Towards simultaneous quantification of protease inhibitors and inflammatory biomarkers in serum for people living with HIV

Therapeutic drug monitoring (TDM) is useful for guiding pharmacotherapy, especially for therapies in which there is a significant chance of adverse effects. Combination antiretroviral therapy (cART), the current standard of care for HIV, is effective, but patients often remain in a persistent inflammatory state. To maximize the efficacy of cART and monitor inflammation, a TDM tool is needed to simultaneously detect both the plasma concentration of antiretrovirals and inflammatory biomarkers. However, the multiplex analysis of low molecular weight drugs and much larger proteins is an unsolved challenge for the sensors and diagnostics field. To address this issue, we demonstrate that Arrayed Imaging Reflectometry (AIR) is able to detect darunavir (DRV), an HIV protease inhibitor, and the inflammatory biomarker interleukin-6 (IL-6), on the same sensor chip. The detection range was found to be 18.18-72.73 nM for DRV and 0.5-100 ng mL^-1 for IL-6 in 20% fetal bovine serum. This provides proof-of-concept of AIR as a promising TDM tool for HIV.