Abstract

QUIROGA, Patricia N. et al. False-positive immunoassay results for urine benzodiacepines probably caused by efavirenz metabolites. Acta toxicol. argent. [online]. 2007, vol.15, n.2, pp.44-50. ISSN 1851-3743.

Efavirenz (EFV) is an antiretroviral drug used in the acquired immunodeficiency syndrome (AIDS) treatment. Immunoassay techniques have been widely used for abuse drug screening test. The presence of structurally related substances in urine samples can interfere by cross reactions causing false positive results. High percentage of false positive results (78%) for benzodiazepines (BDZ) had been established for 18 urine samples assayed by immunoassay test Triage^® (Ascend Multi Immune Assay). Gas chromatography-mass spectrometry (GC-MS) evaluation was negative for BDZ for all cases. One hundred percent (100%) of the positive results came from patients treated with EFV. With the aim to determine the cause of this cross- reaction, EFV and its metabolites were isolated by solid phase extraction (SPE) and high performance thin-layer chromatography (HPTLC) and then, identified by gas chromatography mass spectrometry (GC-MS and GC-MS/MS/MS). GC-MS/MS/MS analysis showed that EFV metabolites (8-OH-EFV and/or 7-OH-EFV) could probably be responsible for the cross reaction observed in the immunologic assays.

Keywords : Efavirenz; False positive; Benzodiacepine; Triage; AIDS.

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