Long-term immunovirogical effect and tolerability of a maraviroc-containing regimen in routine clinical practice.
OBJECTIVE
to analyze the long-term immunovirological effect and tolerability of a maraviroc-containing antiretroviral therapy in viraemic and pretreated HIV-infected patients with a high prevalence of hepatitis C virus (HCV) coinfection.


METHODS
forty-six R5 HIV-infected patients (48% HCV-coinfected) started a maraviroc-containing antiretroviral regimen, including patients with multidrug resistant virus and patients after first virologic failure. A retrospective study was performed, analysing percentage of patients with undetectable viral load, mean CD4+ gain, liver enzymes, clinical events and treatment modification up to week 48.


RESULTS
Raltegravir plus a boosted protease inhibitor was combined with maraviroc in 65.2% of the patients (mainly patients with multidrug resistant virus), while the coformulation lamivudine/abacavir was combined with maraviroc in 26.1% (all of them patients after first virologic failure). After 48 weeks on maraviroc-containing regimen, 96.3% of the patients had achieved undetectability and a mean CD4+ count increase of 151 cells/mm3 was observed. Liver enzymes did not increase along the follow up. One patient died after 24 weeks follow up due to heroin overdose. One patient developed a non-Hodgkin lymphoma after 36 weeks follow up, despite undetectable viral load and significant CD4+ increase was achieved (the only AIDS-defining event observed). Treatment modification was performed in 19.6% of the patients: 77.7% of them experienced a treatment simplification and only 1/46 suspended maraviroc.


CONCLUSIONS
maraviroc-containing regimen is long-term effective and well tolerated in HIV-infected patients in routine clinical practice and in different clinical scenarios.
Genebat
Miguel
M
Biochemistry Department, Virgen del Rocío University Hospital, Biomedicine Institute of Seville, Spain.
Ruiz-Mateos
Ezequiel
E
Pulido
Ildefonso
I
González-Serna
Alejandro
A
García-Pergañeda
Antonio
A
Méndez
Gema
G
Romero-Sánchez
María Concepción
MC
Ferrando-Martínez
Sara
S
Leal
Manuel
M
D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects / Q000627:therapeutic use*; D044966:Anti-Retroviral Agents / Q000009:adverse effects / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D003510:Cyclohexanes / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy* / Q000276:immunology / Q000821:virology; D017320:HIV Protease Inhibitors / Q000627:therapeutic use; D015497:HIV-1 / Q000187:drug effects; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D008297:Male; D000077592:Maraviroc; D008875:Middle Aged; D011760:Pyrrolidinones / Q000627:therapeutic use; D000068898:Raltegravir Potassium; D012189:Retrospective Studies; D013030:Spain; D013995:Time; D014230:Triazoles / Q000009:adverse effects / Q000627:therapeutic use*; D019562:Viral Load
D019380:Anti-HIV Agents; D044966:Anti-Retroviral Agents; D003510:Cyclohexanes; D017320:HIV Protease Inhibitors; D011760:Pyrrolidinones; D014230:Triazoles; D000068898:Raltegravir Potassium; D000077592:Maraviroc