Lamivudine Concentration in Hair and Prediction of Virologic Failure and Drug Resistance among HIV Patients Receiving Free ART in China.
The assessment of adherence to antiretroviral therapy (ART) is important in order to predict treatment outcomes. Lamivudine (3TC) is one of the most widely used NRTIs in China, but its concentrations in hair and association with virologic failure and drug resistance have not been studied.



We conducted a cross-sectional survey to investigate 3TC concentrations in hair as a predictor of virologic failure and drug resistance among HIV patients receiving free ART. We also compared the capacity of hair 3TC concentrations with self-reported adherence in predicting virologic responses. Hair 3TC concentrations were detected through the LC-MS/MS system.



In patients without HIV drug resistance (HIVDR), with a threshold hair 3TC concentration of 260 ng/g, the sensitivity and specificity in predicting virologic suppression were 76.9% and 89.9%, respectively. Some factors, including CD4+ cell counts, initial treatment regimens with 3TC, and current regimens with second-line drugs, influenced the association between hair 3TC concentrations and virologic suppression. In patients who experienced virologic failure with HIVDR, with a threshold of 180 ng/g, the sensitivity and specificity were 70.0% and 74.4%, respectively. Hair 3TC concentrations had higher sensitivity and specificity in predicting virologic failure and drug resistance than self-reported adherence.



The hair 3TC concentration was a stronger indicator than self-reported adherence in predicting virologic failure and drug resistance in HIV patients receiving free ART.
State Key Laboratory of Infectious Disease Prevention and Control (SKLID), National Center for AIDS/STD Control (NCAIDS) and Prevention, Chinese Center for Disease Control and Prevention (China CDC), Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing, China.
Jing
J
Yan
Henan Center for Disease Control and Prevention, Zhenzhou, Henan Province, China.
Jia
J
Liu
Anhui Center for Disease Control and Prevention, Hefei, Anhui Province, China.
Bin
B
Su
Zhejiang Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, China.
Xiaohong
X
Pan
Henan Center for Disease Control and Prevention, Zhenzhou, Henan Province, China.
Zhe
Z
Wang
Anhui Center for Disease Control and Prevention, Hefei, Anhui Province, China.
Jianjun
J
Wu
Zhejiang Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, China.
Jiafeng
J
Zhang
State Key Laboratory of Infectious Disease Prevention and Control (SKLID), National Center for AIDS/STD Control (NCAIDS) and Prevention, Chinese Center for Disease Control and Prevention (China CDC), Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing, China.
Yuhua
Y
Ruan
State Key Laboratory of Infectious Disease Prevention and Control (SKLID), National Center for AIDS/STD Control (NCAIDS) and Prevention, Chinese Center for Disease Control and Prevention (China CDC), Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing, China.
Jenny
J
Hsi
State Key Laboratory of Infectious Disease Prevention and Control (SKLID), National Center for AIDS/STD Control (NCAIDS) and Prevention, Chinese Center for Disease Control and Prevention (China CDC), Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing, China.
Lingjie
L
Liao
State Key Laboratory of Infectious Disease Prevention and Control (SKLID), National Center for AIDS/STD Control (NCAIDS) and Prevention, Chinese Center for Disease Control and Prevention (China CDC), Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing, China.
Yiming
Y
Shao
State Key Laboratory of Infectious Disease Prevention and Control (SKLID), National Center for AIDS/STD Control (NCAIDS) and Prevention, Chinese Center for Disease Control and Prevention (China CDC), Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing, China.
Hui
H
Xing
D000328:Adult; D019380:Anti-HIV Agents / Q000032:analysis* / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D015415:Biomarkers / Q000032:analysis; D018791:CD4 Lymphocyte Count; D002681:China; D002853:Chromatography, Liquid; D003430:Cross-Sectional Studies; D016903:Drug Monitoring / Q000379:methods*; D024882:Drug Resistance, Viral / Q000502:physiology*; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000821:virology; D015497:HIV-1 / Q000187:drug effects / Q000502:physiology; D006197:Hair / Q000737:chemistry*; D006801:Humans; D019259:Lamivudine / Q000032:analysis* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D053719:Tandem Mass Spectrometry; D017211:Treatment Failure; D019562:Viral Load / Q000502:physiology
D019380:Anti-HIV Agents; D015415:Biomarkers; D019259:Lamivudine