title: Four-year outcome of a PI and NRTI-sparing salvage regimen: maraviroc, raltegravir, etravirine.
abstract: Aim of this study was to report the 204-week efficacy and safety results of a novel PI- and NRTI-sparing regimen for salvage therapy including maraviroc, raltegravir, etravirine in 28 failing HIV-infected patients with R5-tropic virus. The trend of laboratory parameters was tested by ANOVA for repeated measures and Greenhouse-Geisser probabilities were reported. Results were described as median (Q1-Q3) values. Twenty-six (93%) out of 28 patients completed 204 weeks of treatment. Virological success (HIV-RNA<50 copies/mL) at week 204 was 96%. CD4+ counts significantly increased [244 (158-213) cells/mm3, p<0.0001] from baseline [247 (68-355) cells/mm(3)] as well as CD4+ percentage. Four serious adverse events (1 death due to Hodgkins's lymphoma, 1 anal cancer, 1 Hodgkins's lymphoma, 1 recurrence of mycobacterial spondylodiscitis) were observed; three events led to transitory discontinuation of the antiretroviral therapy due to drug-drug interaction. BMI (p<0.0001) and waist circumference (p<0.0001) significantly increased over 204 weeks. An amelioration was also observed in relation to haemoglobin (p=0.0006), platelets (p<0.0001), white blood cell (p=0.013), neutrophils (p=0.301), lymphocytes (p=0.207) and creatinine (p<0.0001). In highly treatment-experienced patients the maraviroc, raltegravir and etravirine combination is associated with a good long-term efficacy and safety profile.
authors.affiliation: Department of Infectious Diseases, San Raffaele Scientific Institute, Milan, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Nozza
authors.forename: Laura
authors.initials: L
authors.lastname: Galli
authors.forename: Alba
authors.initials: A
authors.lastname: Bigoloni
authors.forename: Nicola
authors.initials: N
authors.lastname: Gianotti
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Spagnuolo
authors.forename: Alessia
authors.initials: A
authors.lastname: Carbone
authors.forename: Stefania
authors.initials: S
authors.lastname: Chiappetta
authors.forename: Marco
authors.initials: M
authors.lastname: Ripa
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Tambussi
authors.forename: Adriano
authors.initials: A
authors.lastname: Lazzarin
authors.forename: Antonella
authors.initials: A
authors.lastname: Castagna
mesh_terms: D019380:Anti-HIV Agents / Q000008:administration & dosage* / Q000009:adverse effects; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects; D001772:Blood Cell Count; D003510:Cyclohexanes / Q000008:administration & dosage* / Q000009:adverse effects; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy* / Q000821:virology; D015497:HIV-1 / Q000187:drug effects / Q000235:genetics / Q000502:physiology; D006801:Humans; D000077592:Maraviroc; D008875:Middle Aged; D009570:Nitriles; D011724:Pyridazines / Q000008:administration & dosage* / Q000009:adverse effects; D011743:Pyrimidines; D011760:Pyrrolidinones / Q000008:administration & dosage* / Q000009:adverse effects; D000068898:Raltegravir Potassium; D016896:Treatment Outcome; D014230:Triazoles / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D019380:Anti-HIV Agents; D003510:Cyclohexanes; D009570:Nitriles; D011724:Pyridazines; D011743:Pyrimidines; D011760:Pyrrolidinones; D014230:Triazoles; C451734:etravirine; D000068898:Raltegravir Potassium; D000077592:Maraviroc