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(4):469-77.
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 (NNRTIs) and protease inhibitors (Pls) 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 for the second time in Rome, Italy. This was following the inaugural meeting in Perugia, Italy, in October 2000, which resulted in the manuscript published in AIDS 2002, 16(Suppl 1):S5-S37. The objectives of this second meeting were to review and update the numerous 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. A major focus of the meeting was to discuss and critically analyse recent and precedent clinical drug-drug interaction data to provide a clear framework of the pharmacological basis of how one drug may impact the disposition of another. This report, which has been updated to include material published or presented at international conferences up to the end of December 2004, reviews recent pivotal pharmacokinetic interaction data and provides advice to clinical care providers on how some drug-drug interactions may be prevented, avoided or managed, and, when data are available, on what dose adjustments and interventions should be performed.
当前国际上关于人类免疫缺陷病毒（HIV）感染治疗指南的共识是，非核苷类逆转录酶抑制剂（NNRTIs）和蛋白酶抑制剂（PIs）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，一个专家小组在意大利罗马第二次会面。这是继2000年10月在意大利佩鲁贾举行的首次会议之后，那次会议产生了发表于《艾滋病》2002年第16卷增刊1：S5 - S37的手稿。第二次会议的目标是审查和更新围绕抗逆转录病毒药物TDM的众多问题，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。会议的一个主要重点是讨论并批判性地分析近期和以往的临床药物相互作用数据，以提供一种药物如何影响另一种药物处置的药理学基础的清晰框架。本报告已更新，纳入了截至2004年12月底在国际会议上发表或展示的材料，回顾了近期关键的药代动力学相互作用数据，并就如何预防、避免或处理某些药物相互作用向临床护理提供者提供建议，以及在有数据时应进行何种剂量调整和干预。
