title: Urine nevirapine as a predictor of antiretroviral adherence.
abstract: OBJECTIVE
  Incomplete adherence is a major contributor to failure of antiretroviral therapy. Although the available methods to monitor adherence to therapy have proved to be predictive of outcomes, the results are variable. We assessed the feasibility of detecting nevirapine (NVP) in spot urine samples to monitor patient adherence to antiretroviral treatment and to study the urinary excretion of NVP in healthy volunteers after oral administration of a single dose of NVP (200 mg).
  
  
  METHODS
  Spot urine samples were collected from 50 HIV-infected patients (36 on treatment regimen containing NVP and 14 on drugs other than NVP) and tested for NVP by HPLC in a blinded manner. Sixteen healthy volunteers (9 males and 7 females) were administered a single oral dose of 200 mg NVP and spot urine samples were collected on day '0' before drug administration, and thereafter every 24 h up to 9 days and tested for NVP.
  
  
  RESULTS
  All the urine samples collected from patients undergoing treatment with NVP-containing regimens at different time points after drug administration tested positive for NVP. Thirteen out of 14 samples from patients not on NVP yielded a negative result. The drug was detected in the urine of healthy volunteers up to 9 days. The urinary excretion of NVP was prolonged in females than in males.
  
  
  CONCLUSIONS
  In view of its long half-life, NVP gets excreted in urine for a long period of time. Hence, testing spot urine samples for NVP may not be a useful measure to monitor patient adherence to treatment.
authors.affiliation: HIV/AIDS Division, Tuberculosis Research Centre (ICMR), Mayor V.R. Ramanathan Road, Chetput, Chennai 600 031, India.
authors.forename: A K Hemanth
authors.initials: AK
authors.lastname: Kumar
authors.forename: Geetha
authors.initials: G
authors.lastname: Ramachandran
authors.forename: Banu
authors.initials: B
authors.lastname: Saradha
authors.forename: G
authors.initials: G
authors.lastname: Narendran
authors.forename: Soumya
authors.initials: S
authors.lastname: Swaminathan
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000652:urine*; D016903:Drug Monitoring; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000652:urine; D006207:Half-Life; D006801:Humans; D008297:Male; D008875:Middle Aged; D019829:Nevirapine / Q000008:administration & dosage / Q000652:urine*; D010349:Patient Compliance
chemical_list: D019380:Anti-HIV Agents; D019829:Nevirapine