Patrick W G Mallon1, John Ray, David A Cooper. 1. National Centre in HIV Epidemiology and Clinical Research, Faculty of Medicine, St Vincent's Hospital Medical Centre, University of New South Wales, 376 Victoria Street, Sydney NSW 2010, Australia. pmallon@nchecr.unsw.edu.au
Abstract
BACKGROUND: The role of therapeutic drug monitoring (TDM) in the routine management of HIV-infected individuals is still unclear, largely due to a lack of basic data regarding specific drug concentrations and how they correlate with maximal effect and minimal toxicity within given populations. Nevertheless, it has a potentially important role to play in the management of HIV-infected patients, with the aim of limiting toxicity, optimising antiviral effect and decreasing virological failure and emergence of viral resistance. OBJECTIVES: To measure serum concentrations of specific antiretroviral drugs in individuals changing antiretroviral therapy and assess relationship to virological response. STUDY DESIGN: A prospective, non-randomised, 24-week study of 40 antiretroviral experienced HIV-infected patients. Subjects had failed their previous antiretroviral regimen and were beginning new regimens based on genotypic testing. Serum antiretroviral concentrations and virological response was measured after initiation of treatment. RESULTS: There was a significant correlation between higher concentrations of lopinavir and efavirenz and better virological outcome. This was not seen with amprenavir. CONCLUSIONS: Use of TDM in this setting helps predict virological response to therapy. Optimal use of TDM would require dose adjustment on the basis of a TDM level. Further research is necessary to enable this practice to become routine in the management of HIV-infected patients. Copyright 2002 Elsevier Science B.V.
BACKGROUND: The role of therapeutic drug monitoring (TDM) in the routine management of HIV-infected individuals is still unclear, largely due to a lack of basic data regarding specific drug concentrations and how they correlate with maximal effect and minimal toxicity within given populations. Nevertheless, it has a potentially important role to play in the management of HIV-infectedpatients, with the aim of limiting toxicity, optimising antiviral effect and decreasing virological failure and emergence of viral resistance. OBJECTIVES: To measure serum concentrations of specific antiretroviral drugs in individuals changing antiretroviral therapy and assess relationship to virological response. STUDY DESIGN: A prospective, non-randomised, 24-week study of 40 antiretroviral experienced HIV-infectedpatients. Subjects had failed their previous antiretroviral regimen and were beginning new regimens based on genotypic testing. Serum antiretroviral concentrations and virological response was measured after initiation of treatment. RESULTS: There was a significant correlation between higher concentrations of lopinavir and efavirenz and better virological outcome. This was not seen with amprenavir. CONCLUSIONS: Use of TDM in this setting helps predict virological response to therapy. Optimal use of TDM would require dose adjustment on the basis of a TDM level. Further research is necessary to enable this practice to become routine in the management of HIV-infectedpatients. Copyright 2002 Elsevier Science B.V.
Authors: M Medina-Ramírez; V Sánchez-Merino; S Sánchez-Palomino; A Merino-Mansilla; C B Ferreira; I Pérez; N González; A Alvarez; J M Alcocer-González; F García; J M Gatell; J Alcamí; E Yuste Journal: J Virol Date: 2011-04-06 Impact factor: 5.103
Authors: Geetha Ramachandran; A K Hemanth Kumar; C Ponnuraja; K Ramesh; Lakshmi Rajesh; C Chandrasekharan; Soumya Swaminathan Journal: Indian J Med Res Date: 2013-12 Impact factor: 2.375