The impact of adherence counseling incorporating a point of care urine tenofovir assay on virologic suppression among individuals failing tenofovir-lamivudine-dolutegravir: A pre-post intervention study
Objectives: To examine if point-of-care (POC) urine tenofovir testing-informed counseling could be used to improve virologic suppression (VS) among participants with virologic failure (VF) after ≥1 prior round of enhanced adherence counseling (EAC). Methods: Participants were enrolled from 42 clinic...
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Elsevier
2025-02-01
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| Series: | International Journal of Infectious Diseases |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S120197122400403X |
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| author | Leonard Bikinesi Matthew A. Spinelli Ntombizodwa Nyoni Daniella Mouton Assegid Mengistu Jacques Kamangu Iyaloo Konstantinus Pearl Kalimugogo Gram Mutandi Fekir Negussie Guohong Wang Susie Welty Willi McFarland R. Suzanne Beard Jessica Haberer Suzanne McCluskey Monica Gandhi Steven Y. Hong |
| author_facet | Leonard Bikinesi Matthew A. Spinelli Ntombizodwa Nyoni Daniella Mouton Assegid Mengistu Jacques Kamangu Iyaloo Konstantinus Pearl Kalimugogo Gram Mutandi Fekir Negussie Guohong Wang Susie Welty Willi McFarland R. Suzanne Beard Jessica Haberer Suzanne McCluskey Monica Gandhi Steven Y. Hong |
| author_sort | Leonard Bikinesi |
| collection | DOAJ |
| description | Objectives: To examine if point-of-care (POC) urine tenofovir testing-informed counseling could be used to improve virologic suppression (VS) among participants with virologic failure (VF) after ≥1 prior round of enhanced adherence counseling (EAC). Methods: Participants were enrolled from 42 clinics across Namibia. At each monthly medication pick-up, participants completed the POC urine test and received EAC informed by this testing (EAC+). If VS was not achieved after 3 months of EAC+, up to 3 additional rounds of EAC+ were provided, with resistance testing at month (M)9. Results: Of 310 potentially eligible participants across 42 clinics in Namibia, we enrolled 211 participants with VF (median age 33 years, 61% female); 195 reached M3 defined as receiving EAC+ and follow-up viral load testing; 169 achieved VS within M3 (87%, P < 0.001) and 97% by M9 (181/186) compared to 40% (22/55) prior to the intervention (P < 0.001). Resistance testing was performed in five remaining participants with VF at M9, of whom 1/5 (20%) developed dolutegravir resistance. Conclusion: The urine tenofovir assay when incorporated into adherence counseling has potential to be a cost-effective intervention among participants failing tenofovir-based regimens, increasing VS to 97% in those failing Tenofovir-Lamivudine-Dolutegravir. Encouraging results of this pre-post intervention will be rigorously tested in a randomized trial. |
| format | Article |
| id | doaj-art-2273381398724d92acffd5c1514fde86 |
| institution | Kabale University |
| issn | 1201-9712 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Infectious Diseases |
| spelling | doaj-art-2273381398724d92acffd5c1514fde862025-01-11T06:38:37ZengElsevierInternational Journal of Infectious Diseases1201-97122025-02-01151107328The impact of adherence counseling incorporating a point of care urine tenofovir assay on virologic suppression among individuals failing tenofovir-lamivudine-dolutegravir: A pre-post intervention studyLeonard Bikinesi0Matthew A. Spinelli1Ntombizodwa Nyoni2Daniella Mouton3Assegid Mengistu4Jacques Kamangu5Iyaloo Konstantinus6Pearl Kalimugogo7Gram Mutandi8Fekir Negussie9Guohong Wang10Susie Welty11Willi McFarland12R. Suzanne Beard13Jessica Haberer14Suzanne McCluskey15Monica Gandhi16Steven Y. Hong17Ministry of Health and Social Services, Windhoek, NamibiaDivision of HIV, Infectious Diseases and Global Medicine, University of California San Francisco (UCSF), USAUniversity of California San Francisco Global Programs for Research and Training, Windhoek, Namibia; Corresponding author: Ntombizodwa Nyoni, Number 5 Barnhoff Street, Windhoek 9000, Namibia.Namibia Institute of Pathology Limited, Windhoek, NamibiaMinistry of Health and Social Services, Windhoek, NamibiaMinistry of Health and Social Services, Windhoek, NamibiaNamibia Institute of Pathology Limited, Windhoek, NamibiaCenters for Disease Control and Prevention, Division of Global HIV and Tuberculosis (DGHT), Windhoek, NamibiaCenters for Disease Control and Prevention, Division of Global HIV and Tuberculosis, Atlanta, Georgia, USAUniversity of California San Francisco Global Programs