Therapeutic drug monitoring (TDM) constitutes a compelling approach for the optimization of antiretroviral therapy in treatment-experienced HIV-1 patients. While various inhibitory indices have been proposed to predict virologic outcome, there is a lack of consensus on the clinical value of TDM. Here, we report the comparative results of TDM in 14 HIV-1-infected patients who had previously received at least two different PI-based regimens and who initiated darunavir (DRV)-based salvage therapy. Pharmacokinetic/pharmacodynamics (PK/PD) parameters were calculated for each subject. Seventy-nine percent of subjects had a viral load <50 copies/mL at 48 weeks. The only subject with two consecutive viral loads >50 copies/mL at the end of the study period was the patient with the lowest instantaneous inhibitory potential (IIP). The sample size was insufficient to show an association between any of the PK/PD parameters and virologic response. Based on our observations, we suggest that the utility of IIP for antiretroviral combinations for the prediction of virologic outcome in HIV-1 drug-experienced patients should be studied further.

治疗药物监测（TDM）构成了一种令人信服的方法，可以优化有治疗经验的HIV-1患者的抗逆转录病毒疗法。尽管已经提出了各种抑制指数来预测病毒学结果，但是对于TDM的临床价值缺乏共识。在这里，我们报告了14名接受过HIV-1感染的患者的TDM的比较结果，这些患者先前至少接受了两种不同的基于PI的治疗方案，并开始了基于darunavir（DRV）的挽救治疗。计算每个受试者的药代动力学/药效学（PK / PD）参数。48周时有79％的受试者的病毒载量小于50拷贝/ mL。在研究期结束时，仅有两个连续病毒载量大于50拷贝/ mL的受试者是瞬时抑制潜能（IIP）最低的患者。样本量不足以显示任何PK / PD参数与病毒学应答之间的关联。根据我们的观察，我们建议应进一步研究IIP在抗逆转录病毒药物组合中用于预测HIV-1药物治疗患者的病毒学结局的效用。