scholarly journals Income Inequality Is Associated With Low Cumulative Antiretroviral Adherence in Persons With Human Immunodeficiency Virus

2020 ◽  
Vol 7 (10) ◽  
Author(s):  
Frances Vernon ◽  
Mary Morrow ◽  
Samantha MaWhinney ◽  
Ryan Coyle ◽  
Stacey Coleman ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Income Inequality ◽  
Gini Coefficient ◽  
Viral Suppression ◽  
Clinical Care ◽  
Dried Blood Spots ◽  
Antiretroviral Adherence ◽  
Blood Spots ◽  
Antiretroviral Drug ◽  
Immunodeficiency Virus

Abstract Background The adherence biomarker tenofovir diphosphate (TFV-DP) in dried blood spots (DBS) is associated with viral suppression and predicts future viremia. However, its association with social determinants of health (SDoH) in people with human immunodeficiency virus (PWH) remains unknown. Methods Dried blood spots for TFV-DP were longitudinally collected from a clinical cohort of PWH receiving tenofovir disoproxil fumarate-based therapy (up to 3 visits over 48 weeks) residing in 5 Colorado counties. To assign SDoH, zip codes at enrollment were matched with SDoH data from AIDSVu (https://aidsvu.org/). The SDoH included household income, percentage living in poverty, education level, and income inequality (quantified using Gini coefficient, where 0 and 1 represent perfect income equality and inequality, respectively). Log-transformed TFV-DP concentrations were analyzed using a mixed-effects model to estimate percentage change (95% confidence interval) in TFV-DP for every significant change in the SDoH and adjusted for relevant covariates including age, gender, race, estimated glomerular filtration rate, body mass index, hematocrit, CD4+ T-cell count, antiretroviral drug class, and 3-month self-reported adherence. Results Data from 430 PWH totaling 950 person-visits were analyzed. In an adjusted analysis, income inequality was inversely associated with TFV-DP in DBS. For every 0.1 increase in the Gini coefficient, TFV-DP concentrations decreased by 9.2% (−0.5 to −17.1; P = .039). This remained significant after adjusting for human immunodeficiency virus viral suppression, where a 0.1 increase in Gini was associated with a decrease of 8.7% (−0.3 to −17.9; P = .042) in TFV-DP. Conclusions Higher income inequality was associated with lower cumulative antiretroviral adherence. These findings support the need for further research on how SDoH impact adherence and clinical care.

scholarly journals Tenofovir Diphosphate in Dried Blood Spots Is Strongly Associated With Viral Suppression in Individuals With Human Immunodeficiency Virus Infections

2018 ◽  
Vol 68 (8) ◽  
pp. 1335-1342 ◽  
Author(s):  
Jose R Castillo-Mancilla ◽  
Mary Morrow ◽  
Ryan P Coyle ◽  
Stacey S Coleman ◽  
Edward M Gardner ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Viral Suppression ◽  
Geometric Mean ◽  
Dried Blood Spots ◽  
Hiv Treatment ◽  
Virologic Suppression ◽  
Blood Spots ◽  
Persons Living With Hiv ◽  
Immunodeficiency Virus ◽  
Tenofovir Diphosphate

Abstract Background Although tenofovir diphosphate (TFV-DP) in dried blood spots (DBS) is a predictor of adherence and pre-exposure prophylaxis efficacy, its utility in human immunodeficiency virus (HIV) treatment remains unknown. Methods DBS for TFV-DP were collected up to 3 times over 48 weeks in persons living with HIV (PLWH) who were receiving TFV disoproxil fumarate (TDF)-based therapy. Log-transformed baseline TFV-DP was compared using t-tests or analyses of variance; generalized estimating equations were used to estimate the adjusted odds ratio (aOR) of viral suppression (<20 copies/mL) based on the TFV-DP concentration at the study visit. Results We analyzed 1199 DBS from 532 participants (76 female; 101 Black, 101 Hispanic). Among the virologically-suppressed participants at baseline (n = 347), TFV-DP was lower in Blacks (geometric mean 1453, 95% confidence interval [CI] 1291–1635) vs Whites (1793, 95% CI 1678–1916; P = .002) and Hispanics (1760, 95% CI 1563–1982; P = .025); in non-boosted (1610, 95% CI 1505–1723) vs. boosted (1888, 95% CI 1749–2037; P = .002) regimens; and in non-nucleoside reverse transcription inhibitor–based (1563, 95% CI 1432–1707) vs. boosted protease inhibitor–based (1890, 95% CI 1704–2095; P = .006) and multiclass-based (1927, 95% CI 1650–2252; P = .022) regimens. The aOR of virologic suppression, after adjusting for age, gender, race, body mass index, estimated glomerular filtration rate, CD4+ T-cell count, antiretroviral drug class and duration of therapy, was 73.5 (95% CI 25.7–210.5; P < .0001) for a TFV-DP concentration ≥1850 fmol/punch compared to <350 fmol/punch. Conclusions TFV-DP in DBS is strongly associated with virologic suppression in PLWH on TDF-based therapy and is associated with certain participant characteristics. Further research is required to evaluate this drug adherence and exposure measure in clinical practice. Clinical Trials Registration NCT02012621.

