The Influence of Plasma and Peritoneal Antiretroviral Drugs Levels on the Shedding of HIV-1 Into Peritoneal Dialysis Effluent.
10 affiliations
- 1Department of Internal Medicine, University of the Free State, Bloemfontein, South Africa.
- 2Next Generation Sequencing Unit and Division of Virology, University of the Free State, Bloemfontein, South Africa.
- 3Division of Nephrology, University of the Free State, Bloemfontein, South Africa.
- 4Department of Health of the Free State, Bloemfontein, South Africa.
- 5Department of Community Health, University of the Free State, Bloemfontein, South Africa.
- 6Division of Virology, University of the Free State, Bloemfontein, South Africa.
- 7Ampath Laboratories, Pretoria, South Africa.
- 8PathCare Vermaak, Pretoria, South Africa.
- 9Department of Microbiology and Biochemistry, University of the Free State, Bloemfontein, South Africa.
- 10Milnerton Mediclinic, Cape Town, South Africa.
Abstract
Penetrance of antiretroviral therapy in the peritoneal cavity and its influence on the shedding of HIV-1 into continuous ambulatory peritoneal dialysis (CAPD) was investigated. This prospective cross-sectional study of HIV-positive end-stage kidney failure (ESKF) patients managed with ART and CAPD, collected enrolled patients' demographic information, clinical and laboratory data. ART levels were quantified using liquid chromatography coupled to mass spectrometry. There were 60 patients recruited with a median age of 43.0 (IQR: 38.0-47) years and were predominantly on abacavir (88.3%) lamivudine (98.3%) and efavirenz (70.0%) for a median duration of 8 (IQR: 5-11) years. Participants with detectable HIV-1 had lower abacavir (2.10 vs. 8.15 ng/µL; p = 0.054), lamivudine (0.018 vs. 1.065 ng/µL; p = 0.003) and efavirenz (3.605 vs. 57.1 ng/µL; p = 0.012) plasma levels compared to those with undetectable HIV-1 in CAPD effluents. Measured lamivudine (1.065 vs. 0.888 ng/µL; p = 0.001), abacavir (8.15 vs. 4.95 ng/µL; p = 0.024), efavirenz (57.1 vs. 3.65 ng/µL; p < 0.001) and dolutegravir (2.68 vs. 0.65 ng/µL; p < 0.001) drug levels were significantly higher in plasma than CAPD effluents. The peritoneal to plasma (D/P) ratios of these ART agents was highly variable. On Spearman's rank correlation test, plasma levels of lamivudine (p = 0.003), abacavir (p < 0.035) and efavirenz (p = 0.008) were significantly correlated with HIV-1 shedding into CAPD effluents. The findings suggest that low plasma ART drug levels were strongly associated with HIV-1 shedding into CAPD effluents. Moreover, there was an inverse correlation between plasma drug concentration of lamivudine, efavirenz, and abacavir and the HIV-1 viral load detectable in CAPD effluents.
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BibTeX
@article{mooko2026influence,
title = {{The Influence of Plasma and Peritoneal Antiretroviral Drugs Levels on the Shedding of HIV-1 Into Peritoneal Dialysis Effluent.}},
author = {Teboho Mooko and Feziwe Bisiwe and Perpetual Chikobvu and Molefi Morobadi and Martin Nyaga and Dominique Goedhals and Thabiso Mofokeng and Gabre Kemp and Kwazi Ndlovu},
journal = {Journal of medical virology},
year = {2026},
month = oct,
doi = {10.1002/jmv.71192},
url = {https://europepmc.org/article/MED/42925490},
note = {CC BY},
}
RIS
TY - JOUR
TI - The Influence of Plasma and Peritoneal Antiretroviral Drugs Levels on the Shedding of HIV-1 Into Peritoneal Dialysis Effluent.
AU - Teboho Mooko
AU - Feziwe Bisiwe
AU - Perpetual Chikobvu
AU - Molefi Morobadi
AU - Martin Nyaga
AU - Dominique Goedhals
AU - Thabiso Mofokeng
AU - Gabre Kemp
AU - Kwazi Ndlovu
PY - 2026
DA - 2026/10/01
JO - Journal of medical virology
DO - 10.1002/jmv.71192
UR - https://europepmc.org/article/MED/42925490
AB - Penetrance of antiretroviral therapy in the peritoneal cavity and its influence on the shedding of HIV-1 into continuous ambulatory peritoneal dialysis (CAPD) was investigated. This prospective cross-sectional study of HIV-positive end-stage kidney failure (ESKF) patients managed with ART and CAPD, collected enrolled patients' demographic information, clinical and laboratory data. ART levels were quantified using liquid chromatography coupled to mass spectrometry. There were 60 patients recruited with a median age of 43.0 (IQR: 38.0-47) years and were predominantly on abacavir (88.3%) lamivudine (98.3%) and efavirenz (70.0%) for a median duration of 8 (IQR: 5-11) years. Participants with detectable HIV-1 had lower abacavir (2.10 vs. 8.15 ng/µL; p = 0.054), lamivudine (0.018 vs. 1.065 ng/µL; p = 0.003) and efavirenz (3.605 vs. 57.1 ng/µL; p = 0.012) plasma levels compared to those with undetectable HIV-1 in CAPD effluents. Measured lamivudine (1.065 vs. 0.888 ng/µL; p = 0.001), abacavir (8.15 vs. 4.95 ng/µL; p = 0.024), efavirenz (57.1 vs. 3.65 ng/µL; p < 0.001) and dolutegravir (2.68 vs. 0.65 ng/µL; p < 0.001) drug levels were significantly higher in plasma than CAPD effluents. The peritoneal to plasma (D/P) ratios of these ART agents was highly variable. On Spearman's rank correlation test, plasma levels of lamivudine (p = 0.003), abacavir (p < 0.035) and efavirenz (p = 0.008) were significantly correlated with HIV-1 shedding into CAPD effluents. The findings suggest that low plasma ART drug levels were strongly associated with HIV-1 shedding into CAPD effluents. Moreover, there was an inverse correlation between plasma drug concentration of lamivudine, efavirenz, and abacavir and the HIV-1 viral load detectable in CAPD effluents.
SN - 0146-6615
SN - 1096-9071
ER -