{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T11:08:26Z","timestamp":1788433706283,"version":"build-2803163510"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2022,9,22]],"date-time":"2022-09-22T00:00:00Z","timestamp":1663804800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Dutch AIDS Fund","award":["P-50101"],"award-info":[{"award-number":["P-50101"]}]},{"DOI":"10.13039\/100000200","name":"U.S. Agency for International Development","doi-asserted-by":"crossref","award":["AID-OAA-A-15-00069"],"award-info":[{"award-number":["AID-OAA-A-15-00069"]}],"id":[{"id":"10.13039\/100000200","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Unitaid","award":["2016-07-Wits RHI"],"award-info":[{"award-number":["2016-07-Wits RHI"]}]},{"DOI":"10.13039\/501100001322","name":"South African Medical Research Council","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001322","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100005564","name":"Gilead Sciences","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100005564","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100010877","name":"ViiV Healthcare","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100010877","id-type":"DOI","asserted-by":"crossref"}]},{"name":"OraSure Technologies Inc"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,2,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Viral rebound during antiretroviral treatment (ART) is most often driven by suboptimal adherence in the absence of drug resistance. We assessed the diagnostic performance of point-of-care (POC) tenofovir (TFV) detection in urine for the prediction of viral rebound and drug resistance during ART.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a nested case-control study within the ADVANCE randomized clinical trial (NCT03122262) in Johannesburg, South Africa. Adults with human immunodeficiency virus (HIV) and newly initiating ART were randomized to receive either dolutegravir or efavirenz, tenofovir disoproxil fumarate or alafenamide, and emtricitabine. All participants with rebound \u2265200 copies\/mL between 24 and 96 weeks of follow-up were selected as cases and matched to controls with virological suppression &amp;lt;50 copies\/mL. Rapid POC urine-TFV detection was performed retrospectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We included 281 samples from 198 participants. Urine-TFV was detectable in 30.7% (70\/228) of cases and in 100% (53\/53) of controls. Undetectable urine-TFV predicted rebound with a sensitivity of 69% [95% confidence interval {CI}: 63\u201375] and specificity of 100% [93\u2013100]. In cases with virological failure and sequencing data (n = 42), NRTI drug resistance was detected in 50% (10\/20) of cases with detectable urine-TFV versus in 8.3% (2\/24) of cases with undetectable urine-TFV. Detectable urine-TFV predicted NRTI resistance (odds ratio [OR] 10.4 [1.8\u2013114.4] P = .005) with a sensitivity of 83% [52\u201398] and specificity of 69% [50\u201384].<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>POC objective adherence testing using a urine-TFV test predicted viral rebound with high specificity. In participants with rebound, urine-TFV testing predicted the selection of drug resistance. Objective adherence testing may be used to rapidly provide insight into adherence, suppression, and drug resistance during ART.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciac755","type":"journal-article","created":{"date-parts":[[2022,9,22]],"date-time":"2022-09-22T12:58:45Z","timestamp":1663851525000},"page":"e553-e560","source":"Crossref","is-referenced-by-count":21,"title":["Point-of-Care Tenofovir Urine Testing for the Prediction of Treatment Failure and Drug Resistance During Initial Treatment for Human Immunodeficiency Virus Type 1 (HIV-1) Infection"],"prefix":"10.1093","volume":"76","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8741-5852","authenticated-orcid":false,"given":"Lucas E","family":"Hermans","sequence":"first","affiliation":[{"name":"Infectious Diseases and HIV Medicine, Department of Medicine, University of Cape Town , Cape Town , South Africa"},{"name":"Department of Microbiology, University Medical Center Utrecht , Utrecht , The 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