{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T05:20:17Z","timestamp":1792819217362,"version":"4.5.0"},"reference-count":25,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2023,9,21]],"date-time":"2023-09-21T00:00:00Z","timestamp":1695254400000},"content-version":"vor","delay-in-days":20,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100023234","name":"Oxford Health NHS Foundation Trust","doi-asserted-by":"publisher","award":["MIC\u20102016\u2010018"],"award-info":[{"award-number":["MIC\u20102016\u2010018"]}],"id":[{"id":"10.13039\/501100023234","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc."],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Novel point\u2010of\u2010care assays which measure urine tenofovir (TFV) concentrations may have a role in improving adherence monitoring for people living with HIV (PLHIV) receiving antiretroviral therapy (ART). However, further studies of their diagnostic accuracy, and whether results are associated with viraemia and drug resistance, are needed to guide their use, particularly in the context of the global dolutegravir rollout.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a cross\u2010sectional evaluation among PLHIV receiving first\u2010line ART containing tenofovir disoproxil fumarate at enrolment into a randomized trial in two South African public sector clinics. We calculated the diagnostic accuracy of the Abbott point\u2010of\u2010care immunoassay to detect urine TFV compared to liquid chromatography\u2010tandem mass spectrometry (LC\u2010MS\/MS). We evaluated the association between point\u2010of\u2010care urine TFV results and self\u2010reported adherence, viraemia \u22651000 copies\/ml and HIV drug resistance, among people receiving either efavirenz or dolutegravir\u2010based ART.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Between August 2020 and March 2022, we enrolled 124 participants. The median age was 39 (IQR 34\u201345) years, 55% were women, 74 (59.7%) were receiving efavirenz and 50 (40.3%) dolutegravir. The sensitivity and specificity of the immunoassay to detect urine TFV \u22651500 ng\/ml compared to LC\u2010MS\/MS were 96.1% (95% CI 90.0\u221298.8) and 95.2% (75.3\u2212100.0), respectively. Urine TFV results were associated with short (\n                      <jats:italic>p<\/jats:italic>\n                      &lt;0.001) and medium\u2010term (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.036) self\u2010reported adherence. Overall, 44\/124 (35.5%) had viraemia, which was associated with undetectable TFV in those receiving efavirenz (OR 6.01, 1.27\u221239.0,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.014) and dolutegravir (OR 25.7, 4.20\u2212294.8,\n                      <jats:italic>p<\/jats:italic>\n                      &lt;0.001). However, in those with viraemia while receiving efavirenz, 8\/27 (29.6%) had undetectable urine TFV, compared to 11\/17 (64.7%) of those receiving dolutegravir. Drug resistance was detected in 23\/27 (85.2%) of those receiving efavirenz and only 1\/16 (6.3%) of those receiving dolutegravir. There was no association between urine TFV results and drug resistance.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Among PLHIV receiving ART, a rapid urine TFV immunoassay can be used to accurately monitor urine TFV levels compared to the gold standard of LC\u2010MS\/MS. Undetectable point\u2010of\u2010care urine TFV results were associated with viraemia, particularly among people receiving dolutegravir.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>Pan\u2010African Clinical Trials Registry: PACTR202001785886049.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jia2.26172","type":"journal-article","created":{"date-parts":[[2023,9,22]],"date-time":"2023-09-22T01:05:03Z","timestamp":1695344703000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Diagnostic accuracy of a point\u2010of\u2010care urine tenofovir assay, and associations with HIV viraemia and drug resistance among people receiving dolutegravir and efavirenz\u2010based antiretroviral therapy"],"prefix":"10.1002","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6072-1430","authenticated-orcid":false,"given":"Jienchi","family":"Dorward","sequence":"first","affiliation":[{"name":"Nuffield Department of Primary Care Health Sciences University of Oxford  Oxford UK"},{"name":"Centre for the AIDS Programme of Research in South Africa (CAPRISA) University of KwaZulu\u2013Natal  Durban South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Lessells","sequence":"additional","affiliation":[{"name":"Centre for the AIDS Programme of Research in South Africa (CAPRISA) University of KwaZulu\u2013Natal  Durban South Africa"},{"name":"KwaZulu\u2010Natal Research and Innovation Sequencing Platform (KRISP) University of KwaZulu\u2010Natal  Durban South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katya","family":"Govender","sequence":"additional","affiliation":[{"name":"Africa Health Research 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