Patient Preference and Adherence (Aug 2022)

Hair Zidovudine Concentrations Predict Virologic Outcomes Among People Living with HIV/AIDS in China

  • Wu Y,
  • Liu S,
  • Chu L,
  • Zhang Q,
  • Yang J,
  • Qiao S,
  • Li X,
  • Zhou Y,
  • Deng H,
  • Shen Z

Journal volume & issue
Vol. Volume 16
pp. 1885 – 1896

Abstract

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Yan Wu,1– 3,* Shuaifeng Liu,4,* Liuxi Chu,1– 3 Quan Zhang,5,6 Jin Yang,3,7 Shan Qiao,5 Xiaoming Li,5 Yuejiao Zhou,4 Huihua Deng,1– 3 Zhiyong Shen4 1Department of Brain and Learning Science, School of Biological Science & Medical Engineering, Southeast University, Nanjing, People’s Republic of China; 2Key Laboratory of Child Development and Learning Science (Southeast University), Ministry of Education, Nanjing, People’s Republic of China; 3Institute of Child Development and Education, Research Center for Learning Science, Southeast University, Nanjing, People’s Republic of China; 4Unit of AIDS Prevention and Control, Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Nanning, People’s Republic of China; 5Department of Health Promotion, Education and Behavior, South Carolina SmartState Center for Healthcare Quality (CHQ), Arnold School of Public Health, University of South Carolina, Columbia, SC, USA; 6College of Graduate Health Sciences, The University of Tennessee Health Science Center, Memphis, TN, USA; 7Department of Preventive Medicine, School of Public Health, Southeast University, Nanjing, People’s Republic of China*These authors contributed equally to this workCorrespondence: Huihua Deng, Department of Brain and Learning Science, School of Biological Science & Medical Engineering, Southeast University, No. 2 Sipailou, Nanjing, 210096, People’s Republic of China, Tel +86 25 8379 5664, Fax +86 25 8379 3779, Email [email protected] Zhiyong Shen, Unit of AIDS Prevention and Control, Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, No. 18 Jinzhou Road, Nanning, 530028, People’s Republic of China, Tel +86 771 251 8838, Email [email protected]: Hair antiretroviral concentrations are an objective and non-invasive measure of adherence to long-term antiretroviral therapy (ART) and can further predict virologic outcomes among people living with HIV/AIDS (PLWH). Zidovudine, one of the mainstream antiretrovirals in China, has been verified to have high reliability in adherence assessment, especially for its hair concentrations. However, data are limited in its predicting virologic outcomes. Therefore, this study aimed to characterize whether hair zidovudine concentrations can predict virologic suppression among Chinese PLWH compared with hair lamivudine concentrations and two self-reported measures, the overall frequency of adherence behaviors and percentage adherence.Methods: This cross-sectional study randomly recruited 564 PLWH currently treated with zidovudine, lamivudine, and other ART agents (efavirenz, nevirapine, or lopinavir/ritonavir) in Guangxi, China. Hair antiretroviral concentrations were determined using the LC-ESI+-MS/MS method. Receiver operating characteristic (ROC) curves were used to estimate the optimal classification thresholds of hair concentrations of zidovudine and lamivudine, and the two self-reported measures. Based on those optimal classification thresholds, logistic regression was used to examine whether those four adherence measures can predict virologic suppression (HIV-1 RNA 58 pg/mg had an adjusted odds ratio (aOR) of 43.191 (95% confidence interval (CI) = 10.171‒183.418, p 0.149).Conclusion: Hair zidovudine concentrations can be served as an alternative tool for clinically predicting virologic suppression among PLWH in China.Keywords: hair antiretroviral concentrations, zidovudine, virologic suppression, PLWH, LC-MS/MS

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