OBJECTIVES: Nucleoside reverse transcriptase inhibitor (NRTI)-sparing regimens may be needed in patients with NRTI toxicity. Maraviroc (MVC) plus ritonavir-boosted darunavir (DRV-r) or atazanavir is associated with slightly lower response rates than triple therapy in drug-naïve patients. No information is available on these combinations in pretreated patients. The aim of this study was to assess the efficacy and safety of MVC plus DRV/r once-daily (qd) in HIV-infected pretreated patients. METHODS: A retrospective cohort study including patients starting MVC 150 mg plus DRV/r 800/100 mg qd, with CCR5 tropism and no resistance mutations for DRV/r, was performed. The primary efficacy endpoint was the achievement of plasma HIV RNA < 50 HIV-1 RNA copies/mL after 48 weeks. The frequency of serious adverse effects was investigated. RESULTS: Sixty patients were recruited to the study, of whom 48 (80%) had HIV RNA < 50 copies/mL at baseline. Reasons for starting MVC plus DRV/r were: adverse effects in 38 individuals (63%), simplification in 15 (25%) and virological failure in seven (12%). The main analysis (intention to treat, noncompleter = failure) showed that 47 patients (78%) achieved HIV RNA < 50 copies/mL at 48 weeks (paired comparison with baseline, P = 1.0). On-treatment analysis showed that 42 (86%) of 49 patients presented HIV RNA < 50 copies/mL at 48 weeks (paired comparison with baseline, P = 1.0). Median (interquartile range) CD4 cell counts increased from 491 (301-729) to 561 (367-793) cells/μL at 48 weeks (P = 0.013). Only one patient discontinued therapy because of adverse effects. CONCLUSIONS: Most individuals starting MVC plus DRV/r qd because of simplification or adverse effects maintained HIV suppression after 48 weeks of follow-up.
OBJECTIVES: Nucleoside reverse transcriptase inhibitor (NRTI)-sparing regimens may be needed in patients with NRTI toxicity. Maraviroc (MVC) plus ritonavir-boosted darunavir (DRV-r) or atazanavir is associated with slightly lower response rates than triple therapy in drug-naïve patients. No information is available on these combinations in pretreated patients. The aim of this study was to assess the efficacy and safety of MVC plus DRV/r once-daily (qd) in HIV-infected pretreated patients. METHODS: A retrospective cohort study including patients starting MVC 150 mg plus DRV/r 800/100 mg qd, with CCR5 tropism and no resistance mutations for DRV/r, was performed. The primary efficacy endpoint was the achievement of plasma HIV RNA < 50 HIV-1 RNA copies/mL after 48 weeks. The frequency of serious adverse effects was investigated. RESULTS: Sixty patients were recruited to the study, of whom 48 (80%) had HIV RNA < 50 copies/mL at baseline. Reasons for starting MVC plus DRV/r were: adverse effects in 38 individuals (63%), simplification in 15 (25%) and virological failure in seven (12%). The main analysis (intention to treat, noncompleter = failure) showed that 47 patients (78%) achieved HIV RNA < 50 copies/mL at 48 weeks (paired comparison with baseline, P = 1.0). On-treatment analysis showed that 42 (86%) of 49 patients presented HIV RNA < 50 copies/mL at 48 weeks (paired comparison with baseline, P = 1.0). Median (interquartile range) CD4 cell counts increased from 491 (301-729) to 561 (367-793) cells/μL at 48 weeks (P = 0.013). Only one patient discontinued therapy because of adverse effects. CONCLUSIONS: Most individuals starting MVC plus DRV/r qd because of simplification or adverse effects maintained HIV suppression after 48 weeks of follow-up.
Authors: Sarah Lilian Pett; Janaki Amin; Andrejz Horban; Jaime Andrade-Villanueva; Marcelo Losso; Norma Porteiro; Juan Sierra Madero; Waldo Belloso; Elise Tu; David Silk; Anthony Kelleher; Richard Harrigan; Andrew Clark; Wataru Sugiura; Marcelo Wolff; John Gill; Jose Gatell; Martin Fisher; Amanda Clarke; Kiat Ruxrungtham; Thierry Prazuck; Rolf Kaiser; Ian Woolley; Juan Alberto Arnaiz; David Cooper; Jürgen K Rockstroh; Patrick Mallon; Sean Emery Journal: Clin Infect Dis Date: 2016-04-05 Impact factor: 9.079
Authors: Manoli Vourvahis; Lynn McFadyen; Sunil Nepal; Srinivas Rao Valluri; Annie Fang; Gwendolyn D Fate; Linda S Wood; Jean-Claude Marshall; Phylinda L S Chan; Angus Nedderman; Julian Haynes; Mark E Savage; Andrew Clark; Kimberly Y Smith; Jayvant Heera Journal: J Clin Pharmacol Date: 2018-09-07 Impact factor: 3.126
Authors: Chloe Orkin; Pedro Cahn; Antonella Castagna; Brinda Emu; P Richard Harrigan; Daniel R Kuritzkes; Mark Nelson; Jonathan Schapiro Journal: HIV Med Date: 2022-03-16 Impact factor: 3.094
Authors: Andrea De Luca; Patrizio Pezzotti; Charles Boucher; Matthias Döring; Francesca Incardona; Rolf Kaiser; Thomas Lengauer; Nico Pfeifer; Eugen Schülter; Anne-Mieke Vandamme; Maurizio Zazzi; Anna Maria Geretti Journal: PLoS One Date: 2019-11-21 Impact factor: 3.240