{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T05:08:26Z","timestamp":1777871306943,"version":"3.51.4"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T00:00:00Z","timestamp":1758067200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100005564","name":"Gilead Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005564","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Tenofovir-diphosphate (TFV-DP) in dried blood spots (DBS) is an objective drug concentration measure predictive of future viremia in virally suppressed persons with human immunodeficiency virus (PWH) on TFV-based antiretroviral therapy (ART). Viral load (VL):TFV-DP mismatch (suppressed VL despite low TFV-DP concentrations) may increase future viremia risk. Previously, Black race, male sex, and higher body mass index were associated with lower TFV-DP concentrations among PWH receiving tenofovir disoproxil fumarate. This study assessed mismatch rates in PWH on tenofovir alafenamide (TAF).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>DBS samples were obtained from Multicenter AIDS Cohort Study\/Women's Interagency HIV Study Combined Cohort participants receiving TAF-based ART for \u22653 months. Associations between prespecified covariates and pharmacologic virologic mismatch (plasma VL &amp;lt;200\u2005copies\/mL and intracellular TFV-DP concentrations &amp;lt;1800 fmol\/punches) were evaluated using logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>DBS were measured in 627 PWH (63% female) with a median (IQR) age of 55 (47\u201361) years. TFV-DP for VLs &amp;lt;200\u2005copies\/mL and \u2265200\u2005copies\/mL was 2375 (1493\u20133340) and 264 (13\u2013949) fmol\/punches, respectively. Females experienced 39% mismatch. Higher estimated glomerular filtration rate (eGFR; +15\u2005mL\/min\/1.73\u2005m2), weight (+15\u2005kg), and lower self-reported adherence (&amp;lt;95%) were associated with higher mismatch odds: 1.77 (1.40\u20132.28), 1.32 (1.11\u20131.57), and 5.12 (2.16\u201312.90), respectively. Males experienced 27% mismatch. Higher eGFR, weight, Black race, and lower adherence were associated with higher mismatch odds: 1.75 (1.22\u20132.62), 1.66 (1.19\u20132.39), 7.53 (2.87\u201322.28), and 9.61 (2.17\u201351.95), respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Weight, eGFR, self-reported adherence, and Black race in males were associated with mismatch. These characteristics should be considered when designing adherence interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciaf509","type":"journal-article","created":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T11:38:09Z","timestamp":1758022689000},"page":"575-582","source":"Crossref","is-referenced-by-count":0,"title":["In the Mismatch: Viral Suppression Despite Low Tenofovir-Diphosphate in Dried Blood Spots in the Multicenter AIDS Cohort Study\/Women's Interagency HIV Study Combined Cohort"],"prefix":"10.1093","volume":"82","author":[{"given":"Sarah C","family":"Mann","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, University of Colorado Anschutz Medical Campus , Aurora, Colorado ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Lykins","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Informatics, Colorado School of 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