Simultaneous Determination of 6 Antiretroviral Drugs in Human Hair Using an LC-ESI+-MS/MS Method: Application to Adherence Assessment

Wu, Yan; Chu, Liuxi; Yang, H.; Wang, Wei; Zhang, Quan; Yang, Jin; Qiao, Shan; Li, Xiaoming; Shen, Zhiyong; Zhou, Yuejiao; Liu, Shuaifeng; Deng, Huihua

doi:10.1097/ftd.0000000000000878

Cited by 2 publications

(4 citation statements)

References 37 publications

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“…Our group is working on developing series LC-MS/MS methods for simultaneously determining multiple antiretrovirals in hair in order to reduce the assay cost. 41 , 42 Another group also reported a low-cost method for the concentration determination of hair nevirapine. 55 In the future, it is believed that hair antiretroviral concentrations and/or thresholds will play an important role in assessing long-term adherence and further predicting clinical outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…Hair samples were analyzed with the method recently developed in our lab. 42 Briefly, the collected 1-cm hair samples were rinsed twice with 2 mL methanol and then dried under pure nitrogen gas at 50°C. Thereafter, the dried samples were cut into pieces (1‒2 mm) and weighed at 10 mg for analysis.…”

Section: Methodsmentioning

confidence: 99%

“…Other method validation parameters (eg, inter- and intra-day precisions, recovery, matrix effect, and stability) also met the acceptance criteria following the US Food and Drug Administration and European Medicines Agency guidelines as previously reported. 42 …”

Section: Methodsmentioning

confidence: 99%

“…Moreover, as indicated by our previous findings, hair zidovudine concentrations can be a reliable measure of long-term adherence, including showing a significant difference between PLWH with high and low adherences and significant correlations with hair concentrations of other antiretrovirals. 41 , 42 In addition, antiretrovirals from an identical ART regimen have their individual characteristic effects in predicting virologic outcomes as evidenced by a previous study. 43 Notably, they also show significant inter-drug differences in hair concentration because of their differences in the metabolisms of the circulation system and the incorporation mechanism into the hair shaft.…”

Section: Introductionmentioning

confidence: 91%

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Hair Zidovudine Concentrations Predict Virologic Outcomes Among People Living with HIV/AIDS in China

Wu¹,

Liu²,

Chu³

et al. 2022

PPA

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Background Hair antiretroviral concentrations are an objective and non-invasive measure of adherence to long-term antiretroviral therapy (ART) and can further predict virologic outcomes among people living with HIV/AIDS (PLWH). Zidovudine, one of the mainstream antiretrovirals in China, has been verified to have high reliability in adherence assessment, especially for its hair concentrations. However, data are limited in its predicting virologic outcomes. Therefore, this study aimed to characterize whether hair zidovudine concentrations can predict virologic suppression among Chinese PLWH compared with hair lamivudine concentrations and two self-reported measures, the overall frequency of adherence behaviors and percentage adherence. Methods This cross-sectional study randomly recruited 564 PLWH currently treated with zidovudine, lamivudine, and other ART agents (efavirenz, nevirapine, or lopinavir/ritonavir) in Guangxi, China. Hair antiretroviral concentrations were determined using the LC-ESI + -MS/MS method. Receiver operating characteristic (ROC) curves were used to estimate the optimal classification thresholds of hair concentrations of zidovudine and lamivudine, and the two self-reported measures. Based on those optimal classification thresholds, logistic regression was used to examine whether those four adherence measures can predict virologic suppression (HIV-1 RNA <200 copies/mL). Results ROC curves demonstrated good classification performance for association with virologic suppression of zidovudine with the optimal threshold at 58 pg/mg and lamivudine at 255 pg/mg but no self-reported measures. PLWH with hair zidovudine concentrations >58 pg/mg had an adjusted odds ratio (aOR) of 43.191 (95% confidence interval (CI) = 10.171‒183.418, p < 0.001) for virologic suppression. Hair lamivudine concentrations were also associated with virologic suppression (aOR = 10.656, 95% CI = 3.670‒30.943, p < 0.001). However, two self-reported measures did not predict virologic suppression (aORs = 1.157 and 2.488, p s >0.149). Conclusion Hair zidovudine concentrations can be served as an alternative tool for clinically predicting virologic suppression among PLWH in China.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 91%

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Hair Zidovudine Concentrations Predict Virologic Outcomes Among People Living with HIV/AIDS in China

Wu¹,

Liu²,

Chu³

et al. 2022

PPA

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Sample Matrices for Mass Spectrometry–Based Adherence Monitoring: A Systematic Critical Review

Jacobs,

Wagmann,

Meyer

2023

Therapeutic Drug Monitoring

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Background: Analytical monitoring of adherence using mass spectrometry (MS) plays an important role in clinical toxicology. Unambiguous detection of drugs (of abuse) and/or their metabolites in body fluids is needed to monitor intake of medication as prescribed or to monitor abstinence as a follow-up to detoxification procedures. This study focused on the advantages and disadvantages of different sample matrices used for MS-based adherence monitoring. Methods: Relevant articles were identified through a literature search in the PubMed database. English articles published between January 01, 2017, and December 31, 2022, were selected using the keywords “adherence assess*” or “adherence monit*” or “compliance assess*” or “compliance monit*” in combination with “mass spectrom*” in the title or abstract. Results: A total of 51 articles were identified, 37 of which were within the scope of this study. MS-based monitoring was shown to improve patient adherence to prescribed drugs. However, MS analysis may not be able to assess whether treatment was rigorously followed beyond the last few days before the sampling event, except when hair is the sample matrix. For medication adherence monitoring, blood-based analyses may be preferred because reference plasma concentrations are usually available, whereas for abstinence control, urine and hair samples have the advantage of extended detection windows compared with blood. Alternative sample matrices, such as dried blood samples, oral fluid, and exhaled breath, are suitable for at-home sampling; however, little information is available regarding the pharmacokinetics and reference ranges of drug (of abuse) concentrations. Conclusions: Each sample matrix has strengths and weaknesses, and no single sample matrix can be considered the gold standard for monitoring adherence. It is important to have sufficient information regarding the pharmacokinetics of target substances to select a sample matrix in accordance with the desired purpose.

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Simultaneous Determination of 6 Antiretroviral Drugs in Human Hair Using an LC-ESI+-MS/MS Method: Application to Adherence Assessment

Cited by 2 publications

References 37 publications

Hair Zidovudine Concentrations Predict Virologic Outcomes Among People Living with HIV/AIDS in China

Hair Zidovudine Concentrations Predict Virologic Outcomes Among People Living with HIV/AIDS in China

Sample Matrices for Mass Spectrometry–Based Adherence Monitoring: A Systematic Critical Review

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