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JAIDS Journal of Acquired Immune Deficiency Syndromes:
doi: 10.1097/QAI.0000000000000154
Brief Report: Clinical Science

Antiretroviral Concentrations in Small Hair Samples as a Feasible Marker of Adherence in Rural Kenya

Hickey, Matthew D. BS*,†,‡; Salmen, Charles R. MPhil (Oxon)*,†,‡; Tessler, Robert A. MD§; Omollo, Dan BSc; Bacchetti, Peter PhD; Magerenge, Richard; Mattah, Brian; Salmen, Marcus R. MD; Zoughbie, Daniel MSc, DPhil (Oxon); Fiorella, Kathryn J. MPH†,¶; Geng, Elvin MD, MPH*; Njoroge, Betty MBChB, MPH#; Jin, Chengshi PhD, MS; Huang, Yong PhD**; Bukusi, Elizabeth A. MBChB, MMed (ObGyn), MPH, PhD, PGD (Ethics)#,††; Cohen, Craig R. MD, MPH††; Gandhi, Monica MD, MPH*

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Abstract: 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.

© 2014 by Lippincott Williams & Wilkins


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