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14.06.2016 | Original Research | Ausgabe 3/2016 Open Access

Infectious Diseases and Therapy 3/2016

Maraviroc Intensification Improves Endothelial Function in Abacavir-Treated Patients, an Open-Label Randomized Cross-Over Pilot Study

Zeitschrift:
Infectious Diseases and Therapy > Ausgabe 3/2016
Autoren:
Maaike Krikke, Kiki Tesselaar, Joop E. Arends, Julia Drylewicz, Sigrid A. Otto, Steven F. L. van Lelyveld, Frank J. L. Visseren, Andy I. M. Hoepelman
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1007/​s40121-016-0115-0) contains supplementary material, which is available to authorized users.

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Abstract

Background

The increased risk of abacavir in cardiovascular disease (CVD) in HIV-infected patients is still being debated. Maraviroc, a CCR5 blocker, has been shown to decrease immune activation and monocyte infiltration in atherosclerotic plaques in murine experiments. Therefore, we examined the effect of maraviroc intensification on flow-mediated dilatation (FMD) in abacavir-treated HIV-infected patients and its effect on immunological and inflammatory parameters.

Methods

A open-label prospective crossover study with a duration of 16 weeks: 8 weeks of intervention (maraviroc intensification) and 8 weeks of control (unchanged cART regimen). FMD, HIV-specific variables, expression of HIV co-receptors, markers of inflammation and coagulation and cellular markers of immune activation were measured at weeks 0, 8 and 16. The changes (Δ) in these variables were compared between intervention and control periods using non-parametric tests. To evaluate the relation with the change in FMD, linear regression modeling was used.

Results

Twenty-one male patients with suppressed plasma HIV-RNA, on cART, had a known HIV infection for 9.2 years (IQR 6.9–13.5) with abacavir use for 6.5 years (2.8–9.3). A significantly increased FMD of 0.73% (IQR −0.25 to 1.70) was seen after maraviroc intensification compared to a decrease of −0.42% (IQR −1.89 to 0.25; p = 0.049) in the control period. There was a negative relation between ΔFMD with ΔD-dimer (β −22.70, 95% CI −39.27; −6.13, p = 0.011) and ΔCD95+ CD4+ T cells (β −0.16, 95% CI −0.28; −0.04, p = 0.013), adjusted for age and duration of HIV.

Conclusion

Maraviroc intensification modestly improves endothelial function in HIV-infected patients on an abacavir-containing regimen.

Trial registration

NCT01389063.
Zusatzmaterial
Supplementary material 1 (DOCX 15 kb)
40121_2016_115_MOESM1_ESM.docx
Literatur
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