Therapeutic Drug Monitoring of Anti-human Immunodeficiency Virus Drugs in a Patient with Short Bowel Syndrome

An elderly woman with human immunodeficiency virus-1 infection developed short bowel syndrome as a result of extensive intestinal resection. Considering the possibility of poor absorption of antiretroviral drugs (ARVs), therapeutic drug monitoring (TDM) was performed. A single-dose test of 6 ARVs (darunavir, ritonavir, lopinavir, etravirine, maraviroc, and raltegravir) did not provide information on the appropriate ARV, and repeated TDM under continuous antiretroviral therapy resulted in viral suppression below 50 copies/mL, which was considered to be treatment success. These assessments suggest the importance of TDM in the steady state for the successful treatment of individuals with impaired gastrointestinal function using ARVs.