title: Current status and future prospects of therapeutic drug monitoring and applied clinical pharmacology in antiretroviral therapy.
abstract: The consensus of current international guidelines for the treatment of HIV infection is that data on therapeutic drug monitoring (TDM) of non-nucleoside reverse transcriptase inhibitors and protease inhibitors provide a framework for the implementation of TDM in certain defined scenarios in clinical practice. However, the utility of TDM is considered to be on an individual basis until more data are obtained from large clinical trials showing the benefit of TDM. In April 2004, a panel of experts met in Rome, Italy. This followed an inaugural meeting in Perugia, Italy, in October 2000, which resulted in the article published in AIDS 2002, 16(Suppl 1):S5-S37. The objectives of this second meeting were to review the questions surrounding TDM of antiretroviral drugs and discuss the clinical utility, current concerns and future prospects of drug concentration monitoring in the care of HIV-1-infected individuals. This report, which has been updated to include material published or presented at international conferences up to the end of September 2004, reviews pharmacokinetic and pharmacodynamic data and reports the issues discussed by the panel, offering advice to clinical care providers who may be currently, or are considering incorporating TDM into the routine care of their patients. In addition, the panel formulated a series of position statements that are relevant to the interpretation of current data and can aid the design of future clinical trials.
authors.affiliation: Chelsea and Westminster Hospital, London, UK. marta.boffito@chelwest.nhs.uk
authors.forename: Marta
authors.initials: M
authors.lastname: Boffito
authors.forename: Edward
authors.initials: E
authors.lastname: Acosta
authors.forename: David
authors.initials: D
authors.lastname: Burger
authors.forename: Courtney V
authors.initials: CV
authors.lastname: Fletcher
authors.forename: Charles
authors.initials: C
authors.lastname: Flexner
authors.forename: Rodolphe
authors.initials: R
authors.lastname: Garaffo
authors.forename: Giorgio
authors.initials: G
authors.lastname: Gatti
authors.forename: Michael
authors.initials: M
authors.lastname: Kurowski
authors.forename: Carlo Federico
authors.initials: CF
authors.lastname: Perno
authors.forename: Gilles
authors.initials: G
authors.lastname: Peytavin
authors.forename: Mario
authors.initials: M
authors.lastname: Regazzi
authors.forename: David
authors.initials: D
authors.lastname: Back
mesh_terms: D019380:Anti-HIV Agents / Q000493:pharmacokinetics* / Q000627:therapeutic use*; D002648:Child; D016903:Drug Monitoring; D005006:Ethnicity; D005260:Female; D015658:HIV Infections; D006801:Humans; D017093:Liver Failure; D008297:Male; D010349:Patient Compliance; D011247:Pregnancy; D011485:Protein Binding; D012737:Sex Factors; D014180:Transplantation
chemical_list: D019380:Anti-HIV Agents