Defining a Cutoff for Atazanavir in Hair Samples Associated With Virological Failure Among Adolescents Failing Second-Line Antiretroviral Treatment.

Journal of Acquired Immune Deficiency Syndromes : JAIDS
Tariro D ChawanaAdolescent Treatment Failure (ATF) study team

Abstract

Adequate antiretroviral exposure is crucial to virological suppression. We assessed the relationship between atazanavir hair levels with self-reported adherence, virological outcomes, and the effect of a home-based adherence intervention in HIV-infected adolescents failing second-line antiretroviral treatment in Zimbabwe. HIV-infected adolescents on atazanavir/ritonavir-based second-line treatment for ≥6 months with viral load (VL) >1000 copies/mL were randomized to either standard care (control) or standard care plus modified directly administered antiretroviral therapy (intervention). Questionnaires were administered; VL and hair samples were collected at baseline and after 90 days in each group. Viral suppression was defined as <1000 copies/mL after follow-up. Fifty adolescents (10-18 years) were enrolled; 23 (46%) were randomized to intervention and 27 (54%) to control. Atazanavir hair concentration <2.35 ng/mg (lower interquartile range for those with virological suppression) defined a cutoff below which most participants experienced virological failure. Male sex (P = 0.03), virological suppression at follow-up (P = 0.013), greater reduction in VL (P = 0.006), and change in average self-reported adherence over the previous...Continue Reading

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Citations

Mar 24, 2018·Current Opinion in HIV and AIDS·Leslie A EnaneCaroline Foster
Jan 10, 2018·Rapid Communications in Mass Spectrometry : RCM·Nhi PhungHoward Horng
Mar 14, 2019·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Monica GandhiMaria L Ekstrand
May 20, 2020·Current HIV/AIDS Reports·Matthew A SpinelliMonica Gandhi
Jun 13, 2021·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Tariro D ChawanaUNKNOWN Adolescent Treatment Failure (ATF) Study Team

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