title: Update on clinical and methodological recommendations for genotypic determination of HIV tropism to guide the usage of CCR5 antagonists.
abstract: The genotypic determination of HIV tropism to guide the use of maraviroc, the first CCR5 antagonist with specific antiviral activity against CCR5 (R5)-tropic HIV variants, has been widespread in the last two years. Retrospective analyses from maraviroc clinical trials (MOTIVATE and MERIT) demonstrated that specific genotypic tools and the phenotypic assay TrofileTM are comparable in predicting virologic response to maraviroc. Moreover, recent studies performed in cohorts of patients outside clinical trials have reported overall rates of virologic response to maraviroc up to 82% in patients harboring HIV R5-tropic variants according to genotypic tools. Specific technical requirements as well as recommendations for proper HIV tropism determination in the clinical setting have been improving, according to new data reported in several studies related with this issue. This review updates clinical and methodological recommendations for genotypic determination of HIV tropism to guide therapeutic decisions using CCR5 antagonists, considering the most recently reported data.
authors: Infectious Diseases Department, Hospital Carlos III, Madrid, Spain. evapoveda@hotmail.com
authors: Eva
authors: E
authors: Poveda
authors: Roger
authors: R
authors: Paredes
authors: Santiago
authors: S
authors: Moreno
authors: José
authors: J
authors: Alcamí
authors: Juan
authors: J
authors: Córdoba
authors: Rafael
authors: R
authors: Delgado
authors: Félix
authors: F
authors: Gutiérrez
authors: Josep M
authors: JM
authors: Llibre
authors: Miguel
authors: M
authors: García Deltoro
authors: José
authors: J
authors: Hernández-Quero
authors: Federico
authors: F
authors: Pulido
authors: José Antonio
authors: JA
authors: Iribarren
authors: Federico
authors: F
authors: García
mesh_terms: D065100:CCR5 Receptor Antagonists; D002986:Clinical Trials as Topic; D003510:Cyclohexanes / Q000627:therapeutic use*; D005260:Female; D005838:Genotype; D023581:HIV Fusion Inhibitors / Q000627:therapeutic use*; D006679:HIV Seropositivity / Q000188:drug therapy* / Q000235:genetics / Q000821:virology; D015497:HIV-1 / Q000235:genetics / Q000502:physiology*; D006801:Humans; D008297:Male; D000077592:Maraviroc; D010641:Phenotype; D019713:Receptors, CCR5 / Q000627:therapeutic use; D014230:Triazoles / Q000627:therapeutic use*; D056189:Viral Tropism / Q000235:genetics / Q000502:physiology*
chemical_list: D065100:CCR5 Receptor Antagonists; D003510:Cyclohexanes; D023581:HIV Fusion Inhibitors; D019713:Receptors, CCR5; D014230:Triazoles; D000077592:Maraviroc