From Medscape General Medicine

eJIAS: eJournal of the International AIDS Society

Can Urine Lamivudine Be Used to Monitor Antiretroviral Treatment Adherence?

Posted 12/13/2006

Agibothu K. Hemanth Kumar, PhD; Geetha Ramachandran, PhD; Periyaiyah Kumar, MSc; Vasanthapuram Kumaraswami, MD, PhD; Soumya Swaminathan, MD, DNB
Author Information

Abstract

Patient adherence to treatment is an important factor in the effectiveness of antiretroviral regimens. Adherence to treatment could be monitored by estimation of antiretroviral drugs in biological fluids. We aimed to obtain information on the quantity and duration of excretion of lamivudine in urine following oral administration of a single dose of 300 mg and to assess its suitability for adherence monitoring purposes. Spot urine samples were collected before dosing and at 4, 8, 12, 24, 28, 32, 48, 72, and 96 hours post dosing from 10 healthy subjects, and lamivudine was estimated by high-pressure liquid chromatography (HPLC). Lamivudine values were expressed as a ratio of urine creatinine. About 91% of the ingested drug was excreted by 24 hours, and the concentration thereafter in urine was very negligible. A lamivudine value of 0.035 mg/mg creatinine or less at 48 hours is suggestive of a missed dose in the last 24 hours. The study findings showed that estimation of urine lamivudine in spot specimens could be useful in monitoring patient adherence to antiretroviral treatment. However, this needs to be confirmed on a larger sample size and among patients on once-daily and twice-daily treatment regimens.

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Author Information

Agibothu K. Hemanth Kumar, PhD, Research Assistant, Tuberculosis Research Centre (ICMR) Chetput, Chennai, India

Geetha Ramachandran, PhD, Research Officer, Tuberculosis Research Centre (ICMR), Chetput, Chennai, India

Periyaiyah Kumar, MSc, Junior Research Fellow, Tuberculosis Research Centre (ICMR), Chetput, Chennai, India

Vasanthapuram Kumaraswami, MD, PhD, Deputy Director (Senior Grade), Tuberculosis Research Centre (ICMR), Chetput, Chennai, India

Soumya Swaminathan, MD, DNB, Deputy Director (Senior Grade), Tuberculosis Research Centre (ICMR), Chetput, Chennai, India

Dr. Soumya Swaminathan
Deputy Director (Sr. Grade)
Tuberculosis Research Centre
Mayor V. R. Ramanathan Road
Chetput, Chennai, 600 031
Email: doctorsoumya@yahoo.com

Disclosure: Agibothu K. Hemanth Kumar, PhD, has disclosed no relevant financial relationships.

Disclosure: Geetha Ramachandran, PhD, has disclosed no relevant financial relationships.

Disclosure: Periyaiyah Kumar, MSc, has disclosed no relevant financial relationships.

Disclosure: Vasanthapuram Kumaraswami, MD, PhD, has disclosed no relevant financial relationships.

Disclosure: Soumya Swaminathan, MD, DNB, has disclosed no relevant financial relationships.

Medscape General Medicine.  2006;8(4):53.  ©2006 Medscape

 
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