Among 124 participants, 68 (54.8%) were women, median age was 39âyears [interquartile range (IQR) 34-45] and 74 (59.7%) were receiving efavirenz versus 50 (40.3%) receiving dolutegravir. Higher concentrations of urine TFV [1000âng/ml increase, odds ratio (OR) 0.97 95% CI 0.94-0.99, P â=â0.005] and DBS TFV-DP (100âfmol/punch increase, OR 0.76, 95% CI 0.67-0.86, P â<â0.001) were associated with lower odds of viraemia. There was evidence that these associations were stronger among people receiving dolutegravir than among people receiving efavirenz (urine TFV, P â=â0.072; DBS TFV-DP, P â=â0.003). Nagelkerke pseudo- R2 for the DBS TFV-DP models was higher for the urine TFV models, demonstrating a stronger relationship between DBS TFV-DP and viraemia. Among people receiving dolutegravir, a DBS TFV-DP concentration of 483âfmol/punch had 88% sensitivity and 85% specificity to predict concurrent viraemia ≥1000âcopies/ml.CONCLUSION:
Among PWH receiving TDF-based ART, urine TFV concentrations, and in particular DBS TFV-DP concentrations, were strongly associated with concurrent viraemia, especially among people receiving dolutegravir.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Oxazinas
/
Organofosfatos
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Piperazinas
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Piridonas
/
Adenina
/
Infecciones por VIH
/
Fármacos Anti-VIH
/
Ciclopropanos
/
Benzoxazinas
/
Alquinos
Límite:
Adult
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Female
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Humans
/
Male
Idioma:
En
Revista:
AIDS
Asunto de la revista:
SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS)
Año:
2024
Tipo del documento:
Article
País de afiliación:
Reino Unido
Pais de publicación:
Reino Unido