Monitoring HIV drug adherence with a paper-based assay

Treating HIV in developing countries involves highly active antiretroviral therapies that require strict adherence by the patient. Current methods of self-reporting to monitor adherence to a drug regimen are less reliable than a drug test. This work introduces proof-of-concept of a new assay involving azide-alkyne cycloaddition to detect the presence of azidothymidine (AZT), a common antiretroviral therapy used in developing countries, in patient urine. Spotting experiments were performed on a paper-based platform with simple materials that selectively detects urine samples containing AZT and these results were confirmed by NMR and UV-Vis spectroscopy. The detection of the assay to AZT was found to be around 12mM. This assay can be translated into a point-of-care set-up that can be used by clinicians to directly monitor patient adherence while increasing efficiency and reducing the costs of health care for HIV patients.