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

Even with antiretroviral therapy, people with HIV often face residual immune activation and chronic systemic inflammation, heightening their risk for early-onset comorbidities such as cardiovascular disease. In a study of 492 men who have sex with men, suboptimal ART adherence, measured by undetectable urine tenofovir, was directly associated with elevated C-reactive protein, even after adjusting for viral suppression and stimulant use. These findings highlight the importance of adherence monitoring to reduce inflammation-related chronic health outcomes.