Accès ouvert

Diagnostic accuracy of point-of-care urine tenofovir test, and associations between metrics of tenofovir use and treatment outcomes in a community ART programme

Article scientifique 2026 Autre

Résumé

Abstract Background Urine tenofovir (uTFV) and dried blood spot (DBS) tenofovir diphosphate (TFV-DP) concentrations respectively estimate short- and medium-term adherence to tenofovir disoproxil fumarate (TDF)-based antiretroviral therapy (ART). We evaluated the accuracy of a point-of-care uTFV assay, and associations between uTFV/TFV-DP, and viral load (VL) and retention outcomes within a South African community ART programme. Methods We measured uTFV and DBS TFV-DP concentrations using liquid chromatography-tandem mass spectrometry (LC-MS/MS). We calculated sensitivity and specificity of the point-of-care uTFV assay at the manufacturer-recommended threshold of ≥1,500 ng/mL compared to LC-MS/MS. We assessed associations of the point-of-care uTFV assay, and DBS TFV-DP concentrations with concurrent viraemia, and with retention-in-care by 16 weeks post-enrolment. Results Of 196 adults median age was 44 years, 127 (64.8%) were female, and 191 (97.4%) were receiving TDF. 185 (94.4%) had detectable point-of-care uTFV, which had high sensitivity (99.5%, 95% CI 96.5-100%) and moderate specificity (76.9%, 95% CI 46.0-93.8%) for detecting uTFV ≥1,500 ng/mL. Two participants had concurrent viraemia ≥1,000 copies/mL; of these 50.0% (95% CI 9.4-90.5) had undetectable point-of-care uTFV, and 100% (95% CI 19.7-100) had low TFV-DP <483 fmol/punch. Among participants without viraemia 97.4% (95% CI 93.6-99.0) had detectable uTFV, and 98.1% (95.3-99.6) had high TFV-DP ≥483 fmol/punch. Point-of-care uTFV and DBS TFV-DP were not associated with retention-in-care. Conclusions The point-of-care uTFV assay demonstrated high sensitivity and moderate specificity to detect uTFV. Over 95% of people without viraemia had detectable point-of-care uTFV or high DBS TFV-DP levels respectively, but these were not associated with 16-week retention-in-care.

Citer ce document

Naidu, L., Tlhaku, K., Govender, K., Sookrajh, Y., Moodley, P., Molen, J., Samsunder, N., Lewis, L., Gandhi, M., Drain, P., Butler, C., Hayward, G., Garrett, N., Dorward, J. (2026). Diagnostic accuracy of point-of-care urine tenofovir test, and associations between metrics of tenofovir use and treatment outcomes in a community ART programme. https://doi.org/10.64898/2026.08.13.26360358

Accès au document

Texte intégral en lecture en ligne, réservé aux abonnés SPHAERO et aux membres de l'institution. Se connecter

Voir l'article sur le site de la revue

Auteur(s)

Lisanthini Naidu Kwena Tlhaku Katya Govender Yukteshwar Sookrajh Pravi Moodley Johan van der Molen Natasha Samsunder Lara Lewis Monica Gandhi Paul K. Drain Christopher Butler Gail Hayward Nigel Garrett Jienchi Dorward

Statistiques

Consultations : 1

Téléchargements : 0