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Evaluation of an immunoassay for determination of plasma efavirenz concentrations in resource-limited settings

INTRODUCTION: Therapeutic drug monitoring (TDM) may improve antiretroviral efficacy through adjustment of individual drug administration. This could result in reduced toxicity, prevent drug resistance, and aid management of drug–drug interactions. However, most measurement methods are too costly to...

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Autores principales: Abdissa, Alemseged, Wiesner, Lubbe, McIlleron, Helen, Friis, Henrik, Andersen, Åse Bengård, Kæstel, Pernille
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International AIDS Society 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4049128/
https://www.ncbi.nlm.nih.gov/pubmed/24909561
http://dx.doi.org/10.7448/IAS.17.1.18979
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author Abdissa, Alemseged
Wiesner, Lubbe
McIlleron, Helen
Friis, Henrik
Andersen, Åse Bengård
Kæstel, Pernille
author_facet Abdissa, Alemseged
Wiesner, Lubbe
McIlleron, Helen
Friis, Henrik
Andersen, Åse Bengård
Kæstel, Pernille
author_sort Abdissa, Alemseged
collection PubMed
description INTRODUCTION: Therapeutic drug monitoring (TDM) may improve antiretroviral efficacy through adjustment of individual drug administration. This could result in reduced toxicity, prevent drug resistance, and aid management of drug–drug interactions. However, most measurement methods are too costly to be implemented in resource-limited settings. This study evaluated a commercially available immunoassay for measurement of plasma efavirenz. METHODS: The immunoassay-based method was applied to measure efavirenz using a readily available Humastar 80 chemistry analyzer. We compared plasma efavirenz concentrations measured by the immunoassay with liquid chromatography tandem mass spectrometry (LC-MS/MS) (reference method) in 315 plasma samples collected from HIV patients on treatment. Concentrations were categorized as suboptimal<1 µg/ml, normal 1–4 µg/ml or high>4 µg/ml. Agreement between results of the methods was assessed via Bland-Altman plot and κ statistic values. RESULTS: The median Interquartile range (IQR) efavirenz concentration was 2.8 (1.9; 4.5) µg/ml measured by the LC–MS/MS method and 2.5 (1.8; 3.9) µg/ml by the immunoassay and the results were well correlated (ρ=0.94). The limits of agreement assessed by Bland–Altman plots were −2.54; 1.70 µg/ml. Although immunoassay underestimated high concentrations, it had good agreement for classification into low, normal or high concentrations (K=0.74). CONCLUSIONS: The immunoassay is a feasible alternative to determine efavirenz in areas with limited resources. The assay provides a reasonable approximation of efavirenz concentration in the majority of samples with a tendency to underestimate high concentrations. Agreement between tests evaluated in this study was clinically satisfactory for identification of low, normal and high efavirenz concentrations.
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spelling pubmed-40491282014-06-12 Evaluation of an immunoassay for determination of plasma efavirenz concentrations in resource-limited settings Abdissa, Alemseged Wiesner, Lubbe McIlleron, Helen Friis, Henrik Andersen, Åse Bengård Kæstel, Pernille J Int AIDS Soc Short Report INTRODUCTION: Therapeutic drug monitoring (TDM) may improve antiretroviral efficacy through adjustment of individual drug administration. This could result in reduced toxicity, prevent drug resistance, and aid management of drug–drug interactions. However, most measurement methods are too costly to be implemented in resource-limited settings. This study evaluated a commercially available immunoassay for measurement of plasma efavirenz. METHODS: The immunoassay-based method was applied to measure efavirenz using a readily available Humastar 80 chemistry analyzer. We compared plasma efavirenz concentrations measured by the immunoassay with liquid chromatography tandem mass spectrometry (LC-MS/MS) (reference method) in 315 plasma samples collected from HIV patients on treatment. Concentrations were categorized as suboptimal<1 µg/ml, normal 1–4 µg/ml or high>4 µg/ml. Agreement between results of the methods was assessed via Bland-Altman plot and κ statistic values. RESULTS: The median Interquartile range (IQR) efavirenz concentration was 2.8 (1.9; 4.5) µg/ml measured by the LC–MS/MS method and 2.5 (1.8; 3.9) µg/ml by the immunoassay and the results were well correlated (ρ=0.94). The limits of agreement assessed by Bland–Altman plots were −2.54; 1.70 µg/ml. Although immunoassay underestimated high concentrations, it had good agreement for classification into low, normal or high concentrations (K=0.74). CONCLUSIONS: The immunoassay is a feasible alternative to determine efavirenz in areas with limited resources. The assay provides a reasonable approximation of efavirenz concentration in the majority of samples with a tendency to underestimate high concentrations. Agreement between tests evaluated in this study was clinically satisfactory for identification of low, normal and high efavirenz concentrations. International AIDS Society 2014-06-05 /pmc/articles/PMC4049128/ /pubmed/24909561 http://dx.doi.org/10.7448/IAS.17.1.18979 Text en © 2014 Abdissa A et al; licensee International AIDS Society http://creativecommons.org/licenses/by/3.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Short Report
Abdissa, Alemseged
Wiesner, Lubbe
McIlleron, Helen
Friis, Henrik
Andersen, Åse Bengård
Kæstel, Pernille
Evaluation of an immunoassay for determination of plasma efavirenz concentrations in resource-limited settings
title Evaluation of an immunoassay for determination of plasma efavirenz concentrations in resource-limited settings
title_full Evaluation of an immunoassay for determination of plasma efavirenz concentrations in resource-limited settings
title_fullStr Evaluation of an immunoassay for determination of plasma efavirenz concentrations in resource-limited settings
title_full_unstemmed Evaluation of an immunoassay for determination of plasma efavirenz concentrations in resource-limited settings
title_short Evaluation of an immunoassay for determination of plasma efavirenz concentrations in resource-limited settings
title_sort evaluation of an immunoassay for determination of plasma efavirenz concentrations in resource-limited settings
topic Short Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4049128/
https://www.ncbi.nlm.nih.gov/pubmed/24909561
http://dx.doi.org/10.7448/IAS.17.1.18979
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