Therapeutic drug monitoring of antiretroviral drugs in HIV-infected patients

ABSTRACT

Introduction: Therapeutic drug monitoring (TDM) may be beneficial when applied to antiretroviral (ARV). Even though TDM can be a valuable strategy in HIV management, its role remains controversial.

Areas covered: This review provides a comprehensive update on important issues relating to TDM of ARV drugs in HIV-infected patients. Articles from PubMed with keywords relevant to each topic section were reviewed. Search strategies limited to articles published in English.

Expert commentary: There is evidence supporting the use of TDM in HIV treatment. However, some limitations need to be considered. The evidence supporting the use of routine TDM for all patients is limited, as it is not clear that this strategy offers any advantages over TDM for selected indications. Selected groups of patients including patients with physiological changes, patients with drug-drug interactions or toxicity, and the elderly could potentially benefit from TDM, as optimized dosing is challenging in these populations.

KEYWORDS:

• Therapeutic drug monitoring
• antiretroviral drugs
• HIV

Declaration of interest

DM Burger discloses participating on the advisory board of Merck, BMS, Janssen/Tibotec, Gilead, ViiV Healthcare and Abbvie and has received research grants from Merck, BMS, Janssen/Tibotec and ViiV Healthcare. DM Burger has received educational grants from Merck, Janssen/Tibotec and Gilead and has been a speaker for symposia for Merck, BMS, Janssen/Tibotec, Gilead, ViiV Healthcare and Abbvie. K Ruxrangtham has received the Senior Research Scholar Award from the Thailand Research Fund, and the Research Professor Fund from Chulalongkorn University, Bangkok, Thailand. K Ruxrangtham also received honoraria or consultation fees from Merck, Roche, Jensen-Cilag, Tibotec, Mylan and GPO (Governmental Pharmaceutical Organization, Thailand) as well as participating in a company sponsored speaker’s bureau from Abbott, Gilead, Bristol-Myers Squibb, Merck, Roche, Jensen-Cilag, Tibotec, Mylan and GPO (Governmental Pharmaceutical Organization, Thailand).

Additional information

Funding

This paper was not funded.