Drug Concentrations in Hair and Dried Blood Spots as Preexposure Prophylaxis Adherence Metrics During Pregnancy and Postpartum

J Infect Dis. 2024 Sep 23;230(3):689-695. doi: 10.1093/infdis/jiae208.

Abstract

We evaluated hair tenofovir (TFV) concentrations as an adherence metric for HIV preexposure prophylaxis during pregnancy and postpartum and compared hair levels with TFV-diphosphate levels in dried blood spots (DBSs). Overall 152 hair samples from 102 women and 36 hair-DBS paired samples from 29 women were collected from a subset of women in a cluster-randomized trial. Having a partner with HIV was associated with higher hair TFV levels (P < .001). Hair TFV concentrations were strongly correlated with DBS TFV-diphosphate levels (r = 0.76, P < .001), indicating hair as a promising cumulative adherence metric for perinatal preexposure prophylaxis assessment.

Keywords: HIV; PrEP; hair; postpartum; pregnancy.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adenine / administration & dosage
  • Adenine / analogs & derivatives
  • Adenine / blood
  • Adenine / pharmacokinetics
  • Adenine / therapeutic use
  • Adult
  • Anti-HIV Agents* / administration & dosage
  • Anti-HIV Agents* / blood
  • Anti-HIV Agents* / pharmacokinetics
  • Anti-HIV Agents* / therapeutic use
  • Dried Blood Spot Testing / methods
  • Female
  • HIV Infections* / prevention & control
  • Hair* / chemistry
  • Humans
  • Medication Adherence / statistics & numerical data
  • Organophosphates
  • Postpartum Period*
  • Pre-Exposure Prophylaxis*
  • Pregnancy
  • Pregnancy Complications, Infectious / drug therapy
  • Pregnancy Complications, Infectious / prevention & control
  • Tenofovir* / administration & dosage
  • Tenofovir* / blood
  • Tenofovir* / pharmacokinetics
  • Tenofovir* / therapeutic use
  • Young Adult

Substances

  • Anti-HIV Agents
  • Tenofovir
  • tenofovir diphosphate
  • Adenine
  • Organophosphates