Anti-inflammatory effect of maraviroc in an HIV-infected patient with concomitant myositis: a case report.
We report the surprising yet sought impact that an antiretroviral (ARV) regimen containing maraviroc had on an HIV-infected and heavily highly active antiretroviral therapy (HAART)-experienced patient with chronic polymyositis. The patient had elevated creatine kinase (CK) levels in serum for 6 years, reaching peaks over 900 U/L and showing only partial response to high-dose steroids, not responding to HAART withdrawal. The disease started while on second-line HAART and gradually impaired his muscular function, leading to the absolute loss of the ability to stand on his legs. Atherosclerosis and hypertension contributed to the development of myocardial infarction. The association of unboosted atazanavir (ATV) plus maraviroc was designed hoping in a protective role on the cardiovascular system and in an anti-inflammatory effect that some authors have hypothesized. After only 3 months the patient's CK levels had normalized and with the help of rehabilitation he recovered the ability to walk, which he still maintains at the one year of observation.
Capetti
Amedeo F
AF
1st Division of Infectious Diseases, "Luigi Sacco" Hospital, Milan, Italy. capetti.amedeo@hsacco.it
Pocaterra
Daria
D
Zucchi
Patrizia
P
Carenzi
Laura
L
Rizzardini
Giuliano
G
D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D002908:Chronic Disease; D003402:Creatine Kinase / Q000097:blood; D003510:Cyclohexanes / Q000008:administration & dosage / Q000627:therapeutic use*; D023581:HIV Fusion Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000821:virology; D006801:Humans; D008297:Male; D000077592:Maraviroc; D009220:Myositis / Q000150:complications* / Q000188:drug therapy*; D016896:Treatment Outcome; D014230:Triazoles / Q000008:administration & dosage / Q000627:therapeutic use*
D000893:Anti-Inflammatory Agents; D003510:Cyclohexanes; D023581:HIV Fusion Inhibitors; D014230:Triazoles; D003402:Creatine Kinase; D000077592:Maraviroc