Hemanth Kumar, A K and Ramachandran, Geetha and Saradha, Banu and Narendran, G and Swaminathan, Soumya
(2006)
Urine nevirapine as a predictor of antiretroviral adherence.
Indian Journal of Medical Research, 123 (Apr).
pp. 565-568.
ISSN 0971-5916
Abstract
Background & objectives: Incomplete adherence is a major contributor to failure of antiretroviral
therapy. Although the available methods to monitor adherence to therapy have proved to be
predictive of outcomes, the results are variable. We assessed the feasibility of detecting nevirapine
(NVP) in spot urine samples to monitor patient adherence to antiretroviral treatment and to study
the urinary excretion of NVP in healthy volunteers after oral administration of a single dose of
NVP (200 mg).
Methods: Spot urine samples were collected from 50 HIV-infected patients (36 on treatment regimen
containing NVP and 14 on drugs other than NVP) and tested for NVP by HPLC in a blinded
manner. Sixteen healthy volunteers (9 males and 7 females) were administered a single oral dose of
200 mg NVP and spot urine samples were collected on day ‘0’ before drug administration, and
thereafter every 24 h up to 9 days and tested for NVP.
Results: All the urine samples collected from patients undergoing treatment with NVP-containing
regimens at different time points after drug administration tested positive for NVP. Thirteen out
of 14 samples from patients not on NVP yielded a negative result. The drug was detected in the
urine of healthy volunteers up to 9 days. The urinary excretion of NVP was prolonged in females
than in males.
Interpretation & conclusion: In view of its long half-life, NVP gets excreted in urine for a long
period of time. Hence, testing spot urine samples for NVP may not be a useful measure to monitor
patient adherence to treatment.
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