Biomarker-confirmed suboptimal adherence to isoniazid preventive therapy among children with HIV in western Kenya
In: AIDS, Jg. 38 (2023), Heft 1, S. 39-47
academicJournal
Zugriff:
Objectives: The aim of this study was to assess the level and correlates of biomarker-confirmed adherence to isoniazid (INH) preventive therapy (IPT) among children with HIV (CLHIV). Design: This prospective cohort study assessed adherence among CLHIV on IPT in public sector HIV clinics from 2019 through 2020. Methods: Adherence was assessed by pill counts or caregiver or self-reports, and urine biomarkers (in-house dipstick and Isoscreen). Both urine biomarker tests detect INH metabolites within 48 h of ingestion. Consistent adherence was defined as having positive results on either biomarker at all visits. Correlates of biomarker-confirmed nonadherence at each visit were evaluated using generalized estimating equations. The in-house dipstick was validated using Isoscreen as the reference. Results: Among 97 CLHIV on IPT with adherence assessments, median age was 10 years (IQR 7–13). All were on ART at IPT initiation (median duration 46 months [IQR 4–89]); 81% were virally suppressed (<1000 copies/ml). At all visits, 59% ( n = 57) of CLHIV reported taking at least 80% of their doses, while 39% ( n = 38) had biomarker-confirmed adherence. Viral nonsuppression (adjusted risk ratio [aRR] = 1.65; 95% confidence interval [95% CI] 1.09–2.49) and the sixth month of IPT use (aRR = 2.49; 95% CI 1.34–4.65) were independent correlates of biomarker-confirmed nonadherence at each visit. Sensitivity and specificity of the in-house dipstick were 98.1% ( 94.7 – 99.6%) and 94.7% ( 88.1 – 98.3%) , respectively, versus Isoscreen. Conclusion: Biomarker-confirmed adherence to IPT was sub-optimal and was associated with viral nonsuppression and duration of IPT. Urine dipstick testing may be useful in assessing adherence to IPT in clinical care.
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Biomarker-confirmed suboptimal adherence to isoniazid preventive therapy among children with HIV in western Kenya
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Autor/in / Beteiligte Person: | Onyango, Dickens Otieno ; van der Sande, Marianne A.B. ; Yuen, Courtney M. ; Were, Joyce ; Mecha, Jerphason ; Njagi, Lilian N. ; Panpradist, Nuttada ; Matemo, Daniel ; Leon, Daniel ; Lutz, Barry ; Kinuthia, John ; John-Stewart, Grace ; Lacourse, Sylvia M. |
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Zeitschrift: | AIDS, Jg. 38 (2023), Heft 1, S. 39-47 |
Veröffentlichung: | Ovid Technologies (Wolters Kluwer Health), 2023 |
Medientyp: | academicJournal |
ISSN: | 0269-9370 |
DOI: | 10.1097/qad.0000000000003719 |
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