[Secondary effects of treatment with maraviroc and other CCR5 antagonists. Potential impact of the CCR5 blocker].
Maraviroc is the first inhibitor of CCR5 co-receptors to be marketed as an antiretroviral. The pre-clinical studies and phase III trials have shown that it has a very favourable safety profile. No characteristic adverse effect of maraviroc has been identified. Unlike with aplaviroc, where its clinical development was stopped due to serious hepatoxicity, no increase in liver toxicity has been demonstrated in patients treated with maraviroc even if they are co-infected by hepatotropic virus. Nor was there any evidence of an increase in the incidence of neoplasms or serious infections in patients treated with maraviroc. In a study on naive patients, maraviroc produced nonsignificant changes in total cholesterol, LDL, HDL and triglycerides. Although CCR5 co-receptors play a role in the immune response of the body, it has not been shown whether individuals homozygote for its deletion (delta-32 mutation) have an increased risk of serious infections, with the possible exception of encephalitis due to the West Nile virus. However, long-term follow up is required on patients treated with to be able to rule out any increased susceptibility to infections or neoplasms.
Arribas López
José R
JR
Consulta de Medicina Interna II, Unidad VIH, Hospital La Paz, Madrid, España. jrarribas.hulp@salud.madrid.org
D000328:Adult; D001565:Benzoates / Q000009:adverse effects; D065100:CCR5 Receptor Antagonists; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology; D002986:Clinical Trials as Topic / Q000706:statistics & numerical data; D015897:Comorbidity; D003510:Cyclohexanes / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D054659:Diketopiperazines; D004198:Disease Susceptibility; D015195:Drug Design; D023581:HIV Fusion Inhibitors / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology; D006720:Homozygote; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology; D015994:Incidence; D007239:Infections / Q000453:epidemiology; D000077592:Maraviroc; D008561:Membrane Fusion / Q000187:drug effects; D009369:Neoplasms / Q000453:epidemiology; D010879:Piperazines / Q000009:adverse effects; D019713:Receptors, CCR5 / Q000235:genetics; D017384:Sequence Deletion; D013141:Spiro Compounds / Q000009:adverse effects; D014230:Triazoles / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D053585:Virus Attachment / Q000187:drug effects; D053586:Virus Internalization / Q000187:drug effects; D054299:env Gene Products, Human Immunodeficiency Virus / Q000502:physiology
D001565:Benzoates; D065100:CCR5 Receptor Antagonists; D003510:Cyclohexanes; D054659:Diketopiperazines; D023581:HIV Fusion Inhibitors; D010879:Piperazines; D019713:Receptors, CCR5; D013141:Spiro Compounds; D014230:Triazoles; D054299:env Gene Products, Human Immunodeficiency Virus; C499671:aplaviroc; D000077592:Maraviroc