for Research and Training, Windhoek, NamibiaAbbott Toxicology Unit, Abbott Pharmaceuticals, USADepartment of Epidemiology and Biostatistics, UCSF, USADepartment of Epidemiology and Biostatistics, UCSF, USACenters for Disease Control and Prevention, Division of Global HIV and Tuberculosis, Atlanta, Georgia, USAHarvard Medical School and Massachusetts General Hospital, MA, USAHarvard Medical School and Massachusetts General Hospital, MA, USADivision of HIV, Infectious Diseases and Global Medicine, University of California San Francisco (UCSF), USACenters for Disease Control and Prevention, Division of Global HIV and Tuberculosis, Atlanta, Georgia, USAObjectives: To examine if point-of-care (POC) urine tenofovir testing-informed counseling could be used to improve virologic suppression (VS) among participants with virologic failure (VF) after ≥1 prior round of enhanced adherence counseling (EAC). Methods: Participants were enrolled from 42 clinics across Namibia. At each monthly medication pick-up, participants completed the POC urine test and received EAC informed by this testing (EAC+). If VS was not achieved after 3 months of EAC+, up to 3 additional rounds of EAC+ were provided, with resistance testing at month (M)9. Results: Of 310 potentially eligible participants across 42 clinics in Namibia, we enrolled 211 participants with VF (median age 33 years, 61% female); 195 reached M3 defined as receiving EAC+ and follow-up viral load testing; 169 achieved VS within M3 (87%, P < 0.001) and 97% by M9 (181/186) compared to 40% (22/55) prior to the intervention (P < 0.001). Resistance testing was performed in five remaining participants with VF at M9, of whom 1/5 (20%) developed dolutegravir resistance. Conclusion: The urine tenofovir assay when incorporated into adherence counseling has potential to be a cost-effective intervention among participants failing tenofovir-based regimens, increasing VS to 97% in those failing Tenofovir-Lamivudine-Dolutegravir. Encouraging results of this pre-post intervention will be rigorously tested in a randomized trial.http://www.sciencedirect.com/science/article/pii/S120197122400403XTenofovir-Lamivudine-Dolutegravir (TLD)People living with HIVVirologic suppressionUrine tenofovir assayPoint-of-care assayEnhanced adherence counseling |
| spellingShingle | Leonard Bikinesi Matthew A. Spinelli Ntombizodwa Nyoni Daniella Mouton Assegid Mengistu Jacques Kamangu Iyaloo Konstantinus Pearl Kalimugogo Gram Mutandi Fekir Negussie Guohong Wang Susie Welty Willi McFarland R. Suzanne Beard Jessica Haberer Suzanne McCluskey Monica Gandhi Steven Y. Hong The impact of adherence counseling incorporating a point of care urine tenofovir assay on virologic suppression among individuals failing tenofovir-lamivudine-dolutegravir: A pre-post intervention study International Journal of Infectious Diseases Tenofovir-Lamivudine-Dolutegravir (TLD) People living with HIV Virologic suppression Urine tenofovir assay Point-of-care assay Enhanced adherence counseling |
| title | The impact of adherence counseling incorporating a point of care urine tenofovir assay on virologic suppression among individuals failing tenofovir-lamivudine-dolutegravir: A pre-post intervention study |
| title_full | The impact of adherence counseling incorporating a point of care urine tenofovir assay on virologic suppression among individuals failing tenofovir-lamivudine-dolutegravir: A pre-post intervention study |
| title_fullStr | The impact of adherence counseling incorporating a point of care urine tenofovir assay on virologic suppression among individuals failing tenofovir-lamivudine-dolutegravir: A pre-post intervention study |
| title_full_unstemmed | The impact of adherence counseling incorporating a point of care urine tenofovir assay on virologic suppression among individuals failing tenofovir-lamivudine-dolutegravir: A pre-post intervention study |
| title_short | The impact of adherence counseling incorporating a point of care urine tenofovir assay on virologic suppression among individuals failing tenofovir-lamivudine-dolutegravir: A pre-post intervention study |
| title_sort | impact of adherence counseling incorporating a point of care urine tenofovir assay on virologic suppression among individuals failing tenofovir lamivudine dolutegravir a pre post intervention study |
| topic | Tenofovir-Lamivudine-Dolutegravir (TLD) People living with HIV Virologic suppression Urine tenofovir assay Point-of-care assay Enhanced adherence counseling |
| url | http://www.sciencedirect.com/science/article/pii/S120197122400403X |
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