Bennetto-Hood Chantelle, Johnson Victoria A, King Jennifer R, Hoesley Craig J, Acosta Edward P
Division of Clinical Pharmacology, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA.
HIV Clin Trials. 2009 May-Jun;10(3):193-9. doi: 10.1310/hct1003-193.
Challenges exist regarding antiretroviral quantitation in the female genital tract. Endocervical wicking using sterile tear flow test strips is an alternative to conventional methods due to the consistent sample volume obtained.
A novel method for measuring antiretrovirals in cervicovaginal secretions using Sno-strip wicking was developed and tested by spiking Sno-strips with known concentrations of tenofovir, nevirapine, atazanavir, lopinavir, and ritonavir in blank cervicovaginal lavage fluid. Drug concentrations were determined by high-performance liquid chromatography with ultraviolet or mass spectrometry detection.
Mean extraction recoveries were 91% for tenofovir, 89% for nevirapine, 63% for atazanavir, 60% for lopinavir, and 61% for ritonavir relative to controls. Freezing spiked samples for 24 hours at -80 degrees C had no effect on recovery.
Results suggest that the antiretrovirals tested can be efficiently extracted from Sno-strips, although a greater percentage of tenofovir and nevirapine was recovered. Storage of Sno-strip samples up to 24 hours before analysis showed no difference in the percentage of drug recovered compared with immediate analysis. Quantitating antiretroviral penetration into the female genital tract may assist in determining optimal therapeutic antiretroviral regimens to both decrease the risk of HIV transmission and prevent development of HIV drug resistance.
女性生殖道中抗逆转录病毒药物的定量检测存在挑战。由于能获得一致的样本量，使用无菌泪液流量测试条进行宫颈内吸液是传统方法的一种替代方法。
开发了一种使用Sno-strip吸液法测量宫颈阴道分泌物中抗逆转录病毒药物的新方法，并通过在空白宫颈阴道灌洗液中加入已知浓度的替诺福韦、奈韦拉平、阿扎那韦、洛匹那韦和利托那韦的Sno-strip进行测试。药物浓度通过高效液相色谱结合紫外或质谱检测来确定。
相对于对照，替诺福韦的平均提取回收率为91%，奈韦拉平为89%，阿扎那韦为63%，洛匹那韦为60%，利托那韦为61%。将加标样品在-80℃下冷冻24小时对回收率没有影响。
结果表明，尽管替诺福韦和奈韦拉平的回收率更高，但所测试的抗逆转录病毒药物可以从Sno-strip中有效提取。在分析前将Sno-strip样品保存长达24小时，与立即分析相比，药物回收率百分比没有差异。定量抗逆转录病毒药物在女性生殖道中的渗透情况可能有助于确定最佳的抗逆转录病毒治疗方案，以降低艾滋病毒传播风险并防止艾滋病毒耐药性的发展。
