Role of Therapeutic Drug Monitoring in HIV Therapy

Abstract

Background: Therapeutic drug monitoring (TDM) is increasingly becoming part of the management of antiretroviral therapy for the treatment of HIV.Aim: To review the role of TDM in HIV therapy focusing on the indications for its use and resultant changes to drug therapy.Method: A 6‐month retrospective review of protease inhibitor TDM requests made by HIV clinicians was conducted. Patient medical records, STOCCA (dispensing program), pathology and the HIV outpatient unit database were reviewed to classify each TDM episode according to indication and outcome.Results: 50 protease inhibitor TDM requests were identified for 38 patients. Indications for use ofTDM included 47 cases of suspected inadequate dosing, two suspected toxicities and one suspected drug interaction. Therapy was altered in approximately 16% of all protease inhibitor TDM requests. Drug dose alterations were recorded for 7 of 4 7 levels measured for adequate dosing and 1 of the 2 levels measured for suspected toxicities.Conclusion: TDM is a valuable tool in managing antiretroviral therapy. It may play an important role in detecting both suboptimal or potentially toxic levels of protease inhibitors, which is an important factor in the success of antiretroviral therapy and the management of HIV.