The general aim of this proposal is to determine the minimal therapeutic concentration of antiretroviral drugs (proteases) by liquid chromatography - tandem mass spectrometry (LC-MS/MS) in patients on a triple antirektroviral drug regimen (that includes a protease inhibitor and two nucleoside reverse transcriptase inhibitors) for HIV disease. These determinations will be combined with genotypic determination of HIV resistance, and viral load and Tcell analysis as a model for cutting edge care for individuals with HIV disease. The hypothesis is that having the tools to make informed and accurate decisions about the success or failure of drug therapy leads to a cost-effective treatment of individuals with HIV disease. This study is the first to critically evaluate the use of pharmacokinetic (PK) profiles (together with genotypic testing) in the therapeutic approach to HIV infection.
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