Open AccessAntiretroviral Concentrations in Small Hair Samples as a Feasible Marker of Adherence in Rural Kenya
Author(s) -
Matthew D Hickey,
Charles R. Salmen,
Robert A. Tessler,
Dan Omollo,
Peter Bacchetti,
Richard Magerenge,
Brian Mattah,
Marcus Salmen,
Daniel E. Zoughbie,
Kathryn J. Fiorella,
Elvin Geng,
Betty Njoroge,
Chengshi Jin,
Yong Huang,
Elizabeth A. Bukusi,
Craig R. Cohen,
Monica Gandhi
Publication year - 2014
Publication title -
journal of acquired immune deficiency syndromes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.162
H-Index - 157
eISSN - 1944-7884
pISSN - 1525-4135
DOI - 10.1097/qai.0000000000000154
Subject(s) - interquartile range , medicine , biomarker , kenya , cohort , nevirapine , human immunodeficiency virus (hiv) , antiretroviral treatment , cohort study , antiretroviral therapy , immunology , viral load , biology , ecology , biochemistry
Antiretroviral hair levels objectively quantify drug exposure over time and predict virologic responses. We assessed the acceptability and feasibility of collecting small hair samples in a rural Kenyan cohort. Ninety-five percentage of participants (354/373) donated hair. Although median self-reported adherence was 100% (interquartile range, 96%-100%), a wide range of hair concentrations likely indicates overestimation of self-reported adherence and the advantages of a pharmacologic adherence measure. Higher nevirapine hair concentrations observed in women and older adults require further study to unravel behavioral versus pharmacokinetic contributors. In resource-limited settings, hair antiretroviral levels may serve as a low-cost quantitative biomarker of adherence.