Validation and clinical application of a method to quantify efavirenz in cervicovaginal secretions from flocked swabs using liquid chromatography tandem mass spectrometry

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dc.contributor.authorOlagunju, Adeniyi
dc.contributor.authorNwogu, Jacinta
dc.contributor.authorEniayewu, Oluwasegun
dc.contributor.authorAtoyebi, Shakir
dc.contributor.authorAmara, Alieu
dc.contributor.authorKpamor, John
dc.contributor.authorBolaji, Oluseye
dc.contributor.authorAdejuyigbe, Ebunoluwa
dc.contributor.authorOwen, Andrew
dc.contributor.authorKhoo, Saye
dc.date.accessioned2023-05-17T09:56:01Z
dc.date.available2023-05-17T09:56:01Z
dc.date.issued2022-07-08
dc.description.abstractBackground : A liquid chromatography tandem mass spectrometry method to quantify drugs in dried cervicovaginal secretions from flocked swabs was developed and validated using the antiretroviral efavirenz as an example. Methods: Cervicovaginal swabs (CVS) were prepared by submerging flocked swabs in efavirenz-spiked plasma matrix. Time to full saturation, weight uniformity, recovery and room temperature stability were evaluated. Chromatographic separation was on a reverse-phase C18 column by gradient elution using 1mM ammonium acetate in water/acetonitrile at 400 µL/min. Detection and quantification were on a TSQ Quantum Access triple quadrupole mass spectrometer operated in negative ionisation mode. The method was used to quantify efavirenz in CVS samples from human immunodeficiency virus (HIV)-positive women in the VADICT study (NCT03284645). A total of 98 samples (35 paired intensive CVS and DBS pharmacokinetic samples, 14 paired sparse CVS and DBS samples) from 19 participants were available for this analysis. Results: Swabs were fully saturated within 15 seconds, absorbing 128 µL of plasma matrix with coefficient of variation (%CV) below 1.3%. The method was linear with a weighting factor (1/X) in the range of 25-10000 ng/mL with inter- and intra-day precision (% CV) of 7.69-14.9%, and accuracy (% bias) of 99.1-105.3%. Mean recovery of efavirenz from CVS was 83.8% (%CV, 11.2) with no significant matrix effect. Efavirenz remained stable in swabs for at least 35 days after drying and storage at room temperature. Median (range) CVS efavirenz AUC 0-24h was 16370 ng*h/mL (5803-22088), C max was 1618 ng/mL (610-2438) at a T max of 8.0 h (8.0-12), and C min was 399 ng/mL (110-981). Efavirenz CVS:plasma AUC 0-24h ratio was 0.41 (0.20-0.59). Conclusions: Further application of this method will improve our understanding of the pharmacology of other therapeutics in the female genital tract, including in low- and middle-income countries.en_US
dc.description.sponsorshipThis work was supported by the Wellcome Trust [204776, 204776; International Training Fellowship to Adeniyi Olagunju].en_US
dc.identifier.other10.12688/wellcomeopenres.17202.3
dc.identifier.urihttps://uilspace.unilorin.edu.ng/handle/20.500.12484/10320
dc.language.isoenen_US
dc.publisherWellcome Open Researchen_US
dc.subjectLC-MS/MSen_US
dc.subjectCervicovaginal fluiden_US
dc.subjectSwaben_US
dc.subjectPharmacokineticsen_US
dc.subjectEfavirenzen_US
dc.titleValidation and clinical application of a method to quantify efavirenz in cervicovaginal secretions from flocked swabs using liquid chromatography tandem mass spectrometryen_US
dc.typeArticleen_US

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