scholarly journals Stability of Human Immunodeficiency Virus Serological Markers in Samples Collected as HemaSpot and Whatman 903 Dried Blood Spots

2018 ◽  
Vol 56 (10) ◽  
Author(s):  
Mark M. Manak ◽  
Holly R. Hack ◽  
Ashley L. Shutt ◽  
Brook A. Danboise ◽  
Linda L. Jagodzinski ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Western Blot ◽  
Dried Blood Spots ◽  
Early Infection ◽  
Blood Collection ◽  
Signal Recovery ◽  
Sample Collection ◽  
Blood Spots ◽  
Immunodeficiency Virus ◽  
Hiv 1

ABSTRACTDried blood spots (DBS) are frequently used in clinical testing for biosurveillance, infectious disease and confirmatory testing, and clinical trials, particularly for populations in remote areas. The HemaSpot-HF blood collection device (HS) provides an alternative format to the Whatman 903 cards (903) to simplify sample collection and processing. In this study, the performance of the HS was compared to that of the 903 using previously characterized clinical specimens and HIV seroconversion panels known to exhibit markers of early human immunodeficiency virus (HIV) infection. HS and 903 samples were prepared and tested by Bio-Rad GS HIV Combo Ag/Ab enzyme immunoassay (EIA), GS HIV-1/-2 Plus O EIA, GS HIV-1 Western blot, and HIV-1 Geenius assays. Both HS and 903 performed well for up to 6 months at room temperature, but a marked loss of Western blot and low titer antibody signals from early infection samples was observed in samples stored for 180 days at elevated (37 to 45°C) temperatures and high humidity (95%). HemaSpot samples placed in sealed bags with additional desiccant were protected from degradation and showed improved signal recovery relative to that of the 903. HS was easier to use than the 903 and showed higher sensitivity and reproducibility for early infection samples and improved stability.

scholarly journals Dried blood spots as a practical and inexpensive source for human immunodeficiency virus and hepatitis C virus surveillance

2005 ◽  
Vol 100 (4) ◽  
pp. 265-370 ◽  
Author(s):  
Antonio Carlos de Castro Toledo Jr. ◽  
José Nélio Januário ◽  
Renata Maria Silva Rezende ◽  
Arminda Lúcia Siqueira ◽  
Bernardo Freire de Mello ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Dried Blood Spots ◽  
Blood Spots ◽  
Virus Surveillance ◽  
Immunodeficiency Virus

scholarly journals Application of human immunodeficiency virus type 1 BED enzyme immunoassay on dried blood spots in India

2009 ◽  
Vol 58 (3) ◽  
pp. 312-317 ◽  
Author(s):  
Vemu Lakshmi ◽  
Talasila Sudha ◽  
Rakhi Dandona ◽  
Vijay D. Teja ◽  
G. Anil Kumar ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Enzyme Immunoassay ◽  
Incidence Rate ◽  
Dried Blood Spots ◽  
Population Based ◽  
Annual Incidence ◽  
Hiv Incidence ◽  
Blood Spots ◽  
Immunodeficiency Virus ◽  
Hiv 1

Dried blood spots (DBSs) on filter paper are being used increasingly in population-based human immunodeficiency virus (HIV) studies. This study evaluated the application of a BED enzyme immunoassay (EIA) on DBSs to estimate HIV incidence in a population-based study in India. The Calypte HIV-1 BED Incidence EIA was performed on 224 HIV-1-positive DBS samples, after screening 12 617 individuals from a population-based sample in Guntur district in the southern Indian state of Andhra Pradesh. The number of recently infected HIV cases was identified using this BED assay and was used to estimate the annual HIV incidence rate based on calculations and adjustment formulae suggested by the Centers for Disease Control and Prevention (CDC). The updated BED data management software provided by the CDC was used for analyses. Of the 224 HIV-1 antibody-positive DBS samples, 29 (12.95 %) were estimated by the BED HIV-1 assay to have been infected within the past 155 days. After adjusting for age, gender and rural/urban distribution of the population, the annual incidence rate of HIV-1 infection was estimated to be 0.32 % (95 % confidence interval 0.20–0.44 %). This annual incidence was 18.6 % of the HIV prevalence of 1.72 % in this study. Thus, the BED assay revealed a higher incidence of HIV in this study than was expected from the prevalence. Correlation of the BED assay with panel testing and longitudinal incidence data in the Indian population is needed to calibrate it for use in India.

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