title: Clinical outcome of maraviroc-containing therapy in heavily pre-treated HIV-1-infected patients.
abstract: Available data on the use of maraviroc (MVC) in clinical settings are limited. In this cohort study, the clinical outcomes of HIV-1-infected patients treated with MVC were analysed and the predictive values of different tropism assays were compared. Baseline viral tropism was assessed and compared by phenotypic (Trofile and MT-2) and genotypic assays. Virological and immunological responses were evaluated. In total, 62 predominantly extensively pre-treated patients started MVC [median GSS 2.0 (IQR 2.0-2.5)]. Tropism assays were performed on baseline samples of 58 patients (93.5%). Thirty-two samples (80.0%) were classified as R5 by Trofile, 41 (80.4%) by genotypic tropism test (GTT) and 17 (81.0%) by MT-2. At least two types of tropism assay were performed on samples from 39 patients, whereas in 15 patients all three assays were performed (concordance 84.8-94.1%). Plasma HIV-RNA was <50 copies/mL in 82.1%, 85.0% and 68.8% of patients after 12, 24 and 36 months, respectively; median CD4 cell increase was 199 (IQR 108-283), 291 (IQR 187-413) and 234 (IQR 106-444)cells/μL. The predictive values of different tropism assays were comparably high: at Month 24, 92.9% (Trofile and GTT) and 100.0% (MT-2) of patients had plasma HIV-RNA <50 copies/mL. Three patients stopped MVC treatment because of suspected side effects. Five patients died during follow-up. In this heavily pre-treated cohort, treatment with MVC was well tolerated and resulted in good immunological and virological responses. Results generated by the different tropism assays correlated well with each other and had a high predictive value.
authors.affiliation: Department of Internal Medicine & Gastroenterology, Spaarne Gasthuis, Haarlem, The Netherlands; Department of Internal Medicine & Infectious Diseases, University Medical Center Utrecht, Utrecht, The Netherlands. Electronic address: s.van.lelyveld@kg.nl.
authors.forename: S F L
authors.initials: SF
authors.lastname: van Lelyveld
authors.affiliation: Department of Medical Microbiology & Virology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: Symons
authors.affiliation: Department of Medical Microbiology & Virology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: P
authors.initials: P
authors.lastname: van Ham
authors.affiliation: Department of Medical Microbiology & Virology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: B J
authors.initials: BJ
authors.lastname: Connell
authors.affiliation: Department of Medical Microbiology & Virology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Nijhuis
authors.affiliation: Department of Medical Microbiology & Virology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: A M J
authors.initials: AM
authors.lastname: Wensing
authors.affiliation: Department of Internal Medicine & Infectious Diseases, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: A I M
authors.initials: AI
authors.lastname: Hoepelman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000008:administration & dosage* / Q000009:adverse effects; D018791:CD4 Lymphocyte Count; D003510:Cyclohexanes / Q000008:administration & dosage* / Q000009:adverse effects; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology*; D015497:HIV-1 / Q000302:isolation & purification* / Q000502:physiology; D006801:Humans; D008297:Male; D000077592:Maraviroc; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D014230:Triazoles / Q000008:administration & dosage* / Q000009:adverse effects; D019562:Viral Load; D056189:Viral Tropism; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents; D003510:Cyclohexanes; D014230:Triazoles; D000077592:Maraviroc
keywords: CCR5 antagonist; HIV Infection; Human immunodeficiency virus; Maraviroc; Tropism