Background: Several clinical trials, as well as observational statistics, have exhibited
that the advantages of antiretroviral [ARV] treatment for humans with Human Immunodeficiency
Virus / Acquired Immune Deficiency Syndrome HIV/AIDS exceed their risks.
Therapeutic drug monitoring [TDM] plays a key role in optimization of ARV therapy. Determination
of ARV’s in plasma, blood cells, and other biological matrices frequently requires
separation techniques capable of high effectiveness, specific selectivity and high sensitivity.
High-performance liquid chromatography [HPLC] coupled with ultraviolet [UV], Photodiode
array detectors [PDA], Mass spectrophotometer [MS] detectors etc. are the important quantitative
techniques used for the estimation of pharmaceuticals in biological samples.
Objective: This review article is aimed to give an extensive outline of different bio-analytical
techniques which have been reported for direct quantitation of ARV’s. This article aimed to
establish an efficient role played by the TDM in the optimum therapeutic outcome of the ARV
treatment. It also focused on establishing the prominent role played by the separation techniques
like HPLC and UPLC along with the detectors like UV and Mass in TDM.
Methods: TDM is based on the principle that for certain drugs, a close relationship exists between
the plasma level of the drug and its clinical effect. TDM is of no value if the relationship
does not exist. The analytical methodology employed in TDM should: 1) distinguish similar
compounds; 2) be sensitive and precise and 3) is easy to use.
Results: This review highlights the advancement of the chromatographic techniques beginning
from the HPLC-UV to the more advanced technique like UPLC-MS/MS. TDM is essential to
ensure adherence, observe viral resistance and to personalize ARV dose regimens. It is observed
that the analytical methods like immunoassays and liquid chromatography with detectors
like UV, PDA, Florescent, MS, MS/MS and Ultra performance liquid chromatography
(UPLC)-MS/MS have immensely contributed to the clinical outcome of the ARV therapy.
Assay methods are not only helping physicians in limiting the side effects and drug interactions
but also assisting in monitoring patient’s compliance.
Conclusion: The present review revealed that HPLC has been the most widely used system
irrespective of the availability of more sensitive chromatographic technique like UPLC.