Utility of therapeutic drug monitoring in the management of HIV-infected pregnant women in receipt of lopinavir

R. J. Caswell; D. Phillips; M. Chaponda; S. H. Khoo; G. P. Taylor; M. Ghanem; Mary Poulton; J. Welch; S. Gibbons; V. Jackson; J. S. Lambert

doi:10.1258/ijsa.2009.009184

Utility of therapeutic drug monitoring in the management of HIV-infected pregnant women in receipt of lopinavir

R. J. Caswell, D. Phillips, M. Chaponda, S. H. Khoo, G. P. Taylor, M. Ghanem, Mary Poulton, J. Welch, S. Gibbons, V. Jackson, J. S. Lambert^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

10 Citations (Scopus)

Abstract

The pharmacokinetics of antiretroviral drugs in pregnancy is poorly understood. We reviewed the use of therapeutic drug monitoring (TOM) in clinical settings to document plasma concentrations of lopinavir during pregnancy and investigated how clinicians acted upon TOM results. A retrospective review was carried out of all HIV-infected pregnant women taking boosted lopinavir-based highly active antiretroviral therapy (HAART) at five National Health Service (NHS) centres in the UK between May 2004 and March 2007. Seventy-three women in receipt of lopinavir were identified, of whom 89% had plasma lopinavir concentrations above the suggested minimum recommended for wild-type HIV. Initial TDM results prompted dosage change in 10% and assessment of adherence and/or pharmacist review in 11%. TOM was repeated in 29%. TOM can play an important role in the clinical management of HIV-positive pregnant women, allowing informed dose modification and an alternative measure of adherence.

Original language	English
Pages (from-to)	11-14
Number of pages	4
Journal	International Journal of STD & AIDS
Volume	22
Issue number	1
DOIs	https://doi.org/10.1258/ijsa.2009.009184
Publication status	Published - Jan 2011

Keywords

lopinavir
therapeutic drug monitoring
pharmacokinetics
HIV
pregnancy
ANTIRETROVIRAL THERAPY
PROTEASE INHIBITORS
PLASMA
RITONAVIR
PHARMACOKINETICS
SAQUINAVIR

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1258/ijsa.2009.009184

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title = "Utility of therapeutic drug monitoring in the management of HIV-infected pregnant women in receipt of lopinavir",

abstract = "The pharmacokinetics of antiretroviral drugs in pregnancy is poorly understood. We reviewed the use of therapeutic drug monitoring (TOM) in clinical settings to document plasma concentrations of lopinavir during pregnancy and investigated how clinicians acted upon TOM results. A retrospective review was carried out of all HIV-infected pregnant women taking boosted lopinavir-based highly active antiretroviral therapy (HAART) at five National Health Service (NHS) centres in the UK between May 2004 and March 2007. Seventy-three women in receipt of lopinavir were identified, of whom 89% had plasma lopinavir concentrations above the suggested minimum recommended for wild-type HIV. Initial TDM results prompted dosage change in 10% and assessment of adherence and/or pharmacist review in 11%. TOM was repeated in 29%. TOM can play an important role in the clinical management of HIV-positive pregnant women, allowing informed dose modification and an alternative measure of adherence.",

keywords = "lopinavir, therapeutic drug monitoring, pharmacokinetics, HIV, pregnancy, ANTIRETROVIRAL THERAPY, PROTEASE INHIBITORS, PLASMA, RITONAVIR, PHARMACOKINETICS, SAQUINAVIR",

author = "Caswell, {R. J.} and D. Phillips and M. Chaponda and Khoo, {S. H.} and Taylor, {G. P.} and M. Ghanem and Mary Poulton and J. Welch and S. Gibbons and V. Jackson and Lambert, {J. S.}",

year = "2011",

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doi = "10.1258/ijsa.2009.009184",

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AU - Caswell, R. J.

AU - Phillips, D.

AU - Chaponda, M.

AU - Khoo, S. H.

AU - Taylor, G. P.

AU - Ghanem, M.

AU - Poulton, Mary

AU - Welch, J.

AU - Gibbons, S.

AU - Jackson, V.

AU - Lambert, J. S.

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N2 - The pharmacokinetics of antiretroviral drugs in pregnancy is poorly understood. We reviewed the use of therapeutic drug monitoring (TOM) in clinical settings to document plasma concentrations of lopinavir during pregnancy and investigated how clinicians acted upon TOM results. A retrospective review was carried out of all HIV-infected pregnant women taking boosted lopinavir-based highly active antiretroviral therapy (HAART) at five National Health Service (NHS) centres in the UK between May 2004 and March 2007. Seventy-three women in receipt of lopinavir were identified, of whom 89% had plasma lopinavir concentrations above the suggested minimum recommended for wild-type HIV. Initial TDM results prompted dosage change in 10% and assessment of adherence and/or pharmacist review in 11%. TOM was repeated in 29%. TOM can play an important role in the clinical management of HIV-positive pregnant women, allowing informed dose modification and an alternative measure of adherence.

AB - The pharmacokinetics of antiretroviral drugs in pregnancy is poorly understood. We reviewed the use of therapeutic drug monitoring (TOM) in clinical settings to document plasma concentrations of lopinavir during pregnancy and investigated how clinicians acted upon TOM results. A retrospective review was carried out of all HIV-infected pregnant women taking boosted lopinavir-based highly active antiretroviral therapy (HAART) at five National Health Service (NHS) centres in the UK between May 2004 and March 2007. Seventy-three women in receipt of lopinavir were identified, of whom 89% had plasma lopinavir concentrations above the suggested minimum recommended for wild-type HIV. Initial TDM results prompted dosage change in 10% and assessment of adherence and/or pharmacist review in 11%. TOM was repeated in 29%. TOM can play an important role in the clinical management of HIV-positive pregnant women, allowing informed dose modification and an alternative measure of adherence.

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KW - therapeutic drug monitoring

KW - pharmacokinetics

KW - HIV

KW - pregnancy

KW - ANTIRETROVIRAL THERAPY

KW - PROTEASE INHIBITORS

KW - PLASMA

KW - RITONAVIR

KW - PHARMACOKINETICS

KW - SAQUINAVIR

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DO - 10.1258/ijsa.2009.009184

M3 - Article

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JO - International Journal of STD & AIDS

JF - International Journal of STD & AIDS

IS - 1

ER -

Utility of therapeutic drug monitoring in the management of HIV-infected pregnant women in receipt of lopinavir

Abstract

Keywords

UN SDGs

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