It is essential for HIV-positive individuals to follow a certain medication schedule in order to maintain their health. But people can skip doses to avoid the negative side effects of these treatments, such as nausea and dizziness.
A small piece of technology can now play an important role in motivating patients to take their medication on time, according to a new UCLA study involving 130 HIV-positive individuals.
Honghu Liu, head of the department of public and population health at the UCLA School of Dentistry, served as the project's principal investigator. Researchers examined whether using an ingestible electronic sensor system—a tiny microchip inside a pill capsule that wirelessly sends data to a server and reminders to users' cell phones—would increase the likelihood that people would take their antiretroviral medication on time.
The results, published in The Lancet Ebiomedicine, showed that people who used the ingestible sensor had higher plasma drug concentrations in their body after 28 weeks than those in the control group that did not use the technology (16 weeks of sensor data collection followed by 12 weeks of continuous observation).
90% of those using the sensors reported being “happy” or “very satisfied” with the device, and those using the technology had significantly lower HIV viral levels than the control group.
According to Liu, who is also a faculty member at the UCLA David Geffen School of Medicine and the UCLA Fielding School of Public Health, ingestible sensor technology is the most sensitive IT-based tool for measuring, monitoring and improving adherence behavior. Maintaining the HIV drug regimen is crucial to reduce the viral load as well as the risk of developing drug-resistant strains in the future.
of the Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center. Eric Daar in the $4 million National Institute of Mental Health grant supporting the study, Dr. He is Liu's assistant principal investigator.
To complete the study, half of the participants were given an FDA-approved ingestible sensor system, while the other half had to rely solely on their own reports to determine whether they were taking their medication as prescribed. Participants were recruited from HIV clinics in Southern California during the recruitment phase of the study, which took place between 2018 and 2020.
The small sensor, which is synchronized with a battery-operated patch placed on the stomach lining and worn on the person's body, is triggered when the user consumes the drug. When a dose of medication is received, the system transmits a signal via Bluetooth to the user's mobile device, which then sends an encrypted message to a central server that can be monitored by medical personnel.
If the sensor detects that the user has not received their prescription more than an hour after the recommended time, the system will send a text message coded for patient privacy, such as “Time to eat your pizza” as a reminder.
According to Daar, study participants often noted that the ingestible sensor device provided them with the additional feedback and assistance they needed to properly control their HIV infection.
The study is timely in part because individuals who have successfully suppressed the amount of HIV in their blood to undetectable levels qualify for a long-acting injectable HIV treatment, a drug taken every four to eight weeks instead of daily for pill-based antiretrovirals. The FDA authorized this drug in January 2021. According to Liu, the availability of the long-acting drug may provide HIV-positive individuals with an additional incentive to follow their treatment regimen.
Liu's research is in line with UCLA Dentistry's longstanding commitment to providing care for HIV/AIDS patients. The general dental clinic at the institution sees approximately 700 patients a year, of whom an average of 8.000 are HIV/AIDS.