Association of Hair Concentrations of Antiretrovirals with Virologic Outcomes Among People Living with HIV in Guangxi, China

Figures & data

Table 1 Sociodemographic and HIV-Related Characteristics of Participants

Characteristics	Total n=215 (100%)	Virologic Suppression n=197 (91.6%)	Virologic Failure n=18 (8.4%)	p-value
Age, years	43.13 ± 8.31	43.44 ± 11.71	43.10 ±7.97	0.865
Gender
Male	147 (68.4%)	137 (69.5%)	10 (55.6%)	0.222
Female	68 (31.6%)	60 (30.5%)	8 (44.4%)
Ethnicity
Han	122 (56.7%)	113 (57.4%)	9 (50.0%)	0.546
No-Han	93 (44.3%)	84 (42.6%)	9 (50.0%)
Marital status
Married	169 (78.6%)	157(79.7%)	12 (66.7%)	0.197
Others	46 (21.4%)	40 (20.3%)	6 (33.3%)
Education levels
> 9 years	18 (8.4%)	18 (9.1%)	0 (0%)	0.180
≤ 9 years	197 (91.6%)	179 (90.9%)	18 (100%)
Employment status
Employed	186 (86.5%)	172 (87.3%)	14 (77.8%)	0.257
Unemployed	29 (13.5%)	25 (12.7%)	4 (22.2)
Monthly income levels
≥2000 Chinese Yuan	99 (46.0%)	92 (46.7%)	7 (38.9%)	0.524
<2000 Chinese Yuan	116 (54.0%)	105 (53.3%)	11 (61.6%)
Years of HIV diagnosis, years	2.8 (2.3–3.4)	2.8 (2.3–3.4)	2.5 (1.9–3.3)	0.228
Current cART status
First-line cART	185 (86.0%)	173 (87.8%)	12 (66.7%)	0.013
Second-line cART	30 (14.0%)	24 (12.2%)	6 (33.3%)
Years of current cART, years	2.7 (2.3–3.4)	2.8 (2.3–3.4)	2.5 (1.9–3.2)	0.249
CD4 count-, cells/mm^Citation3
< 350	102(47.4%)	88 (44.7%)	14 (77.8%)	0.007
≥ 350	113(52.6%)	109 (55.3%)	4 (22.4%)
Self-reported adherence
100%	181 (84.2%)	167 (93.2%)	14 (77.8%)	0.436
Less than 100%	34 (15.8%)	30 (15.2%)	4 (22.2%)

Abbreviation: cART, combination antiretroviral therapy.

Table 2 Correlation Between Hair Concentrations of Antiretrovirals and Sociodemographic and Other Clinical Characteristics

Characteristics	3TC Concentrations N=215		AZT Concentrations N=67		EFV Concentrations N=163
	r	p-value	r	p-value	r	p-value
Age	0.100	0.142	0.026	0.836	0.005	0.947
Gender	0.114	0.097	0.188	0.127	0.127	0.107
Ethnicity	−0.034	0.662	0.123	0.321	0.083	0.293
Marital status	−0.050	0.468	0.022	0.863	−0.089	0.259
Education levels	0.120	0.080	0.043	0.730	−0.023	0.770
Employment status	−0.170	0.013	−0.130	0.294	−0.028	0.724
Monthly income levels	0.112	0.102	0.193	0.024	0.031	0.693
Years of HIV diagnosis	0.105	0.125	−0.097	0.435	−0.126	0.108
Current cART satus	0.127	0.063	−0.245	0.045	-	-
Years of current cART	0.114	0.096	−0.097	0.435	−0.090	0.252
Self-reported adherence	0.181	0.008	0.340	0.005	0.149	0.057
CD4 count	−0.016	0.811	0.240	0.097	−0.104	0.186

Abbreviations: cART, combination antiretroviral therapy; 3TC, lamivudine; AZT, zidovudine; EFV, efavirenz.

Table 3 Hair Concentrations of Antiretrovirals by the Virologic Outcome

Antiretrovirals	Virologic Suppression		Virologic Failure		p-value
	n	Median (IQR), pg/mg	n	Median (IQR), pg/mg
3TC	197	476.55 (315.33–695.38)	18	247.42 (36.66–454.67)	0.008
AZT	60	289.48 (166.35–471.21)	7	10.00 (10.00–185.98)	0.016
EFV	153	4814.74 (3472.07–7111.86)	10	3262.33 (53.18–5252.53)	0.030

Abbreviations: IQR, interquartile range; 3TC, lamivudine; AZT, zidovudine; EFV, efavirenz.

Table 4 Logistic Regression Results Predicting Virologic Suppression Based on Hair Concentrations of Antiretrovirals

		Univariate		Multivariate
	n (%)	cORs (95% CI)	p	aORs (95% CI)	p
3TC (n=215)
Lowest tertile	60 (84.5%)	1.00 (ref)	–	1.00(ref)	–
Middle tertile	67 (94.4%)	3.07 (0.93–10.16)	0.066	5.65 (1.21–26.34)	0.028
Highest tertile	70 (95.9%)	4.28 (1.14–16.05)	0.031	16.52 (2.51–108.60)	0.004
AZT (n=67)
Lowest tertile	17 (77.3%)	1.00 (ref)	–
Middle tertile	21 (95.5%)	6.18 (0.66–58.03)	0.111	1.06 (0.02–47.85)	0.976
Highest tertile	22 (95.7%)	6.47 (0.69–60.68)	0.102	1.77 (0.06–56.14)	0.747
EFV (n=163)
Lowest tertile	49 (90.7%)	1.00 (ref)	–
Middle tertile	50 (92.6%)	1.28 (0.32–5.02)	0.728	1.72 (0.34–8.78)	0.511
Highest tertile	54 (98.2%)	5.51 (0.62–48.82)	0.125	14.26 (1.18–172.01)	0.036

Abbreviations: CI, confidence interval; cOR, crude odds ratio; aOR, adjusted odds ratio; 3TC, lamivudine; AZT, zidovudine; EFV, efavirenz.

Robbins RN, Spector AY, Mellins CA, Remien RH. Optimizing ART adherence: update for HIV treatment and prevention. Curr HIV/AIDS Rep. 2014;11(4):423–433. doi:10.1007/s11904-014-0229-5

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