Preprint
Urine tenofovir and dried blood spot tenofovir diphosphate concentrations and viraemia in people taking efavirenz and dolutegravir based antiretroviral therapy
- Abstract:
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Objective: We aimed to determine whether urine tenofovir (TFV) and dried blood spot (DBS) tenofovir diphosphate (TFV-DP) concentrations are associated with concurrent HIV viraemia.
Design: Cross-sectional study among people with HIV (PWH) receiving tenofovir disoproxil fumarate (TDF)-based antiretroviral therapy (ART).
Methods: We used dual tandem liquid chromatography and mass spectrometry to measure urine TFV and DBS TFV-DP concentrations, and evaluated their associations with concurrent viraemia ≥ 1000 copies/mL using logistic regression models. In exploratory analyses, we used receiver operating curves to estimate optimal urine TFV and DBS TFV-DP thresholds to predict concurrent viraemia.
Results: Among 124 participants, 68 (54.8%) were women, median age was 39 years (interquartile range [IQR] 34-45) and 74 (59.7%) were receiving efavirenz versus 50 (40.3%) receiving dolutegravir. Higher concentrations of urine TFV (1000 ng/mL increase, odds ratio [OR] 0.97 95%CI 0.94-0.99, p=0.005) and DBS TFV-DP (100 fmol/punch increase, OR 0.76, 95%CI 0.67-0.86, p<0.001) were associated with lower odds of viraemia. There was evidence that these associations were stronger among people receiving dolutegravir than among people receiving efavirenz (urine TFV p=0.072, DBS TFV-DP p=0.003). Nagelkerke Pseudo-R2 for the DBS TFV-DP models was higher than for the urine TFV models, demonstrating a stronger relationship between DBS TFV-DP and viraemia. Among people receiving dolutegravir, a DBS TFV-DP concentration of 483 fmol/punch had 88% sensitivity and 85% specificity to predict concurrent viraemia ≥ 1000 copies/ml.
Conclusions: Among PWH receiving TDF-based ART, urine TFV concentrations, and in particular DBS TFV-DP concentrations, were strongly associated with concurrent viraemia, especially among people receiving dolutegravir.
- Publication status:
- Published
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(Preview, Pre-print, pdf, 257.2KB, Terms of use)
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- Preprint server copy:
- 10.1101/2023.09.27.23296217
Authors
- Funder identifier:
- https://ror.org/029chgv08
- Grant:
- 216421/Z/19/Z
- Funder identifier:
- https://ror.org/0187kwz08
- Grant:
- NF-SI-0515-10056
- CL-2022-13-005
- MIC-2016-018
- NIHR300105
- Preprint server:
- medRxiv
- Publication date:
- 2023-09-28
- DOI:
- Server owner:
- Cold Spring Harbor Laboratory
- Language:
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English
- Keywords:
- Pubs id:
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1557612
- Local pid:
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pubs:1557612
- Deposit date:
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2026-05-29
- ARK identifier:
Terms of use
- Copyright holder:
- Dorward et al.
- Copyright date:
- 2023
- Rights statement:
- The copyright holder for this preprint is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY 4.0 International license.
- Licence:
- CC Attribution (CC BY)
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