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Short Communication: Cascade of Antiretroviral Therapy Adherence in Virologically Suppressed Persons Living with HIV.

Authors
  • Castillo-Mancilla, Jose R1
  • Coyle, Ryan P1
  • Coleman, Stacey S2
  • Morrow, Mary3
  • Gardner, Edward M1
  • Zheng, Jia-Hua4
  • Ellison, Lucas4
  • Bushman, Lane R4
  • Kiser, Jennifer J4
  • MaWhinney, Samantha3
  • Anderson, Peter L4
  • 1 Division of Infectious Diseases, School of Medicine, University of Colorado-Anschutz Medical Campus, Aurora, Colorado.
  • 2 Duke University Hospital, Durham, North Carolina.
  • 3 Department of Biostatistics and Bioinformatics, Colorado School of Public Health, Aurora, Colorado.
  • 4 Colorado Antiviral Pharmacology Laboratory, Department of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado-AMC, Aurora, Colorado.
Type
Published Article
Journal
AIDS Research and Human Retroviruses
Publisher
Mary Ann Liebert
Publication Date
Mar 01, 2020
Volume
36
Issue
3
Pages
173–175
Identifiers
DOI: 10.1089/AID.2019.0024
PMID: 31204866
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Variable adherence to antiretroviral therapy (ART) can maintain HIV viral suppression, but our understanding of the ART adherence continuum remains limited. In a clinical cohort of adult persons living with HIV treated with a tenofovir (TFV) disoproxil fumarate/emtricitabine (TDF/FTC)-based regimen, data on 3-month self-reported adherence and dried blood spots (DBS) for TFV diphosphate (TFV-DP) and FTC triphosphate (FTC-TP) were collected. Among 521 participants in whom DBS were available upon enrollment, 333 were virologically suppressed (<20 copies/mL). Only 145 (44%) of them reported 100% 3-month adherence, and 69 (21%) had drug concentrations in the highest adherence categories (TFV-DP ≥1,850 fmol/punch and quantifiable FTC-TP). These findings demonstrate a wide range of ART adherence and drug exposure associated with viral suppression, indicating that modern regimens are pharmacologically forgiving. Additional research is needed to understand the biologic effects of variable adherence and drug exposure beyond plasma virologic suppression.

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