Featured Research

from universities, journals, and other organizations

Using Hair To Manage HIV/AIDS And Predict Treatment Success

Date:
March 9, 2009
Source:
University of California - San Francisco
Summary:
High levels of antiretrovirals in hair correlated with success in HIV viral suppression in treatment and did so better than any of the other variables usually considered to predict response.

UCSF researchers have found that examining levels of antiretroviral drugs in hair samples taken from HIV patients on therapy strongly predicts treatment success.

The findings, published in the February 20 issue of AIDS, note that the levels of antiretrovirals found in the hair of patients on treatment correlated strongly with levels of HIV virus circulating in patients' blood.

"High levels of antiretrovirals in hair correlated with success in HIV viral suppression in treatment and did so better than any of the other variables usually considered to predict response," said the study's primary investigator, Monica Gandhi, MD MPH, assistant professor of medicine at UCSF's Positive Health Program at San Francisco General Hospital.

Typically, clinicians rely on either self-report by patients, pill counts or expensive medication dispensing devices to monitor how well patients are taking their pills as directed. These methods are highly patient dependent and have not been good predictors of treatment success.

Clinicians can draw blood and then measure plasma levels of medications, but since a single plasma level represents medication exposure only hours prior to the blood draw, this method has also not been a good predictor of viral suppression, according to Gandhi. Single drug levels can vary day-by-day for a single patient and may reflect improved pill-taking by patients just before clinic visits, she said.

Hair, which grows at a rate of about a centimeter a month, gives a reading of drug levels that reflects the rate of pill consumption sustained by patients over weeks, not days. Assessing an average level of drug exposure over time may be more predictive of treatment response than the "snapshot" of exposure provided by a single plasma level of medication, Gandhi said.

"Hair sampling for antiretroviral levels could become a new standard to look at how much drug a patient is getting—an equivalent in HIV clinical care of measuring hemoglobin A1C, the method used in diabetes to monitor average blood glucose levels," said study co-investigator, Ruth M. Greenblatt, MD, UCSF professor of clinical pharmacy and principal investigator of the Women's Interagency HIV study.

Researchers took 10 strands of hair from patients on HIV therapy from the back of the head. They cut the hair sample close to the scalp underneath the top layer of hair, marked the part farthest from the scalp with tape and wrapped the strands in aluminum foil. The sample was then stored at room temperature in a plastic bag until it was analyzed.

"This is a painless, bloodless, biohazard-free, method of collecting a stable specimen from HIV patients that may allow for the monitoring of levels of antiretroviral drugs absorbed over time and the prediction of treatment success," said Gandhi. "Our next step is to test this method in resource-limited settings where blood collection and viral load monitoring may be expensive and difficult. Not only could this method help in measuring pill-taking, but its strong correlation with viral suppression could allow its use as an inexpensive, non-invasive method of monitoring treatment success in particularly challenging settings."

Researchers from this group are also collaborating with public health researchers in testing hair to monitor pill-taking in clinical trials of single or dual antiretrovirals in high risk, HIV negative individuals to prevent infection with HIV (pre-exposure prophylaxis, known as PrEP, trials).

The 224 patients in this study were drawn from the Women's Interagency HIV study, an ongoing multi-center, prospective study of HIV-infected and at risk uninfected women established in 1994.

"Women taking antiretroviral medications may have more adverse events than men taking these regimens. The safety trials of these medications were conducted in trials consisting largely of men, and the highest tolerable amount of drug in order to successfully suppress HIV is usually recommended. One foreseeable use of this technique may be to fine-tune the amount of drug prescribed. We could measure drug levels in hair, find the level correlating with viral suppression, and then reduce the amount of drug prescribed if it was at a point exceeding the level needed for viral control, hopefully reducing toxicities," said Gandhi.

Co-authors include Niloufar Ameli and Yong Huang from the UCSF Department of Clinical Pharmacy; Peter Bacchetti, UCSF Department of Epidemiology and Biostatistics; Stephen J. Grange, Johns Hopkins' Bloomberg School of Public Health; Kathryn Anastos, Albert Einstein College of Medicine; Alexandra Levine, City of Hope National Medical Center; Charles L. Hyman, SUNY Downstate Medical Center; Mardge Cohen, Cook County Bureau of Health Services; and Mary Young, Georgetown University Medical Center.

Funding for this research was provided by the National Institute of Allergy and Infectious Diseases, National Cancer Institute, National Institute on Drug Abuse, National Institute of Child Health and Human Development, National Center for Research Resources and Bristol Meyers Squibb.


Story Source:

The above story is based on materials provided by University of California - San Francisco. Note: Materials may be edited for content and length.


Cite This Page:

University of California - San Francisco. "Using Hair To Manage HIV/AIDS And Predict Treatment Success." ScienceDaily. ScienceDaily, 9 March 2009. <www.sciencedaily.com/releases/2009/03/090303194002.htm>.
University of California - San Francisco. (2009, March 9). Using Hair To Manage HIV/AIDS And Predict Treatment Success. ScienceDaily. Retrieved October 23, 2014 from www.sciencedaily.com/releases/2009/03/090303194002.htm
University of California - San Francisco. "Using Hair To Manage HIV/AIDS And Predict Treatment Success." ScienceDaily. www.sciencedaily.com/releases/2009/03/090303194002.htm (accessed October 23, 2014).

Share This



More Health & Medicine News

Thursday, October 23, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Orthodontist Mom Jennifer Salzer on the Best Time for Braces

Orthodontist Mom Jennifer Salzer on the Best Time for Braces

Working Mother (Oct. 22, 2014) Is your child ready? Video provided by Working Mother
Powered by NewsLook.com
U.S. Issues Ebola Travel Restrictions, Are Visa Bans Next?

U.S. Issues Ebola Travel Restrictions, Are Visa Bans Next?

Newsy (Oct. 22, 2014) Now that the U.S. is restricting travel from West Africa, some are dropping questions about a travel ban and instead asking about visa bans. Video provided by Newsy
Powered by NewsLook.com
US to Track Everyone Coming from Ebola Nations

US to Track Everyone Coming from Ebola Nations

AP (Oct. 22, 2014) Stepping up their vigilance against Ebola, federal authorities said Wednesday that everyone traveling into the US from Ebola-stricken nations will be monitored for symptoms for 21 days. (Oct. 22) Video provided by AP
Powered by NewsLook.com
Doctors Help Paralysed Man Walk Again, Patient in Disbelief

Doctors Help Paralysed Man Walk Again, Patient in Disbelief

AFP (Oct. 22, 2014) Polish doctors describe how they helped a paralysed man walk again, with the patient in disbelief at the return of sensation to his legs. Duration: 1:04 Video provided by AFP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins