{"title":"护理点尿液替诺福韦依从性监测,推动艾滋病治疗和预防干预。","authors":"Matthew Spinelli, Monica Gandhi","doi":"10.1080/14737159.2024.2312122","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Although effective antiretroviral and pre-exposure prophylaxis/PrEP regimens are available globally, adherence challenges persist. Objective measures of adherence can both measure adherence accurately and can be used to drive interventions. The first point-of-care pharmacologic adherence measure, urine tenofovir testing using a lateral flow assay, is now available.</p><p><strong>Areas covered: </strong>This review examines the ability of pharmacologic metrics of adherence to predict HIV and PrEP clinical outcomes and the past use of pharmacologic metrics of adherence as tools to drive adherence interventions. 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Given the ability of point-of-care tenofovir testing to be implemented in settings where viral load testing is not available, and at more frequent intervals due to its low cost, urine-based tenofovir assays have the potential to be highly scalable in diverse clinical settings.</p>","PeriodicalId":12113,"journal":{"name":"Expert Review of Molecular Diagnostics","volume":" ","pages":"169-175"},"PeriodicalIF":3.9000,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562940/pdf/","citationCount":"0","resultStr":"{\"title\":\"Point-of-care urine tenofovir monitoring of adherence to drive interventions for HIV treatment and prevention.\",\"authors\":\"Matthew Spinelli, Monica Gandhi\",\"doi\":\"10.1080/14737159.2024.2312122\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Although effective antiretroviral and pre-exposure prophylaxis/PrEP regimens are available globally, adherence challenges persist. 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引用次数: 0
摘要
导言:尽管全球范围内都有有效的抗逆转录病毒疗法和暴露前预防疗法/PrEP 方案,但在坚持治疗方面仍然存在挑战。客观的依从性测量方法既能准确测量依从性,又能用于推动干预措施。首个护理点药理依从性测量方法--使用侧流检测法进行尿液替诺福韦检测--现已问世:本综述探讨了药理学依从性指标预测艾滋病和 PrEP 临床结果的能力,以及过去将药理学依从性指标用作推动依从性干预的工具的情况。然后讨论了使用护理点依从性指标指导干预措施的初步研究的成功之处:专家意见:鉴于本文总结的试点研究取得了令人鼓舞的成果,现在需要进行大型随机临床试验,以检验护理点依从性干预措施对 HIV 和 PrEP 临床结果的影响。还需要开展混合实施效果研究,以检验将护理点检测纳入常规临床护理服务的最佳方法,包括指导耐药性检测、依从性咨询以及提供其他循证依从性干预措施。鉴于尿基替诺福韦检测能够在无法进行病毒载量检测的环境中进行,而且由于其成本低廉,检测频率更高,因此尿基替诺福韦检测有可能在不同的临床环境中高度推广。
Point-of-care urine tenofovir monitoring of adherence to drive interventions for HIV treatment and prevention.
Introduction: Although effective antiretroviral and pre-exposure prophylaxis/PrEP regimens are available globally, adherence challenges persist. Objective measures of adherence can both measure adherence accurately and can be used to drive interventions. The first point-of-care pharmacologic adherence measure, urine tenofovir testing using a lateral flow assay, is now available.
Areas covered: This review examines the ability of pharmacologic metrics of adherence to predict HIV and PrEP clinical outcomes and the past use of pharmacologic metrics of adherence as tools to drive adherence interventions. The success of preliminary studies using point-of-care adherence metrics to guide interventions is then discussed.
Expert opinion: Large randomized clinical trials are now needed to test the impact of point-of-care adherence interventions on HIV and PrEP clinical outcomes, given promising results of the pilot studies summarized here. Hybrid implementation-effectiveness studies will be needed to examine optimal approaches to incorporating point-of-care testing into routine clinical care delivery, including in guiding resistance testing, adherence counseling, and delivery of other evidence-based adherence interventions. Given the ability of point-of-care tenofovir testing to be implemented in settings where viral load testing is not available, and at more frequent intervals due to its low cost, urine-based tenofovir assays have the potential to be highly scalable in diverse clinical settings.
期刊介绍:
Expert Review of Molecular Diagnostics (ISSN 1473-7159) publishes expert reviews of the latest advancements in the field of molecular diagnostics including the detection and monitoring of the molecular causes of disease that are being translated into groundbreaking diagnostic and prognostic technologies to be used in the clinical diagnostic setting.
Each issue of Expert Review of Molecular Diagnostics contains leading reviews on current and emerging topics relating to molecular diagnostics, subject to a rigorous peer review process; editorials discussing contentious issues in the field; diagnostic profiles featuring independent, expert evaluations of diagnostic tests; meeting reports of recent molecular diagnostics conferences and key paper evaluations featuring assessments of significant, recently published articles from specialists in molecular diagnostic therapy.
Expert Review of Molecular Diagnostics provides the forum for reporting the critical advances being made in this ever-expanding field, as well as the major challenges ahead in their clinical implementation. The journal delivers this information in concise, at-a-glance article formats: invaluable to a time-constrained community.