Factors associated with tenofovir diphosphate concentrations in dried blood spots in persons living with HIV

作者：Ryan P Coyle, Mary Morrow, Stacey S. Coleman, Edward M. Gardner, Jia‐Hua Zheng, Lucas Ellison, Lane R. Bushman, Jennifer J. Kiser, Samantha MaWhinney, Peter L. Anderson, José Castillo‐Mancilla · 发表于：Journal of Antimicrobial Chemotherapy · 年份：2020 · DOI：10.1093/jac/dkaa070 · 被引用次数：23 · 研究领域：HIV/AIDS Research and Interventions、HIV/AIDS drug development and treatment、HIV Research and Treatment

OBJECTIVES: To determine factors associated with interindividual variability in tenofovir diphosphate (TFV-DP) concentrations in dried blood spots (DBSs) among persons living with HIV (PLWH). METHODS: PLWH who were at least 18 years old and taking tenofovir disoproxil fumarate-containing ART were prospectively recruited and enrolled from a clinical cohort and followed longitudinally (up to three visits over 48 weeks). With log-transformed TFV-DP concentrations in DBSs as the outcome, mixed-model regression analyses were used to assess associations between self-reported 3 month ART adherence, race and other clinical covariates (gender, age, BMI, CD4+ T cell count, estimated glomerular filtration rate, haematocrit, duration on current ART and anchor drug class) on TFV-DP in DBSs. RESULTS: Five hundred and twenty-seven participants (1150 person-visits) were analysed. Adjusting for race and other clinical covariates, every 10% increase in self-reported 3 month ART adherence was associated with an average TFV-DP concentration increase in DBSs of 28% (95% CI: 24%-32%; P < 0.0001). In the same model, female participants had 20% (95% CI: 3%-40%; P = 0.02) higher TFV-DP concentrations in DBSs, compared with male participants, and every 1 kg/m2 increase in BMI was associated with a decrease in TFV-DP concentration in DBSs by 2% (95% CI: -3% to -1%; P < 0.0001). CONCLUSIONS: Individual patient characteristics were predictive of TFV-DP concentration in DBSs in PLWH receiving tenofovir di...