OBJECTIVE: Emtricitabine triphosphate (FTC-TP) in dried blood spots (DBS), a measure of short-term antiretroviral therapy (ART) adherence, is associated with viral suppression in persons with HIV (PWH). However, its ability to predict future viremia remains unknown. DESIGN: Prospective, observational cohort (up to three visits in 48 weeks). METHODS: PWH receiving TDF/FTC-based ART had DBS and HIV viral load obtained at routine clinical visits. FTC-TP in DBS was dichotomized into quantifiable vs. below the limit of quantification (BLQ). The adjusted odds ratio (aOR) of future viremia (≥20 copies/ml at next study visit) was estimated according to FTC-TP at the current visit. To assess for possible interactions, additional models adjusted for tenofovir diphosphate (TFV-DP) in DBS and 3-day self-reported adherence. RESULTS: Data from 433 PWH (677 paired DBS/HIV viral load samples) were analyzed. The aOR [95% confidence interval (CI)] for future viremia for BLQ vs. quantifiable FTC-TP was 3.4 (1.8--6.5; P = 0.0002). This diminished after adjusting for TFV-DP [aOR 1.9 (0.9--4.1); P = 0.090]. Among PWH reporting 100% 3-day adherence, the odds of future viremia were 6.0 times higher [(1.8--20.3); P = 0.001] when FTC-TP was BLQ vs. quantifiable. Among participants (n = 75) reporting less than 100% adherence, BLQ FTC-TP in DBS was not predictive of future viremia [aOR 1.3 (0.4--4.6); P = 0.96]. CONCLUSION: Nonquantifiable FTC-TP in DBS predicts future viremia and is particularly informative in PWH reporting perfect adherence. As point-of-care adherence measures become available, mismatches between objective and subjective measures, such as FTC-TP in DBS and self-report, could help clinicians identify individuals at an increased risk of future viremia.
OBJECTIVE: Emtricitabine triphosphate (FTC-TP) in dried blood spots (DBS), a measure of short-term antiretroviral therapy (ART) adherence, is associated with viral suppression in persons with HIV (PWH). However, its ability to predict future viremia remains unknown. DESIGN: Prospective, observational cohort (up to three visits in 48 weeks). METHODS: PWH receiving TDF/FTC-based ART had DBS and HIV viral load obtained at routine clinical visits. FTC-TP in DBS was dichotomized into quantifiable vs. below the limit of quantification (BLQ). The adjusted odds ratio (aOR) of future viremia (≥20 copies/ml at next study visit) was estimated according to FTC-TP at the current visit. To assess for possible interactions, additional models adjusted for tenofovir diphosphate (TFV-DP) in DBS and 3-day self-reported adherence. RESULTS: Data from 433 PWH (677 paired DBS/HIV viral load samples) were analyzed. The aOR [95% confidence interval (CI)] for future viremia for BLQ vs. quantifiable FTC-TP was 3.4 (1.8--6.5; P = 0.0002). This diminished after adjusting for TFV-DP [aOR 1.9 (0.9--4.1); P = 0.090]. Among PWH reporting 100% 3-day adherence, the odds of future viremia were 6.0 times higher [(1.8--20.3); P = 0.001] when FTC-TP was BLQ vs. quantifiable. Among participants (n = 75) reporting less than 100% adherence, BLQ FTC-TP in DBS was not predictive of future viremia [aOR 1.3 (0.4--4.6); P = 0.96]. CONCLUSION: Nonquantifiable FTC-TP in DBS predicts future viremia and is particularly informative in PWH reporting perfect adherence. As point-of-care adherence measures become available, mismatches between objective and subjective measures, such as FTC-TP in DBS and self-report, could help clinicians identify individuals at an increased risk of future viremia.
Authors: K Rivet Amico; William A Fisher; Deborah H Cornman; Paul A Shuper; Caroline G Redding; Deborah J Konkle-Parker; William Barta; Jeffrey D Fisher Journal: J Acquir Immune Defic Syndr Date: 2006-08-01 Impact factor: 3.731
Authors: Jose R Castillo-Mancilla; Mary Morrow; Ryan P Coyle; Stacey S Coleman; Edward M Gardner; Jia-Hua Zheng; Lucas Ellison; Lane R Bushman; Jennifer J Kiser; Samantha Mawhinney; Peter L Anderson Journal: Clin Infect Dis Date: 2019-04-08 Impact factor: 9.079
Authors: A Gonzalez-Serna; L C Swenson; B Watson; W Zhang; A Nohpal; K Auyeung; J S Montaner; P R Harrigan Journal: Clin Microbiol Infect Date: 2016-08-30 Impact factor: 8.067
Authors: Monica Gandhi; Niloufar Ameli; Peter Bacchetti; Kathryn Anastos; Stephen J Gange; Howard Minkoff; Mary Young; Joel Milam; Mardge H Cohen; Gerald B Sharp; Yong Huang; Ruth M Greenblatt Journal: Clin Infect Dis Date: 2011-05 Impact factor: 9.079
Authors: Matthew A Spinelli; David V Glidden; Warren C Rodrigues; Guohong Wang; Michael Vincent; Hideaki Okochi; Karen Kuncze; Megha Mehrotra; Patricia Defechereux; Susan P Buchbinder; Robert M Grant; Monica Gandhi Journal: AIDS Date: 2019-04-01 Impact factor: 4.177
Authors: Katherine Frasca; Mary Morrow; Ryan P Coyle; Stacey S Coleman; Lucas Ellison; Lane R Bushman; Jennifer J Kiser; Jia-Hua Zheng; Samantha Mawhinney; Peter L Anderson; Jose Castillo-Mancilla Journal: J Antimicrob Chemother Date: 2019-05-01 Impact factor: 5.790
Authors: Fan Pu; Sangeeta Pandey; Lane R Bushman; Peter L Anderson; Zheng Ouyang; R Graham Cooks Journal: Anal Bioanal Chem Date: 2020-01-02 Impact factor: 4.142
Authors: Jia-Hua Zheng; Caitlin Rower; Kevin McAllister; Jose Castillo-Mancilla; Brandon Klein; Amie Meditz; L Anthony Guida; Jennifer J Kiser; Lane R Bushman; Peter L Anderson Journal: J Pharm Biomed Anal Date: 2016-01-21 Impact factor: 3.935
Authors: Xin Niu; Rachel W Kubiak; Oraphan Siriprakaisil; Virat Klinbuyaem; Pra Ornsuda Sukrakanchana; Ratchada Cressey; Hideaki Okochi; Monica Gandhi; Tim R Cressey; Paul K Drain Journal: Open Forum Infect Dis Date: 2022-08-10 Impact factor: 4.423