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19.05.2020 | Behavioral-Bio-Medical Interface (RJ DiClemente and JL Brown, Section Editors)

Approaches to Objectively Measure Antiretroviral Medication Adherence and Drive Adherence Interventions

verfasst von: Matthew A. Spinelli, Jessica E. Haberer, Peter R. Chai, Jose Castillo-Mancilla, Peter L. Anderson, Monica Gandhi

Erschienen in: Current HIV/AIDS Reports | Ausgabe 4/2020

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Abstract

Purpose of Review

Traditional methods to assess antiretroviral adherence, such as self-report, pill counts, and pharmacy refill data, may be inaccurate in determining actual pill-taking to both antiretroviral therapy (ART) or pre-exposure prophylaxis (PrEP). HIV viral loads serve as surrogates of adherence on ART, but loss of virologic control may occur well after decreases in adherence and viral loads are not relevant to PrEP.

Recent Findings

Pharmacologic measures of adherence, electronic adherence monitors, and ingestible electronic pills all serve as more objective metrics of adherence, surpassing self-report in predicting outcomes. Pharmacologic metrics can identify either recent adherence or cumulative adherence. Recent dosing measures include antiretroviral levels in plasma or urine, as well as emtricitabine-triphosphate in dried blood spots (DBS) for those on tenofovir-emtricitabine-based therapy. A urine tenofovir test has recently been developed into a point-of-care test for bedside adherence monitoring. Cumulative adherence metrics assess adherence over weeks to months and include measurement of tenofovir-diphosphate in peripheral blood mononuclear cells or DBS, as well as ART levels in hair. Electronic adherence monitors and ingestible electronic pills can track pill bottle openings or medication ingestion, respectively.

Summary

New and objective approaches in adherence monitoring can be used to detect nonadherence prior to loss of prevention efficacy or virologic control with PrEP or ART, respectively.

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Titel: Approaches to Objectively Measure Antiretroviral Medication Adherence and Drive Adherence Interventions
verfasst von: Matthew A. Spinelli
Jessica E. Haberer
Peter R. Chai
Jose Castillo-Mancilla
Peter L. Anderson
Monica Gandhi
Publikationsdatum: 19.05.2020
Verlag: Springer US
Erschienen in: Current HIV/AIDS Reports / Ausgabe 4/2020
Print ISSN: 1548-3568
Elektronische ISSN: 1548-3576
DOI: https://doi.org/10.1007/s11904-020-00502-5

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Approaches to Objectively Measure Antiretroviral Medication Adherence and Drive Adherence Interventions

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