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J Infect Dis. 2015 Nov 1;212(9):1402-6. doi: 10.1093/infdis/jiv239. Epub 2015 Apr 20.

Strong Correlation Between Concentrations of Tenofovir (TFV) Emtricitabine (FTC) in Hair and TFV Diphosphate and FTC Triphosphate in Dried Blood Spots in the iPrEx Open Label Extension: Implications for Pre-exposure Prophylaxis Adherence Monitoring.

Author information

1
Department of Medicine, University of California.
2
Department of Epidemiology and Biostatistics, University of California.
3
Department of Medicine, University of California Bridge HIV, San Francisco Department of Public Health.
4
Department of Pharmaceutical Sciences, University of Colorado, Denver.
5
Department of Bioengineering and Therapeutic Sciences, University of California.
6
Gladstone Institutes, San Francisco.
7
Investigaciones Medicas en Salud, Lima, Peru.
8
STD/AIDS Clinical Research Laboratory, Evandro Chagas National Institute of Infectious Diseases-Fiocruz, Rio de Janeiro, Brazil.
9
Research Institute for Health Sciences, Chiang Mai University, Thailand.
10
The Desmond Tutu HIV Centre, University of Cape Town, South Africa.
11
Department of Medicine, University of California Gladstone Institutes, San Francisco.

Abstract

Self-reported adherence to pre-exposure prophylaxis (PrEP) has limitations, raising interest in pharmacologic monitoring. Drug concentrations in hair and dried blood spots (DBS) are used to assess long-term-exposure; hair shipment/storage occurs at room temperature. The iPrEx Open Label Extension collected DBS routinely, with opt-in hair collection; concentrations were measured with liquid chromatography/tandem mass spectrometry. In 806 hair-DBS pairs, tenofovir (TFV) hair levels and TFV diphosphate (DP) in DBS were strongly correlated (Spearman coefficient r = 0.734; P < .001), as were hair TFV/DBS emtricitabine (FTC) triphosphate (TP) (r = 0.781; P < .001); hair FTC/DBS TFV-DP (r = 0.74; P < .001); hair FTC/DBS FTC-TP (r = 0.587; P < .001). Drug detectability was generally concordant by matrix. Hair TFV/FTC concentrations correlate strongly with DBS levels, which are predictive of PrEP outcomes.

KEYWORDS:

HIV prevention; PrEP; adherence; dried blood spot (DBS) concentrations; hair concentrations; iPrEx Open Label Extension (OLE); pharmacologic monitoring; pre-exposure prophylaxis; tenofovir/emtricitabine

PMID:
25895984
PMCID:
PMC4601920
DOI:
10.1093/infdis/jiv239
[Indexed for MEDLINE]
Free PMC Article

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