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Therapeutic Drug Monitoring for HIV: Why Not?

KEY POINT

Commonly used in Europe, therapeutic drug monitoring (TDM) for antiretroviral medications is slowly making its way across the Atlantic. While data from two recently completed studies conflict somewhat, an increasing body of evidence shows that drugs for HIV are just like other antimicrobial agents: Doses that are too high cause adverse effects, and too-low doses increase development of viral resistance.

SOURCES

Piscitelli SC. Drug–drug interactions & pharmacology: therapeutic drug monitoring. National AIDS Treatment Advocacy Program Reports. 

Burger DM. Second international workshop on clinical pharmacology of HIV therapy. 

Clevenbergh P et al. PharmAdapt: a prospective multicenter randomized controlled trial to evaluate the usefulness of protease inhibitor drug monitoring: 12 weeks results. Program and abstracts of the 2nd International Workshop on Clinical Pharmacology of HIV Therapy; April 2-4, 2001; Noordwijk, the Netherlands. Abstract 6.1.

Burger DM et al. Therapeutic drug monitoring of indinavir in treatment-naive patients improves therapeutic outcome after 1 year: results from Athena. Program and abstracts of the 2nd International Workshop on Clinical Pharmacology of HIV Therapy; April 2-4, 2001; Noordwijk, the Netherlands. Abstract 6.2a.