Drug concentrations in hair and dried blood spots as PrEP adherence metrics during pregnancy and postpartum

Linxuan Wu; John Kinuthia; Peter L Anderson; Jared M Baeten; Julia C Dettinger; Monica Gandhi; Laurén Gomez; Grace John-Stewart; Mary M Marwa; Nancy Ngumbau; Felix Otieno; Pascal Omondi; Ben Odhiambo; Salphine Watoyi; Jillian Pintye

doi:10.1093/infdis/jiae208

Drug concentrations in hair and dried blood spots as PrEP adherence metrics during pregnancy and postpartum

J Infect Dis. 2024 May 3:jiae208. doi: 10.1093/infdis/jiae208. Online ahead of print.

Authors

Linxuan Wu^{1

2}, John Kinuthia^{2

3}, Peter L Anderson⁴, Jared M Baeten^{1

2

5}, Julia C Dettinger², Monica Gandhi⁶, Laurén Gomez^{1

2}, Grace John-Stewart^{1

2

7

5}, Mary M Marwa³, Nancy Ngumbau³, Felix Otieno³, Pascal Omondi³, Ben Odhiambo³, Salphine Watoyi³, Jillian Pintye^{2

8}

Affiliations

¹ Department of Epidemiology, University of Washington, Seattle, WA, USA.
² Department of Global Health, University of Washington, Seattle, WA, USA.
³ Department of Research & Programs, Kenyatta National Hospital, Nairobi, Kenya.
⁴ Department of Pharmaceutical Sciences Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Aurora, CO, USA.
⁵ Department of Medicine, University of Washington, Seattle, USA.
⁶ Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, CA, USA.
⁷ Department of Pediatrics, School of Medicine, University of Washington, Seattle, USA.
⁸ Department of Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle, USA.

PMID: 38700101
DOI: 10.1093/infdis/jiae208

Abstract

We evaluated hair tenofovir (TFV) concentrations as an adherence metric for HIV pre-exposure prophylaxis (PrEP) during pregnancy and postpartum and compared hair levels with tenofovir-diphosphate (TFV-DP) levels in dried blood spots (DBS). 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 known to be living with HIV was associated with higher hair TFV levels (p<0.001). Hair TFV concentrations were strongly correlated with DBS TFV-DP levels (r=0.76, p<0.001), indicating hair as promising cumulative adherence metric for perinatal PrEP assessment.

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

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