*Division of HIV/AIDS, Department of Medicine, University of California, San Francisco, San Francisco, CA; †Mfangano Island Research Group, Organic Health Response, Homa Bay County, Kenya; ‡Microclinic International (MCI), San Francisco, CA; §Department of Surgery, UCSF East Bay, Oakland, CA; ‖Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA; ¶Department of Environmental Science, Policy & Management, University of California, Berkeley, Berkeley, CA; #Center for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya; **Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, San Francisco, CA; and ††Family AIDS Care & Education Services, Kisumu, Kenya.
J Acquir Immune Defic Syndr. 2014 Jul 1;66(3):311-5. doi: 10.1097/QAI.0000000000000154.
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.
抗逆转录病毒的头发水平可以客观地量化随时间推移的药物暴露情况，并预测病毒学反应。我们评估了在肯尼亚农村队列中收集小头发样本的可接受性和可行性。95%的参与者（354/373）捐赠了头发。尽管中位自我报告的依从率为 100%（四分位间距，96%-100%），但头发浓度的广泛范围可能表明自我报告的依从率被高估了，而药物依从性测量的优势更加明显。在女性和老年人中观察到较高的奈韦拉平头发浓度，需要进一步研究以揭示行为因素与药代动力学因素的关系。在资源有限的环境中，头发中的抗逆转录病毒水平可以作为一种低成本的定量药物依从性生物标志物。
