{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T15:59:41Z","timestamp":1781884781679,"version":"3.54.5"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,6,20]],"date-time":"2025-06-20T00:00:00Z","timestamp":1750377600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"US National Institutes of Health (NIH) and South African Medical Research Council"},{"name":"Collaborative Biomedical Research","award":["R01AI152119"],"award-info":[{"award-number":["R01AI152119"]}]},{"DOI":"10.13039\/100000060","name":"NIAID","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012264","name":"NIH","doi-asserted-by":"publisher","award":["2R01AI143340"],"award-info":[{"award-number":["2R01AI143340"]}],"id":[{"id":"10.13039\/501100012264","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Scalable strategies to detect and address inadequate adherence to antiretroviral therapy (ART) are a high priority towards meeting UNAIDS 95-95-95 targets. A urine tenofovir rapid assay (UTRA) at the point-of-care improves adherence among pre-exposure prophylaxis recipients and virologic suppression (VS) in a pre-post study of people with HIV (PWH). Here, we conducted the first randomized trial of UTRA-enhanced adherence support vs standard of care among PWH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Participants receiving dolutegravir (DTG)\u2013 or protease inhibitor (PI)\u2013based ART were randomized to UTRA-enhanced adherence support (n = 100) vs standard of care (n = 100). The primary outcome was VS, HIV-1 RNA &amp;lt;50\u2005copies\/mL, at 12-months and secondary outcome was VS at 6 months. To explore ART adherence over the preceding 6\u20138 weeks, tenofovir diphosphate (TFV-DP) in dried blood spots (DBS) was quantified. C-reactive protein (CRP) was measured as an inflammatory marker.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>At the 12-month visit, 59\/80 (74%) in the intervention and 48\/75 (64%) in the control arm achieved VS (the same proportion as at 6 months; P = .2); TFV-DP concentrations (median, IQR) in DBS were significantly higher in the intervention arm: 884 (491\u20131296) vs 598 (239\u2013964) fmol\/3-mm DBS punch in the control arm (P &amp;lt; .01). Higher TFV-DP DBS concentrations correlated with a slight decrease in CRP (Spearman's rho = \u22120.19; P = .02).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>UTRA-enhanced adherence support did not result in a significantly higher VS rate but was associated with increased TFV-DP in DBS\u2014in turn, associated with lower CRP levels\u2014suggesting that UTRA-enhanced adherence support improves long-term drug exposure and could also reduce HIV-associated inflammation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trials Registration<\/jats:title>\n                    <jats:p>clinicaltrials.gov (https:\/\/clinicaltrials.gov\/study\/NCT05333679).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciaf337","type":"journal-article","created":{"date-parts":[[2025,6,19]],"date-time":"2025-06-19T08:01:01Z","timestamp":1750320061000},"page":"e352-e359","source":"Crossref","is-referenced-by-count":3,"title":["A Real-Time Urine Tenofovir Assay Improves Drug Adherence Among People With HIV With Prior Virologic Failure in a Randomized Controlled Trial"],"prefix":"10.1093","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3021-5101","authenticated-orcid":false,"given":"Gert U","family":"van Zyl","sequence":"first","affiliation":[{"name":"Division of Medical Virology, Department of Pathology, Stellenbosch University , Cape Town ,","place":["South Africa"]},{"name":"National Health Laboratory Service, Tygerberg , Cape Town ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1815-5150","authenticated-orcid":false,"given":"Eric","family":"Decloedt","sequence":"additional","affiliation":[{"name":"Division of Clinical Pharmacology, Department of Medicine, Stellenbosch University , Cape Town ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4749-2404","authenticated-orcid":false,"given":"Lauren","family":"Jennings","sequence":"additional","affiliation":[{"name":"Desmond Tutu HIV Centre, Institute of Infectious Disease and Molecular Medicine and Department of Medicine, University of Cape Town , Cape Town ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1542-4976","authenticated-orcid":false,"given":"Tracy","family":"Kellermann","sequence":"additional","affiliation":[{"name":"Division of Clinical Pharmacology, Department of Medicine, Stellenbosch University , Cape Town ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9003-851X","authenticated-orcid":false,"given":"Khethiwe","family":"Motha","sequence":"additional","affiliation":[{"name":"Division of Clinical Pharmacology, Department of Medicine, Stellenbosch University , Cape Town ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2679-901X","authenticated-orcid":false,"given":"Marije","family":"van Schalkwyk","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Stellenbosch University , Cape Town ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9456-3996","authenticated-orcid":false,"given":"Chantel","family":"Schreuder","sequence":"additional","affiliation":[{"name":"Desmond Tutu HIV Centre, Institute of Infectious Disease and Molecular Medicine and Department of Medicine, University of Cape Town , Cape Town ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-5039-3083","authenticated-orcid":false,"given":"Nicola","family":"Coetzee","sequence":"additional","affiliation":[{"name":"Division of Medical Virology, Department of Pathology, Stellenbosch University , Cape Town ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5888-1419","authenticated-orcid":false,"given":"David V","family":"Glidden","sequence":"additional","affiliation":[{"name":"Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, UCSF\/San Francisco General Hospital , San Francisco, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1134-7475","authenticated-orcid":false,"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 , Cape Town ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6674-5388","authenticated-orcid":false,"given":"Monica","family":"Gandhi","sequence":"additional","affiliation":[{"name":"Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, UCSF\/San Francisco General Hospital , San Francisco, California 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