Therapeutic Drug Monitoring of Indinavir in HIV-Infected Patients Undergoing HAART |
| |
Authors: | P Langmann M Zilly B Weißbrich S Desch T Väth H Klinker |
| |
Institution: | (1) Dept. of Hepatology and Infectious Disease, Medical Policlinic, University of Würzburg, Josef-Schneider-Str. 2, D-97080 Würzburg, Germany; Phone: (+49/93) 1201-2792; Fax: -3485, e-mail: p.langmann@medizin-uni.wuerzburg.de, DE;(2) Institute of Virology, University of Würzburg, Germany, DE |
| |
Abstract: | Background: Therapeutic drug monitoring (TDM) of protease inhibitors (PI) is gaining increasing importance for the management of HIV-infected
patients undergoing highly active antiretroviral therapy (HAART). The PI indinavir (IDV) is widely used in HAART regimens.
Combinations of IDV with ritonavir (RTV) have been used to increase the plasma concentration of IDV. However, the desirable
IDV concentration range in clinical practice remains to be elucidated.
Patients and Methods: To study the value of TDM for IDV in clinical practice, a retrospective analysis of 501 plasma samples of patients treated
with IDV in various dosages was performed. IDV levels were determined during routine outpatient visits. Analysis was performed
by high pressure liquid chromatography (HPLC) with UV detection.
Results: A widespread range of IDV plasma concentrations was seen both within and between patients. The mean IDV level during therapy
with IDV 2.4 g/d was 3,260 ng/ml (95% CI: 2,903 ng/ml; 3,618 ng/ml). IDV levels at a dose of IDV 1.6 g/d in combination with
RTV resulted in a mean IDV plasma concentration of 4,191 ng/ml (95% CI: 3,356 ng/ml; 5,016 ng/ml). There was no significant
difference between plasma levels at the doses of 2.4 g/d and 1.6 g/d. 35 of all 130 patients treated with IDV reached only
suboptimal IDV plasma concentrations below the limit of 150 ng/ml. There was no statistically significant difference between
the number of patients below an IDV plasma concentration of 150 ng/ml in the various dosage regimens.
Conclusion: During therapy with IDV in a b.i.d. scheme, similar IDV plasma concentrations and a comparable number of patients with subinhibitory
plasma concentrations were observed when compared to a therapeutic regimen with t.i.d. dosing. In this study, even at various
times of plasma sampling after oral ingestion, TCM facilitated the surveillance of patients compliance.
Received: August 07, 2000 · Revision accepted: August 27, 2001 |
| |
Keywords: | HIV Indinavir Ritonavir Therapeutic drug monitoring |
本文献已被 PubMed SpringerLink 等数据库收录! |
|