Boffito Marta, Acosta Edward, Burger David, Fletcher Courtney V, Flexner Charles, Garaffo Rodolphe, Gatti Giorgio, Kurowski Michael, Perno Carlo Federico, Peytavin Gilles, Regazzi Mario, Back David
Chelsea and Westminster Hospital, London, UK.
Antivir Ther. 2005;10(3):375-92.
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.
当前国际上关于HIV感染治疗指南的共识是，非核苷类逆转录酶抑制剂和蛋白酶抑制剂的治疗药物监测（TDM）数据为临床实践中某些特定情况下实施TDM提供了框架。然而，在从大型临床试验获得更多显示TDM益处的数据之前，TDM的实用性被认为是基于个体情况的。2004年4月，一组专家在意大利罗马召开会议。此次会议之前，于2000年10月在意大利佩鲁贾召开了首次会议，会议成果发表在2002年的《艾滋病》杂志上，文章题目为《16（增刊1）：S5 - S37》。第二次会议的目标是回顾围绕抗逆转录病毒药物TDM的问题，并讨论在HIV - 1感染个体护理中药物浓度监测的临床实用性、当前关注点和未来前景。本报告已更新，纳入了截至2004年9月底在国际会议上发表或展示的材料，回顾了药代动力学和药效学数据，并报告了专家小组讨论的问题，为可能正在或将TDM纳入其患者常规护理的临床护理提供者提供建议。此外，专家小组制定了一系列与当前数据解读相关的立场声明，可有助于未来临床试验的设计。
