Therapeutic drug monitoring in human immunodeficiency virus/acquired immunodeficiency syndrome

Abstract

Human immunodeficiency virus (HIV) causes acquired immunodeficiency syndrome (AIDS), and it is estimated that 42 million people are infected with HIV. Four classes of drugs are used today to treat people with AIDS; nucleoside reverse transcriptase (NRTIs), non-NRTIs (NNRTIs), protease inhibitors (PIs), and entry blockers (EIs). Evidence is accumulating that both PIs and NNRTIs are good candidates for therapeutic drug monitoring (TDM). However, there is little evidence suggesting that TDM of NRTIs would be helpful other than to assess compliance/adherence to the drug regime. There is no commercially available immunoassay for routine monitoring of antiretrovirals in serum. The current methods for TDM of these drugs include high-performance liquid chromatography (HPLC) and tandem mass spectrometry. Tandem mass spectrometry is a superior technique to HPLC for analysis of these antiretrovirals. © 2008 Humana Press Inc.