Using Lopinavir Concentrations in Hair Samples to Assess Treatment Outcomes on Second-Line Regimens Among Asian Children

• DOI: 10.1089/aid.2015.0111
• Publication Date: 2015-07-22T13:22:22Z
• Authors: Wasana Prasitsuebsai; Stephen J. Kerr; Khanh Huu Truong; Jintanat Ananwora...; Viet Chau Do; Lam Van Nguyen; Nia Kurniati; Pope Kosalaraksa; Tavitiya Sudjaritruk; Kulkanya Chokepha...; Narukjaporn Thamm...; Thida Singtoroj; Sirinya Teeraanan...; Howard Horng; Peter Bacchetti; Monica Gandhi; Annette H. Sohn
• Keywords: Lopinavir; Interquartile range; Ritonavir; Lopinavir/ritonavir; Quartile

We conducted a prospective monitoring study to determine whether antiretroviral (ARV) levels in hair of Asian children on second-line protease inhibitor-based ARV therapy (ART) are associated with virologic failure (VF), compared plasma drug and self-reported adherence. HIV-infected ART regimens were enrolled into longitudinal cohort. Traditional adherence measures, plasma, samples collected 24 weeks after enrollment. Hair determined via liquid chromatography/tandem mass spectrometry. Among 149 lopinavir/ritonavir-based regimens, 47% female; the median [interquartile range (IQR)] age was 10.3 (7.9-13.3) years. The CD4% 26% (IQR 21.7-32.1%) CD4 cell count 754 596-1,013) cells/mm(3). duration lopinavir-based prior week 2.9 1.6-4.2) Adherence >95% 91% (135/148) by visual analogue scale 89% (129/145) pill count. lopinavir concentrations 5.43 3.21-9.01) ng/mg HIV RNA >1,000 copies/ml 9.96 6.51-12.31) <1,000 (p = 0.003). Plasma trough not statistically significantly correlated (Pearson's correlation coefficient 0.20; p 0.13). Increasing quartiles strongly success (odds ratios ≥4.0, overall 0.02), while adherence, count, not. Based this first report outcomes children, concentrations, representing longer-term may be useful identify at risk for VF.