Ikuma Motoko, Watanabe Dai, Yagura Hiroki, Ashida Misa, Takahashi Masaaki, Shibata Masaaki, Asaoka Tadafumi, Yoshino Munehiro, Uehira Tomoko, Sugiura Wataru, Shirasaka Takuma
AIDS Medical Center, National Hospital Organization Osaka National Hospital, Japan.
Intern Med. 2016;55(20):3059-3063. doi: 10.2169/internalmedicine.55.6777. Epub 2016 Oct 15.
An elderly woman with human immunodeficiency virus-1 infection developed short bowel syndrome as a result of extensive intestinal resection. Considering the possibility of poor absorption of antiretroviral drugs (ARVs), therapeutic drug monitoring (TDM) was performed. A single-dose test of 6 ARVs (darunavir, ritonavir, lopinavir, etravirine, maraviroc, and raltegravir) did not provide information on the appropriate ARV, and repeated TDM under continuous antiretroviral therapy resulted in viral suppression below 50 copies/mL, which was considered to be treatment success. These assessments suggest the importance of TDM in the steady state for the successful treatment of individuals with impaired gastrointestinal function using ARVs.
一名感染人类免疫缺陷病毒1型的老年女性因广泛肠道切除而出现短肠综合征。考虑到抗逆转录病毒药物（ARV）吸收不良的可能性，进行了治疗药物监测（TDM）。对6种ARV（达芦那韦、利托那韦、洛匹那韦、依曲韦林、马拉维罗和拉替拉韦）进行的单剂量试验未提供关于合适ARV的信息，在持续抗逆转录病毒治疗下重复进行TDM，结果病毒载量抑制至50拷贝/mL以下，这被认为是治疗成功。这些评估表明，在稳态下进行TDM对于使用ARV成功治疗胃肠功能受损的个体至关重要。
