Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Aug 3:16:1885-1896.
doi: 10.2147/PPA.S371623. eCollection 2022.

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

Yan Wu #  1   2   3 , Shuaifeng Liu #  4 , Liuxi Chu  1   2   3 , Quan Zhang  5   6 , Jin Yang  3   7 , Shan Qiao  5 , Xiaoming Li  5 , Yuejiao Zhou  4 , Huihua Deng  1   2   3 , Zhiyong Shen  4
Affiliations

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

Yan Wu et al. Patient Prefer Adherence. .

Abstract

Background: 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 <200 copies/mL).

Results: ROC curves demonstrated good classification performance for association with virologic suppression of zidovudine with the optimal threshold at 58 pg/mg and lamivudine at 255 pg/mg but no self-reported measures. PLWH with hair zidovudine concentrations >58 pg/mg had an adjusted odds ratio (aOR) of 43.191 (95% confidence interval (CI) = 10.171‒183.418, p < 0.001) for virologic suppression. Hair lamivudine concentrations were also associated with virologic suppression (aOR = 10.656, 95% CI = 3.670‒30.943, p < 0.001). However, two self-reported measures did not predict virologic suppression (aORs = 1.157 and 2.488, ps >0.149).

Conclusion: Hair zidovudine concentrations can be served as an alternative tool for clinically predicting virologic suppression among PLWH in China.

Keywords: LC-MS/MS; PLWH; hair antiretroviral concentrations; virologic suppression; zidovudine.

PubMed Disclaimer

Conflict of interest statement

The authors report no conflicts of interest in the work.

Figures

Figure 1
Figure 1
Receiver operating characteristic curves (A) and its detailed descriptions (B) for hair antiretroviral concentrations and self-reported adherence measures.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Saag MS, Gandhi RT, Hoy JF, et al. Antiretroviral drugs for treatment and prevention of HIV infection in adults: 2020 recommendations of the international antiviral society-USA panel. JAMA. 2020;324(16):1651–1669. doi:10.1001/jama.2020.17025 - DOI - PMC - PubMed
    1. Cohen MS, Chen YQ, McCauley M, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011;365(6):493–505. doi:10.1056/NEJMoa1105243 - DOI - PMC - PubMed
    1. Palella FJ, Baker RK, Moorman AC, et al. Mortality in the highly active antiretroviral therapy era: changing causes of death and disease in the HIV outpatient study. J Acquir Immune Defic Syndr. 2006;43(1):27–34. doi:10.1097/01.qai.0000233310.90484.16 - DOI - PubMed
    1. Bernard L, Vuagnat A, Peytavin G, et al. Relationship between levels of indinavir in hair and virologic response to highly active antiretroviral therapy. Ann Intern Med. 2002;137(8):656–659. doi:10.7326/0003-4819-137-8-200210150-00009 - DOI - PubMed
    1. Conway B. The role of adherence to antiretroviral therapy in the management of HIV infection. J Acquir Immune Defic Syndr. 2007;45(S1):S14–S18. doi:10.1097/QAI.0b013e3180600766 - DOI - PubMed