Suboptimal ART adherence, undetectable urine tenofovir, and higher C-reactive protein values

Delaram Ghanooni1, Megan J Heise2, Kevin Sassaman2

  • 1Florida International University, Robert Stempel College of Public Health and Social Work, Miami, FL.

AIDS (London, England)
|September 26, 2025
PubMed

Insights

Suboptimal adherence to antiretroviral therapy (ART) in people with HIV is linked to higher inflammation, increasing risks for chronic health issues like cardiovascular disease. Monitoring ART adherence is crucial for managing inflammation and improving long-term health outcomes.

Area of Science:

  • Immunology
  • Infectious Diseases
  • Public Health

Background:

  • Antiretroviral therapy (ART) is standard for HIV management.
  • Residual immune activation and chronic inflammation persist in some individuals on ART.
  • This inflammation increases the risk of early-onset comorbidities, including cardiovascular disease.

Purpose of the Study:

  • To investigate the association between ART adherence and markers of inflammation.
  • To identify factors contributing to chronic inflammation in people with HIV on ART.

Main Methods:

  • Study included 492 men who have sex with men.
  • ART adherence was assessed using undetectable urine tenofovir levels.
  • C-reactive protein (CRP) levels were measured as an inflammation marker.
  • Analyses adjusted for viral suppression and stimulant use.

Main Results:

  • Suboptimal ART adherence was directly associated with elevated C-reactive protein.
  • This association remained significant after adjusting for viral suppression and stimulant use.
  • Findings suggest a link between adherence and systemic inflammation.

Conclusions:

  • ART adherence is critical for mitigating residual immune activation and inflammation.
  • Monitoring adherence is essential for reducing inflammation-related chronic health outcomes in people with HIV.
  • Interventions promoting adherence may help prevent comorbidities.

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