title: Short communication: A low-cost method for analyzing nevirapine levels in hair as a marker of adherence in resource-limited settings.
abstract: The measurement of antiretroviral concentrations in hair is emerging as an important technology to objectively quantify adherence to combination antiretroviral therapy. Hair levels of antiretrovirals are the strongest independent predictor of virologic success in large prospective cohorts of HIV-infected patients and surpass self-report in predicting outcomes. Hair is easy to collect and store, but validated methods to analyze antiretroviral levels in hair using liquid chromatography tandem mass spectrometry (LC-MS/MS) are expensive. We report here on the development of a thin-layer chromatography (TLC) assay for the semiquantitative analysis of nevirapine in hair. TLC assay results from 11 samples were consistent with results using LC-MS/MS [Spearman correlation coefficient 0.99 (95% CI 0.95-0.996)]. This simple, low-cost method of analyzing nevirapine concentrations in hair may provide a novel monitoring tool for antiretroviral adherence in resource-limited settings and merits further study in clinical settings.
authors.affiliation: 1 Division of HIV/AIDS, Department of Medicine, University of California , San Francisco, San Francisco, California.
authors.forename: Monica
authors.initials: M
authors.lastname: Gandhi
authors.forename: Qiyun
authors.initials: Q
authors.lastname: Yang
authors.forename: Peter
authors.initials: P
authors.lastname: Bacchetti
authors.forename: Yong
authors.initials: Y
authors.lastname: Huang
mesh_terms: D019380:Anti-HIV Agents / Q000032:analysis*; D002855:Chromatography, Thin Layer / Q000379:methods*; D015658:HIV Infections / Q000188:drug therapy; D006197:Hair / Q000737:chemistry; D006801:Humans; D019829:Nevirapine / Q000032:analysis*; D011446:Prospective Studies; D018894:Reverse Transcriptase Inhibitors / Q000032:analysis; D016896:Treatment Outcome; D016903:Drug Monitoring
chemical_list: D019380:Anti-HIV Agents; D018894:Reverse Transcriptase Inhibitors; D019829:Nevirapine