Dried plasma/blood spots for monitoring antiretroviral treatment efficacy and pharmacokinetics: a cross‐sectional study in rural Burundi

Aims In limited resource settings monitoring antiretroviral (ARV) treatment efficacy is restrained by the lack of access to technological equipment. The aim of the study was to assess the use of dried plasma (DPS) and blood spots (DBS) to facilitate ARV monitoring in remote settings where clinical m...

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Bibliographic Details
Published in:British journal of clinical pharmacology 2015-05, Vol.79 (5), p.801-808
Main Authors: Calcagno, Andrea, Motta, Ilaria, Milia, Maria Grazia, Rostagno, Roberto, Simiele, Marco, Libanore, Valentina, Fontana, Silvia, D'Avolio, Antonio, Ghisetti, Valeria, Di Perri, Giovanni, Bonora, Stefano
Format: Article
Language:English
Subjects:
Adult
Anti-HIV Agents - administration & dosage
Anti-HIV Agents - pharmacokinetics
Anti-HIV Agents - therapeutic use
Blood Stains
Burundi
Child
Cross-Sectional Studies
Drug Monitoring - methods
Drug Resistance, Viral - genetics
efavirenz
Female
HIV Infections - blood
HIV Infections - drug therapy
HIV Infections - virology
HIV-1 - drug effects
HIV-1 - genetics
HIV-1 - isolation & purification
Humans
limited‐resource countries
Male
nevirapine
Nevirapine - administration & dosage
Nevirapine - pharmacokinetics
Nevirapine - therapeutic use
Pharmacokinetics
resistance
Rural Population
Treatment Outcome
Viral Load - drug effects
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Summary:Aims In limited resource settings monitoring antiretroviral (ARV) treatment efficacy is restrained by the lack of access to technological equipment. The aim of the study was to assess the use of dried plasma (DPS) and blood spots (DBS) to facilitate ARV monitoring in remote settings where clinical monitoring is the primary strategy. Methods A cross‐sectional study in HIV‐positive ARV‐treated patients in Kiremba, Burundi was performed. DBS were used for HIV‐1 viral load (limit of the assay 250 copies ml−1) and genotypic drug resistance tests and dried plasma spots were used for concentration measurements. Results Three hundred and seven patients [201 female (88.6%), 14 children (4.5%)] were enrolled. HIV‐1 viral load was 1000 copies ml−1 in 250 (81.7%), 33 (10.8%) and 23 patients (7.5%). Eleven samples out of 23 were successfully amplified revealing nucleoside reverse transcriptase inhibitor (NRTI) and non‐nucleoside reverse transcriptase inhibitor (NNRTI)‐resistance associated mutations [in seven (58.3%) and six patients (50%)]. Nevirapine trough concentrations were
ISSN:0306-5251
1365-2125
DOI:10.1111/bcp.12544