Please use this identifier to cite or link to this item:
Title: Using Lopinavir Concentrations in Hair Samples to Assess Treatment Outcomes on Second-Line Regimens among Asian Children
Authors: Wasana Prasitsuebsai
Stephen J. Kerr
Khanh Huu Truong
Jintanat Ananworanich
Viet Chau Do
Lam Van Nguyen
Nia Kurniati
Pope Kosalaraksa
Tavitiya Sudjaritruk
Kulkanya Chokephaibulkit
Narukjaporn Thammajaruk
Thida Singtoroj
Sirinya Teeraananchai
Howard Horng
Peter Bacchetti
Monica Gandhi
Annette H. Sohn
Keywords: Immunology and Microbiology
Issue Date: 1-Jan-2015
Abstract: © 2015, Mary Ann Liebert, Inc. We conducted a prospective monitoring study to determine whether antiretroviral (ARV) levels in hair of Asian children on second-line protease inhibitor-based ARV therapy (ART) are associated with virologic failure (VF), compared to plasma drug levels and self-reported adherence. HIV-infected Asian children on second-line ART regimens were enrolled into a longitudinal cohort. Traditional adherence measures, plasma, and hair samples were collected 24 weeks after study enrollment. Hair ARV levels were determined via liquid chromatography/tandem mass spectrometry. Among 149 children on lopinavir/ritonavir-based regimens, 47% were female; the median [interquartile range (IQR)] age was 10.3 (7.9-13.3) years. The median CD4% was 26% (IQR 21.7-32.1%) and the median CD4 cell count 754 (IQR 596-1,013) cells/mm<sup>3</sup>. The median duration of lopinavir-based ART prior to week 24 of the study was 2.9 (IQR 1.6-4.2) years. Adherence was >95% in 91% (135/148) by visual analogue scale and 89% (129/145) by pill count. The median lopinavir hair concentrations were 5.43 (IQR 3.21-9.01) ng/mg in children with HIV RNA >1,000 copies/ml and 9.96 (IQR 6.51-12.31) ng/mg in children with HIV RNA <1,000 copies/ml (p = 0.003). Plasma trough and lopinavir hair concentrations were not statistically significantly correlated (Pearson's correlation coefficient 0.20; p = 0.13). Increasing lopinavir hair concentrations in quartiles were strongly associated with virologic success (odds ratios ≥4.0, overall p = 0.02), while self-reported adherence, pill count, and plasma lopinavir levels were not. Based on this first report of hair ARV concentrations and virologic outcomes in children, ARV hair concentrations, representing longer-term adherence, may be useful to identify children at risk for VF.
ISSN: 19318405
Appears in Collections:CMUL: Journal Articles

Files in This Item:
There are no files associated with this item.

Items in CMUIR are protected by copyright, with all rights reserved, unless otherwise indicated.