Evaluation of Antiretroviral Drug Concentrations in Minimally Invasive Specimens for Potential Development of Point-of-Care Drug Assays

• Type of Material: Article
• Authors: Richard E Haaland, Centers for Disease Control and Prevention, Atlanta; Amy Martin, Centers for Disease Control and Prevention, Atlanta; Melkam Mengesha, Centers for Disease Control and Prevention, Atlanta; Chuong Dinh, Centers for Disease Control and Prevention, Atlanta; Jeffrey Fountain, Centers for Disease Control and Prevention, Atlanta; Davis L Lupo, Ctr Dis Control & Prevent; LaShonda Hall, Emory University; Christopher Conway-Washington, Emory University; Colleen Kelley, Emory University
• Language: English
• Date: 2021-02-16
• Publisher: MARY ANN LIEBERT, INC
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: 2021, Mary Ann Liebert, Inc., publishers.
• Final Published Version (URL): http://dx.doi.org/10.1089/aid.2020.0187
• Title of Journal or Parent Work: AIDS RESEARCH AND HUMAN RETROVIRUSES
• Volume: 37
• Issue: 10
• Start Page: 744
• End Page: 747
• Grant/Funding Information: This study was funded by the U.S. Centers for Disease Control and Prevention.
• Keywords: Virology; urine; pre-exposure prophylaxis; point-of-care test; antiretroviral agents; dried blood spot; Science & Technology; Infectious Diseases; Life Sciences & Biomedicine; Immunology; men who have sex with men

Abstract

Point-of-care (POC) tests for antiretroviral drugs (ARVs) could help improve individual adherence. This study sought to define the utility of urine, blood, and buccal swabs as minimally invasive specimens amenable to development of POC tests for ARVs. Urine, dried blood spots (DBS) and buccal swabs were collected from 35 HIV-negative men between 2 and 96 h after a single dose of tenofovir (TFV) alafenamide/emtricitabine (FTC)/elvitegravir (EVG)/cobicistat and darunavir (DRV). ARV concentrations were measured by high-performance liquid chromatography-mass spectrometry. High concentrations of FTC, DRV, and TFV were detectable in urine at least 24 h after dosing. FTC, DRV, and EVG remained detectable in DBS at least 24 h postdose. FTC and DRV were detectable on buccal swabs up to 2 and 24 h postdose, respectively. TFV was not detectable in DBS or buccal swabs collected between 2 and 96 h after dosing. Variable distribution of ARVs in minimally invasive specimens highlights the challenge of developing POC assays for recent ARV exposure.