Evaluation of adherence to tenofovir treatment by hiv patients using drug concentrations in urine and standardized questionnaires
DOI:
https://doi.org/10.1590/s2175-97902025e24239Keywords:
Tenofovir, HIV, Adherence, Tenofovir urine concentrationsAbstract
Adherence to tenofovir-based antiretroviral therapy is crucial for treatment success. In this study, we evaluated tenofovir urine concentrations in a cohort of patients that answered standardized adherence questionnaires Morisky-Green and Brief Medication Questionnaire (BMQ). Adherence evaluations were related to the patients’ viral load. Among the 72 patients who completed the questionnaires, 70 provided urine samples, and 88.6% of them had an undetectable viral load. Among the patients who provided urine samples and completed the Morisky-Green questionnaire, 45.7% were categorized as having high adherence, 54.3% as medium adherence, and 2.9% as low adherence. Utilizing a ROC curve (area under the curve of 0.864, CI 95% 0.757-0.971), a tenofovir urinary concentration of 6288.5 ng/mL was established as the cutoff value to predict high adherence according to the BMQ. This cutoff demonstrated a sensitivity of 93% and specificity of 72% in predicting high adherence according to the BMQ, with 73.5% of patients enrolled in the study categorized as having high adherence. When comparing adherence levels determined by the BMQ and urinary concentration, a moderate kappa index was observed (0.677, p<0.01). The results suggest that urine tenofovir concentration measurement as a feasible and efficient strategy to monitor adherence during HIV treatment with this drug.
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Universidade Feevale
Grant numbers Approval #5,448,391
