LC-MS/MS Quantification of Nevirapine and Its Metabolites in Hair for Assessing Long-Term Adherence
Haoran Yang,
Liuxi Chu,
Yan Wu,
Wei Wang,
Jin Yang,
Quan Zhang,
Shan Qiao,
Xiaoming Li,
Zhiyong Shen,
Yuejiao Zhou,
Shuaifeng Liu,
Huihua Deng
Affiliations
Haoran Yang
Key Laboratory of Child Development and Learning Science, Ministry of Education, Southeast University, Nanjing 210096, China
Liuxi Chu
Key Laboratory of Child Development and Learning Science, Ministry of Education, Southeast University, Nanjing 210096, China
Yan Wu
Key Laboratory of Child Development and Learning Science, Ministry of Education, Southeast University, Nanjing 210096, China
Wei Wang
Key Laboratory of Child Development and Learning Science, Ministry of Education, Southeast University, Nanjing 210096, China
Jin Yang
Key Laboratory of Child Development and Learning Science, Ministry of Education, Southeast University, Nanjing 210096, China
Quan Zhang
Department of Health Promotion, Education and Behavior, South Carolina Smart State Center for Healthcare Quality (CHQ), University of South Carolina, Columbia, SC 29208, USA
Shan Qiao
Department of Health Promotion, Education and Behavior, South Carolina Smart State Center for Healthcare Quality (CHQ), University of South Carolina, Columbia, SC 29208, USA
Xiaoming Li
Department of Health Promotion, Education and Behavior, South Carolina Smart State Center for Healthcare Quality (CHQ), University of South Carolina, Columbia, SC 29208, USA
Zhiyong Shen
Guangxi Center for Disease Control and Prevention, Nanning 530028, China
Yuejiao Zhou
Guangxi Center for Disease Control and Prevention, Nanning 530028, China
Shuaifeng Liu
Guangxi Center for Disease Control and Prevention, Nanning 530028, China
Huihua Deng
Key Laboratory of Child Development and Learning Science, Ministry of Education, Southeast University, Nanjing 210096, China
The adherence assessment based on the combination of nevirapine (NVP) and its two metabolites (2-hydroxynevirapine and 3-hydroxynevirapine) would more comprehensively and accurately reflect long-term adherence than that of a single prototype. This study aimed to develop a specific, sensitive and selective method for simultaneous detection of the three compounds in hair and explore whether there was consistency among the three compounds in assessing long-term adherence. Furthermore, 75 HIV-positive patients who were taking the NVP drug were randomly recruited and divided into two groups (high-and low-adherence group). All participants self-reported their days of oral drug administration per month and provided their hair strands closest to the scalp at the region of posterior vertex. The concentrations of three compounds in the hair were determined using a developed LC-MS/MS method in multiple reaction monitoring. This method showed good performances in limit of quantification and accuracy with the recoveries from 85 to 115% and in precision with the intra-day and inter-day coefficients of variation within 15% for the three compounds. The population analysis revealed that patients with high-adherence showed significantly higher concentrations than those with low-adherence for all three compounds. There were significantly moderate correlations of nevirapine with 2-hydroxynevirapine and 3-hydroxynevirapin and high correlation between 2-hydroxynevirapine and 3-hydroxynevirapin. The two NVP’s metabolites showed high consistency with NVP in evaluating long-term adherence.
