Current HIV Research (v.8, #7)
Long-Term Immunovirogical Effect and Tolerability of a Maraviroc- Containing Regimen in Routine Clinical Practice by Miguel Genebat, Ezequiel Ruiz-Mateos, Ildefonso Pulido, Alejandro Gonzalez-Serna, Antonio Garcia-Perganeda, Gema Mendez, Maria Romero-Sanchez, Sara Ferrando-Martinez, Manuel Leal (482-486).
Objectives: 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 (48and#x25; 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 65.2and#x25; of the patients (mainly patients with multidrug resistant virus), while the coformulation lamivudine/abacavir was combined with maraviroc in 26.1and#x25; (all of them patients after first virologic failure). After 48 weeks on maraviroc-containing regimen, 96.3and#x25; 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 19.6and#x25; 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.