Therapeutic drug monitoring in treatment-experienced HIV-infected patients receiving darunavir-based salvage regimens: A case series

Therapeutic drug monitoring (TDM) constitutes a compelling approach for the optimization of antiretroviral therapy in treatment-experienced HIV-1 patients. While various inhibitory indices have been proposed to predict virologic outcome, there is a lack of consensus on the clinical value of TDM. Her...

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Veröffentlicht in:Antiviral research 2018-04, Vol.152, p.111-116
Hauptverfasser: Landry, Sébastien, Chen, Chi-Nan, Patel, Nimish, Tseng, Alice, Lalonde, Richard G., Thibeault, Denis, Sanche, Steven, Sheehan, Nancy L.
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Sprache:eng
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Zusammenfassung:Therapeutic drug monitoring (TDM) constitutes a compelling approach for the optimization of antiretroviral therapy in treatment-experienced HIV-1 patients. While various inhibitory indices have been proposed to predict virologic outcome, there is a lack of consensus on the clinical value of TDM. Here, we report the comparative results of TDM in 14 HIV-1-infected patients who had previously received at least two different PI-based regimens and who initiated darunavir (DRV)-based salvage therapy. Pharmacokinetic/pharmacodynamics (PK/PD) parameters were calculated for each subject. Seventy-nine percent of subjects had a viral load 50 copies/mL at the end of the study period was the patient with the lowest instantaneous inhibitory potential (IIP). The sample size was insufficient to show an association between any of the PK/PD parameters and virologic response. Based on our observations, we suggest that the utility of IIP for antiretroviral combinations for the prediction of virologic outcome in HIV-1 drug-experienced patients should be studied further. •Therapeutic drug monitoring was performed in 14 HIV-1 patients initiating darunavir-based salvage therapy.•The virologic predictive value of pharmacokinetic/pharmacodynamic parameters was evaluated.•Genotypic inhibitory quotients did not correlate with virologic outcome.•Instantaneous inhibitory potential values of antiretroviral combinations reflected virologic success.
ISSN:0166-3542
1872-9096
DOI:10.1016/j.antiviral.2018.02.010