Low-Cost Method to Monitor Patient Adherence to HIV Antiretroviral Therapy Using Multiplex Cathepsin Zymography.

Autor: Platt MO; Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, 315 Ferst Drive, IBB 1308, Atlanta, GA, 30332, USA. manu.platt@bme.gatech.edu.; The Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, USA. manu.platt@bme.gatech.edu., Evans D; Health Economics and Epidemiology Research Office, Department of Internal Medicine, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa., Keegan PM; Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, 315 Ferst Drive, IBB 1308, Atlanta, GA, 30332, USA.; The Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, USA., McNamara L; Clinical HIV Research Unit, Department of Internal Medicine, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa., Parker IK; The Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, USA.; The George W. Woodruff School of Mechanical Engineering, Atlanta, GA, USA., Roberts LM; Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, 315 Ferst Drive, IBB 1308, Atlanta, GA, 30332, USA.; The Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, USA., Caulk AW; The Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, USA.; The George W. Woodruff School of Mechanical Engineering, Atlanta, GA, USA., Gleason RL Jr; Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, 315 Ferst Drive, IBB 1308, Atlanta, GA, 30332, USA.; The Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, USA.; The George W. Woodruff School of Mechanical Engineering, Atlanta, GA, USA., Seifu D; Department of Biochemistry, Addis Ababa University, Addis Ababa, Ethiopia., Amogne W; Department of Internal Medicine, Addis Ababa University, Addis Ababa, Ethiopia., Penny C; Oncology Division, Department of Internal Medicine, University of the Witwatersrand, Johannesburg, South Africa.
Jazyk: angličtina
Zdroj: Molecular biotechnology [Mol Biotechnol] 2016 Jan; Vol. 58 (1), pp. 56-64.
DOI: 10.1007/s12033-015-9903-0
Abstrakt: Monitoring patient adherence to HIV antiretroviral therapy (ART) by patient survey is inherently error prone, justifying a need for objective, biological measures affordable in low-resource settings where HIV/AIDS epidemic is highest. In preliminary studies conducted in Ethiopia and South Africa, we observed loss of cysteine cathepsin activity in peripheral blood mononuclear cells of HIV-positive patients on ART. We optimized a rapid protocol for multiplex cathepsin zymography to quantify cysteine cathepsins, and prospectively enrolled 350 HIV-positive, ART-naïve adults attending the Themba Lethu Clinic, Johannesburg, South Africa, to test if suppressed cathepsin activity could be a biomarker of ART adherence (103 patients were included in final analysis). Poor adherence was defined as detectable viral load (>400 copies/ml) or simplified medication adherence questionnaire, 4-6 months after ART initiation. 86 % of patients with undetectable viral loads after 6 months were cathepsin negative, and cathepsin-positive patients were twice as likely to have detectable viral loads (RR 2.32 95 % CI 1.26-4.29). Together, this demonstrates proof of concept that multiplex cathepsin zymography may be an inexpensive, objective method to monitor patient adherence to ART. Low cost of this electrophoresis-based assay makes it a prime candidate for implementation in resource-limited settings.
Databáze: MEDLINE
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