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Paediatric Laboratory Medicine

HIV Antiretroviral Drugs

Clinical Significance

Therapeutic drug monitoring (TDM) of antiretroviral drugs is used to optimize the effectiveness of antiretroviral treatment and to help decrease the incidence of adverse effects through dosage adjustments tailored to the patient. This is quickly becoming the standard of practice in many European countries and some parts of North America and is beneficial when used as part of an integrated approach to overall clinical management. The current body of literature suggests that TDM is most valuable when applied to certain clinical scenarios and patient populations: drug-drug interactions, suspected toxicity, hepatic impairment, validation of post dose adjustment, pediatric populations (due to rapid changes in growth), virologic failure and pregnancy, to name a few. Among antiretroviral agents, the protease inhibitors and the non-nucleoside reverse transcriptase inhibitors (NNRTIs) are considered well recognized candidates for TDM

Test Name

HIV Antiretroviral Drugs

Alternate Name/ Synonym

Refer to the requisition for alternative names

Test Code


Drug Class



Therapeutic Drug Monitoring - TDM



External Proficiency Testing

KKGT - Netherlands (Association for Quality Assessment in Therapeutic Drug Monitoring and Clinical Toxicology)

Turn Around Time

Weekly (Tuesdays @ 14:00)



Specimen Type

Plasma (Heparin)

Minimum Specimen Requirements

200 uL

Optimal Collection Time

Trough: 0 – 30 minutes prior to dose

Alternative times: Consult the HSC HIV Antiretroviral requisition


Same day: 4°C (transport with a cool pack if possible), Next Day: -20°C (transport on dry ice)

Approval is not required

CPT Codes


Shipping and Contact Information

The Hospital for Sick Children
Rapid Response Laboratory
170 Elizabeth Street, Room 3642
Toronto, ON
M5G 2G3
Phone: 416-813-7200
Phone: 1-855-381-3212

Therapeutic Range

See report for each individual drug