Factors Related to Hair Antiretroviral Concentration: A Systematic Review of Global Literature.

Abstract

Assessment of antiretroviral (ARV) concentration in hair (hair antiretroviral concentration [HAC]) is one of the latest non-invasive innovations for measuring long-term ARV adherence. We performed a systematic review following Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines to identify the factors that may affect the validity and reliability of HAC. This review included 25 studies that reported data on the associations of hair concentrations of 10 ARVs with 22 potential factors related to HAC. Notwithstanding scarce data and some inconsistencies, the data from existing studies suggested that (1) HAC was associated with hair types, hair segment position, housing, illegal drugs use, high-risk sexual behaviors, renal function, and genetic factors; (2) HAC was not associated with race/ethnicity, location of sample, ARV side effects, length of ARV treatment, smoking, alcohol use, orange consumption, depression, or anthropometry characteristics; and (3) the relationships of HAC with natural hair color, hair treatment, age, sex, dosing schedule, and liver function need further study. This review of factors related to HAC informed the design, analysis, and interpretation of the future HIV treatment and HIV prevention research utilizing hair concentrations of various ARVs as a biomarker of ARV adherence.