{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T19:21:28Z","timestamp":1788463288431,"version":"build-2803163510"},"reference-count":43,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2022,6,1]],"date-time":"2022-06-01T00:00:00Z","timestamp":1654041600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["AIDS Research and Human Retroviruses"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:p>\n                    The high cost of viral load (VL) testing limits its use for antiretroviral therapy (ART) adherence support. A low-cost lateral flow urine tenofovir (TFV) rapid assay predicts pre-exposure prophylaxis breakthroughs, but has not yet been investigated in HIV treatment. We therefore evaluated its utility in a pilot cross-sectional study of TFV-containing ART recipients at an increased risk of virologic failure (VF). Participants who had a treatment interruption \u226530 days or had \u22651 episode of viremia (VL \u2265400 copies\/mL) in the previous year were recruited from a public health setting in Cape Town, South Africa. Self-reported adherence data were collected, the urine TFV assay performed, and concurrent TFV-diphosphate analyzed in dried blood spots. VL testing was done concurrently and, if viremic, genotypic HIV drug resistance testing was performed. Of 48 participants, 18 (37.5%) had VL (&gt;400 copies\/mL) at the time of the study, including 16 of 39 receiving efavirenz (EFV), 2 of 6 receiving protease inhibitors, and 0 of 3 receiving dolutegravir. Resistance testing succeeded in 17\/18, of which 14 had significant mutations compromising \u22652 agents of the current EFV-based regimen. Of these 14, all had detected urine TFV. Urine TFV was undetectable in two out of three without regimen-relevant resistance;\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u2009.02. In participants on EFV-based regimens returning to care, VF was largely due to viral resistance, where detectable urine TFV had 100% sensitivity (14\/14 participants) in predicting resistance. Conversely, when undetectable, the urine-based assay could be used to preclude participants with poor adherence from undergoing costly HIV drug resistance testing.\n                  <\/jats:p>","DOI":"10.1089\/aid.2021.0135","type":"journal-article","created":{"date-parts":[[2021,11,13]],"date-time":"2021-11-13T10:21:58Z","timestamp":1636798918000},"page":"455-462","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":24,"title":["Drug Resistance, Rather than Low Tenofovir Levels in Blood or Urine, Is Associated with Tenofovir, Emtricitabine, and Efavirenz Failure in Resource-Limited Settings"],"prefix":"10.1177","volume":"38","author":[{"given":"Lauren","family":"Jennings","sequence":"first","affiliation":[{"name":"Desmond Tutu HIV Centre, Institute of Infectious Disease and Molecular Medicine and Department of Medicine, University of Cape Town, South Africa."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracy","family":"Kellermann","sequence":"additional","affiliation":[{"name":"Division of Clinical Pharmacology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6368-8664","authenticated-orcid":false,"given":"Matthew","family":"Spinelli","sequence":"additional","affiliation":[{"name":"Division of HIV, Infectious Diseases, and Global Medicine at UCSF\/San Francisco General Hospital, San Francisco, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zukiswa","family":"Nkantsu","sequence":"additional","affiliation":[{"name":"Desmond Tutu HIV Centre, Institute of Infectious Disease and Molecular Medicine and Department of Medicine, University of Cape Town, South Africa."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dolphina","family":"Cogill","sequence":"additional","affiliation":[{"name":"Desmond Tutu HIV Centre, Institute of Infectious Disease and Molecular Medicine and Department of Medicine, University of Cape Town, South Africa."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marije","family":"van Schalkwyk","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Stellenbosch University, Cape Town, South Africa."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Decloedt","sequence":"additional","affiliation":[{"name":"Division of Clinical Pharmacology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gert","family":"van Zyl","sequence":"additional","affiliation":[{"name":"Division of Medical Virology, Stellenbosch University, Faculty of Medicine and Health Sciences, Cape Town, South Africa."},{"name":"National Health Laboratory Service, Tygerberg Business Unit, Cape Town, South Africa."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Orrell","sequence":"additional","affiliation":[{"name":"Desmond Tutu HIV Centre, Institute of Infectious Disease and Molecular Medicine and Department of Medicine, University of Cape Town, South Africa."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7025-1994","authenticated-orcid":false,"given":"Monica","family":"Gandhi","sequence":"additional","affiliation":[{"name":"Division of HIV, Infectious Diseases, and Global Medicine at UCSF\/San Francisco General Hospital, San Francisco, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,6,6]]},"reference":[{"key":"e_1_3_7_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1507198"},{"key":"e_1_3_7_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1506816"},{"key":"e_1_3_7_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.25297"},{"key":"e_1_3_7_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)30418-0"},{"key":"e_1_3_7_6_2","unstructured":"World Health Organization: Consolidated Guidelines on the Use of Antiretroviral Drugs for Treating and Preventing HIV Infection: Recommendations for a Public Health Approach 2nd Ed. 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