Objective methods of measuring antiretroviral adherence are limited. We assessed the relationship between tenofovir disoproxil fumarate (TDF) hair concentrations, self-reported adherence, and virological outcomes in HIV-infected adolescents in Harare, Zimbabwe. HIV-infected adolescents on atazanavir/ritonavir-based second-line treatment for >6 months with viral load (VL) ≥1,000 copies/mL were randomized to either modified directly administered antiretroviral therapy (mDAART) or standard of care. Hair and VL samples were collected at baseline and after 90 days. Treatment outcome was defined as TDF concentrations in hair. Virological suppression was defined as VL <1,000 copies/mL. Thirty-four adolescents had TDF concentrations measured at baseline and follow-up. Mean (median); range age was 16 (16); 13–18 years and 53% were females. Nineteen (56%) were randomized to mDAART. Mean (SD); range TDF concentrations were 0.03 (0.04); 0–0.17 ng/mg hair and 0.06 (0.06); 0–0.3 ng/mg hair at baseline and follow-up, respectively. Higher TDF concentrations were associated with decreased VL [regression coefficient (RC) 0.8; 95% confidence interval (CI) 0.7–1.0; p = .008] and mDAART (RC 0.5; 95% CI 0.3–1.0; p = .04), but were not associated with self-reported adherence and virological suppression (VL <1,000 copies/mL). Higher TDF hair concentrations were observed with virological decrease and an adherence intervention. Hair antiretroviral concentrations could be useful in triggering adherence interventions among adolescents with second-line virological failure.

中文翻译：

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简短的交流：头发中较高的替诺福韦浓度与病毒载量的减少有关，而不是二线病毒学治疗失败的艾滋病毒感染青少年自我报告的依从性


衡量抗逆转录病毒治疗依从性的客观方法是有限的。我们评估了津巴布韦哈拉雷 HIV 感染青少年的富马酸替诺福韦二吡呋酯 (TDF) 毛发浓度、自我报告的依从性和病毒学结果之间的关系。接受基于阿扎那韦/利托那韦的二线治疗超过 6 个月且病毒载量 (VL) ≥1,000 拷贝/mL 的 HIV 感染青少年被随机分配接受改良直接施用抗逆转录病毒治疗 (mDAART) 或标准护理。在基线和 90 天后收集头发和 VL 样本。治疗结果定义为头发中的 TDF 浓度。病毒学抑制被定义为 VL <1 id=33>p = .008] 和 mDAART（RC 0.5；95% CI 0.3–1.0； p = .04），但与自我报告的依从性和病毒学抑制无关（VL <1,000 拷贝/mL）。随着病毒学降低和依从性干预，观察到 TDF 毛发浓度较高。头发抗逆转录病毒浓度可能有助于引发二线病毒学失败的青少年的依从性干预。