Factors Influencing Hair Lamivudine Concentration among People Living with HIV in Guangxi, China

Abstract

Background Hair antiretroviral concentration has served as an innovative and objective measure of antiretroviral adherence. However, some factors (for example, pharma-cokinetics and hair characteristics) may contribute to the variability of hair antiretroviral concentration that may threaten the validity and reliability of the hair measure as a biomarker of adherence. This study aimed to examine the potential factors that may influence the measure of hair antiretroviral concentration. Methods Hair samples from a cohort of 372 people living with HIV (PLHIV) receiving lamivudine (300 mg/day) in Guangxi, China. Lamivudine concentration was analysed using liquid chromatography-tandem mass spectrometry. Multivariable linear regression was used to evaluate the associations of hair lamivudine concentration with age, sex, ethnicity, height, weight, body mass index, duration of HIV diagnosis, duration of current regimen, dosing schedule, concomitant antiretroviral medications, frequency of hair washing, hair care products use, hair cosmetic treatment and self-reported adherence. Results Multivariable models revealed that frequency of hair washing (β=-0.221, P=0.001), dosing schedule (β=0.141, P=0.036) and self-reported adherence (β=0.160, P=0.002) were associated with hair lamivudine concentration. Conclusions We observed that, among those potential factors, hair lamivudine concentration was influenced by frequency of hair washing and dosing schedule. Therefore, frequency of hair washing and dosing schedule should be considered in future research using hair lamivudine concentration as a measure of lamivudine exposure and bio-marker of adherence.

Association of Hair Concentrations of Antiretrovirals with Virologic Outcomes Among People Living with HIV in Guangxi, China

“…42 In addition, we found positive correlations among hair concentrations of 3TC, AZT, and EFV, which might indicate a significant drug-drug interaction among those antiretrovirals. Moreover, we found that hair 3TC concentrations were easily affected by sociodemographic and HIV-related characteristics than hair concentrations of AZT and EFV did (Table 2), which added not only the understanding of the factors related to hair concentrations of antiretrovirals, 19,37 but also the potential reason that hair EFV concentrations had higher effect than hair 3TC concentrations, in addition to hair EFV concentrations are much higher than hair 3TC concentrations.…”

“…The participants of this study were recruited from Wave 3 of the HIV disclosure project, which is a longitudinal study that aims to explore the mechanism underlying the linkage between HIV disclosure and clinical outcomes in Guangxi, China. [35][36][37] With the Guangxi Center for Disease Prevention and Control (Guangxi CDC) 's assistance and collaboration, we randomly selected 10 clinic sites with the largest number of HIV/AIDS cases from 17 cities and 75 counties in Guangxi. The recruitment procedure, including inclusion and exclusion criteria, was described in the previous studies.…”