Food Insecurity Is Associated With Low Tenofovir Diphosphate in Dried Blood Spots in South African Persons With HIV.
adherence
antiretroviral therapy
dried blood spots
food insecurity
tenofovir diphosphate
Journal
Open forum infectious diseases
ISSN: 2328-8957
Titre abrégé: Open Forum Infect Dis
Pays: United States
ID NLM: 101637045
Informations de publication
Date de publication:
Jul 2023
Jul 2023
Historique:
received:
24
04
2023
medline:
20
7
2023
pubmed:
20
7
2023
entrez:
20
7
2023
Statut:
epublish
Résumé
Food insecurity has been linked to suboptimal antiretroviral therapy (ART) adherence in persons with HIV (PWH). This association has not been evaluated using tenofovir diphosphate (TFV-DP) in dried blood spots (DBSs), a biomarker of cumulative ART adherence and exposure. Within a prospective South African cohort of treatment-naive PWH initiating ART, a subset of participants with measured TFV-DP in DBS values was assessed for food insecurity status. Bivariate and multivariate median-based regression analysis compared the association between food insecurity and TFV-DP concentrations in DBSs adjusting for age, sex, ethnicity, medication possession ratio (MPR), and estimated glomerular filtration rate. Drug concentrations were available for 285 study participants. Overall, 62 (22%) PWH reported worrying about food insecurity and 44 (15%) reported not having enough food to eat in the last month. The crude median concentrations of TFV-DP in DBSs differed significantly between those who expressed food insecurity worry versus those who did not (599 [interquartile range {IQR}, 417-783] fmol/punch vs 716 [IQR, 453-957] fmol/punch; In this study, food insecurity worry is associated with lower TFV-DP concentrations in South African PWH. This highlights the role of food insecurity as a social determinant of HIV outcomes including ART failure and resistance.
Sections du résumé
Background
UNASSIGNED
Food insecurity has been linked to suboptimal antiretroviral therapy (ART) adherence in persons with HIV (PWH). This association has not been evaluated using tenofovir diphosphate (TFV-DP) in dried blood spots (DBSs), a biomarker of cumulative ART adherence and exposure.
Methods
UNASSIGNED
Within a prospective South African cohort of treatment-naive PWH initiating ART, a subset of participants with measured TFV-DP in DBS values was assessed for food insecurity status. Bivariate and multivariate median-based regression analysis compared the association between food insecurity and TFV-DP concentrations in DBSs adjusting for age, sex, ethnicity, medication possession ratio (MPR), and estimated glomerular filtration rate.
Results
UNASSIGNED
Drug concentrations were available for 285 study participants. Overall, 62 (22%) PWH reported worrying about food insecurity and 44 (15%) reported not having enough food to eat in the last month. The crude median concentrations of TFV-DP in DBSs differed significantly between those who expressed food insecurity worry versus those who did not (599 [interquartile range {IQR}, 417-783] fmol/punch vs 716 [IQR, 453-957] fmol/punch;
Conclusions
UNASSIGNED
In this study, food insecurity worry is associated with lower TFV-DP concentrations in South African PWH. This highlights the role of food insecurity as a social determinant of HIV outcomes including ART failure and resistance.
Identifiants
pubmed: 37469618
doi: 10.1093/ofid/ofad360
pii: ofad360
pmc: PMC10352648
doi:
Types de publication
Journal Article
Langues
eng
Pagination
ofad360Subventions
Organisme : NIAID NIH HHS
ID : P30 AI050409
Pays : United States
Organisme : NIDDK NIH HHS
ID : R01 DK125187
Pays : United States
Informations de copyright
© The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America.
Déclaration de conflit d'intérêts
Potential conflicts of interest. V. C. M. has received investigator-initiated research grants paid to institution and consultation fees from Eli Lilly, Bayer, Gilead Sciences, and ViiV, outside the current work. All other authors report no potential conflicts.
Références
Clin Infect Dis. 2022 Sep 14;75(5):761-767
pubmed: 34979553
AIDS Res Hum Retroviruses. 2013 Feb;29(2):384-90
pubmed: 22935078
Afr J AIDS Res. 2019 Sep;18(3):198-204
pubmed: 31575338
J Health Popul Nutr. 2013 Jun;31(2):150-70
pubmed: 23930333
Infect Disord Drug Targets. 2011 Apr;11(2):167-74
pubmed: 21406048
BMC Public Health. 2014 Oct 04;14:1035
pubmed: 25280535
J Int AIDS Soc. 2021 Dec;24(12):e25849
pubmed: 34910844
Clin Infect Dis. 2019 Apr 8;68(8):1335-1342
pubmed: 30137238
J Antimicrob Chemother. 2020 Jun 1;75(6):1591-1598
pubmed: 32211787
J Manag Care Spec Pharm. 2019 Oct;25(10):1073-1077
pubmed: 31556829
Soc Sci Med. 2016 Dec;170:228-236
pubmed: 27771206
AIDS. 2014 Jan 2;28(1):59-66
pubmed: 24275255
AIDS Patient Care STDS. 2020 Oct;34(10):425-435
pubmed: 32941054
Clin Infect Dis. 2020 Sep 12;71(6):1517-1523
pubmed: 31608363
J Pharm Biomed Anal. 2016 Apr 15;122:16-20
pubmed: 26829517
J Int Assoc Physicians AIDS Care (Chic). 2008 Mar-Apr;7(2):74-81
pubmed: 18319510
Clin Pharmacokinet. 2004;43(9):595-612
pubmed: 15217303
BMC Infect Dis. 2020 Nov 11;20(1):836
pubmed: 33176715
Antimicrob Agents Chemother. 2017 Dec 21;62(1):
pubmed: 29038282
BMJ Glob Health. 2016 Dec 30;1(4):e000125
pubmed: 28588979
N Engl J Med. 2021 Nov 4;385(19):1737-1749
pubmed: 34554658
HIV Med. 2022 Aug;23(7):727-737
pubmed: 35023287
J Int AIDS Soc. 2017 Mar 3;20(1):21218
pubmed: 28362063
J AIDS Clin Res. 2012;3(7):171
pubmed: 23227443
AIDS. 2022 Jun 1;36(7):933-940
pubmed: 35131960
AIDS Behav. 2014 Oct;18 Suppl 5:S505-15
pubmed: 23842717
Open Forum Infect Dis. 2020 Aug 29;7(10):ofaa391
pubmed: 33072812
AIDS. 2010 Jun 1;24(9):1273-80
pubmed: 20453627
Am J Clin Nutr. 2011 Dec;94(6):1729S-1739S
pubmed: 22089434
New Voices Psychol. 2016;12(2):2-20
pubmed: 29937923
AIDS Behav. 2011 Oct;15(7):1483-9
pubmed: 20714923
PLoS One. 2010 Apr 28;5(4):e10340
pubmed: 20442769
AIDS. 2017 Mar 27;31(6):815-825
pubmed: 28107221
Psychol Med. 2002 Aug;32(6):959-76
pubmed: 12214795