Quantification of zidovudine and individual zidovudine phosphates in peripheral blood mononuclear cells by a combined isocratic high performance liquid chromatography radioimmunoassay method.

Zidovudine (ZDV, AZT) is the first clinically effective drug licensed for use in the treatment of human immunodeficiency virus (HIV) infection. Activation of ZDV requires phosphorylation to ZDV triphosphate by cellular kinases. It is important, therefore, to determine the intracellular levels of the active form because measurement of ZDV concentrations in plasma have not reflected any direct relationship with activity or toxicity. In this paper a validated assay for the measurement of both ZDV and its three phosphorylated anabolites, ZDV mono-, di- and triphosphate, in peripheral blood mononuclear cells (PBMCs) is described. The method consisted of a combination of isocratic high performance liquid chromatography (HPLC) separation and radioimmunoassay (RIA). The PBMCs were separated from whole blood and ZDV and ZDV nucleotides were extracted and separated by isocratic elution with an ion-pairing mobile phase on a reversed-phase HPLC column. The collected ZDV and individual ZDV nucleotide fractions were dephosphorylated to ZDV, cleaned by solid phase extraction and assayed by a commercially available RIA kit. The assay developed was successfully used to determine intracellular ZDV and anabolite concentrations of 10 PBMC samples taken from HIV positive patients on ZDV treatment.