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Antiretroviral concentrations in small hair samples as a feasible marker of adherence in rural Kenya

Hickey, M.D.; Salmen, C.R.; Tessler, R.A.; Omollo, D.; Bacchetti, P.; Magerenge, R.; Mattah, B.; Salmen, M.R.; Zoughbie, D.; Fiorella, K.J.; Geng, E.; Njoroge, B.; Jin, C.; Huang, Y.; Bukusi, E.A.; Cohen, C.R.; Gandhi, M.

Journal of Acquired Immune Deficiency Syndromes 66(3): 311-315

2014

ISSN/ISBN: 1944-7884
PMID: 24694932
DOI: 10.1097/qai.0000000000000154
Document Number: 625233
Antiretroviral hair levels objectively quantify drug exposure over time and predict virologic responses. We assessed the acceptability and feasibility of collecting small hair samples in a rural Kenyan cohort. Ninety-five percentage of participants (354/373) donated hair. Although median self-reported adherence was 100% (interquartile range, 96%-100%), a wide range of hair concentrations likely indicates overestimation of self-reported adherence and the advantages of a pharmacologic adherence measure. Higher nevirapine hair concentrations observed in women and older adults require further study to unravel behavioral versus pharmacokinetic contributors. In resource-limited settings, hair antiretroviral levels may serve as a low-cost quantitative biomarker of adherence.

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