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European Journal of Medical Research
Erschienen in: European Journal of Medical Research 6/2010

01.12.2010 | Research

Maraviroc in treatment-experienced patients with HIV-1 infection - experience from routine clinical practice

verfasst von: S Reuter, P Braken, B Jensen, S Sierra-Aragon, M Oette, M Balduin, R Kaiser, D Häussinger

Erschienen in: European Journal of Medical Research | Ausgabe 6/2010

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Abstract

Objective

Few data are available about the efficacy of maraviroc (MVC) during routine use. We characterized indications for MVC use and the efficacy of MVC in clinical practice.

Methods

Thirty-two patients treated with MVC at our institution between 2006 and 2009 were included. Genotypic (n = 31) and phenotypic (n = 13) tropism analysis was performed. We determined indications for MVC use, characteristics of antiretroviral combination partners and treatment outcome.

Results

Complete suppression of viral replication was achieved in 78% after 6 months. A median increase of 124 CD4+ cells/μl after 6 months was observed. Concordance between phenotypic and genotypic tropism was found in 75%. Indications for MVC treatment included treatment failure (n = 15), intolerance to previous antiretrovirals (n = 6) and add-on MVC for intensification without changing the current regimen (n = 11). The add-on strategy was used in patients with a relatively low viremia in order to achieve complete viral load suppression or in situations with suppressed viral load but judged as unstable due to an extensive resistance pattern. Salvage drugs most frequently combined with MVC were darunavir (n = 14) and raltegravir (n = 14).
The genotypic assay had predicted CXCR4 tropism in 5 patients, using a false positive rate (FPR) of 20%. Lowering the FPR to 5% predicted CCR5 tropism in 4 cases, still resulting in sustained complete viral response under MVC use.

Conclusions

MVC containing salvage regimens achieve relevant CD4 cell increases and high viral response rates. In patients with few remaining treatment options it may be justified to lower the FPR-cutoff to 5% when predicting the coreceptor usage. Hereby, MVC could still be applied in selected patients with otherwise limited treatment options.
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Metadaten
Titel
Maraviroc in treatment-experienced patients with HIV-1 infection - experience from routine clinical practice
verfasst von
S Reuter
P Braken
B Jensen
S Sierra-Aragon
M Oette
M Balduin
R Kaiser
D Häussinger
Publikationsdatum
01.12.2010
Verlag
BioMed Central
Erschienen in
European Journal of Medical Research / Ausgabe 6/2010
Elektronische ISSN: 2047-783X
DOI
https://doi.org/10.1186/2047-783X-15-6-231

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