Long-Term Immunovirogical Effect and Tolerability of a Maraviroc- Containing Regimen in Routine Clinical Practice
Miguel Genebat, Ezequiel Ruiz-Mateos, Ildefonso Pulido, Alejandro Gonzalez-Serna, Antonio Garcia-Perganeda, Gema Mendez, Maria Concepcion Romero-Sanchez, Sara Ferrando-Martinez and Manuel Leal
Affiliation: Av Manuel Siurot s/n, Laboratory of Immunovirology, Biomedicine Institute of Seville (IBIS), Service of Infectious Diseases, Virgen del Rocío University Hospital, Sevilla PC: 41013, Spain.
Keywords: Hepatitis C virus, HIV, maraviroc, routine clinical practice
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 (48% 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 65.2% of the patients (mainly patients with multidrug resistant virus), while the coformulation lamivudine/abacavir was combined with maraviroc in 26.1% (all of them patients after first virologic failure). After 48 weeks on maraviroc-containing regimen, 96.3% 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 19.6% 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.
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