Engagement in Mental Health Care is Associated with Higher Cumulative Drug Exposure and Adherence to Antiretroviral Therapy

AIDS and Behavior
Ryan P CoyleJose R Castillo-Mancilla

Abstract

Mental health (MH) disorders are more prevalent among persons living with HIV compared to the general population, and may contribute to suboptimal adherence to antiretroviral therapy (ART). Tenofovir-diphosphate (TFV-DP), the phosphorylated anabolite of tenofovir (TFV), is a biomarker with a 17-day half-life in red blood cells. TFV-DP can be measured in dried blood spots (DBS) using liquid chromatography/tandem mass spectrometry (LC-MS/MS) to assess adherence and cumulative drug exposure to tenofovir disoproxil fumarate (TDF)-based ART. From a larger clinical cohort (N = 807), TFV-DP concentrations and a paired HIV viral load were available from 521 participants at their enrollment visit. We used multivariable linear regression to evaluate the association between TFV-DP in DBS and engagement in MH care. After adjusting for clinical covariates, participants with MH disorders who were engaged in MH care had 40% higher TFV-DP compared to participants with MH disorders who were not engaged in MH care (p < 0.001), and similar TFV-DP to participants without MH disorders (p = 0.219). Further research is needed to identify the mechanism(s) for these findings, with the goal of optimizing engagement and retention in MH care strategies to...Continue Reading

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Citations

Jan 7, 2020·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Jessica L CastilhoTimothy R Sterling
Feb 26, 2020·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Jessica L CastilhoTimothy R Sterling
Mar 27, 2020·The Journal of Antimicrobial Chemotherapy·Ryan P CoyleJose R Castillo-Mancilla
Oct 20, 2020·Open Forum Infectious Diseases·Frances VernonJose Castillo-Mancilla
Feb 5, 2021·AIDS and Behavior·Thurka SangaramoorthyAmanda D Castel
Mar 7, 2020·The American Journal of Emergency Medicine·Abia AbiaYu-Hsiang Hsieh

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