L Bocket1, G Peytavin2, E K Alidjinou1, F Ajana3, P Choisy3, M Lê2, C Charpentier4, D Descamps4, Yazdan Yazdanpanah5, C Katlama6, A Simon7, V Calvez8, A-G Marcelin8, C Soulie9. 1. Virology Laboratory CHRU, Lille, France. 2. Pharmacology Laboratory Bichat Hospital APHP, Paris, France IAME, UMR 1137-Université Paris Diderot, Sorbonne Paris Cité, France INSERM UMR 1137, F-75018 Paris, France. 3. Infectious Diseases Department Dron Hospital, Tourcoing, France. 4. IAME, UMR 1137-Université Paris Diderot, Sorbonne Paris Cité, France INSERM UMR 1137, F-75018 Paris, France AP-HP, Hôpital Bichat, Laboratoire de Virologie, F-75018 Paris, France. 5. Infectious Diseases Department Bichat Hospital, Paris, France. 6. Sorbonne Universités, UPMC Univ Paris 06-UMR_S 1136, Pierre Louis Institute of Epidemiology and Public Health, F-75005 Paris, France INSERM-UMR_S 1136, Pierre Louis Institute of Epidemiology and Public Health, F-75013 Paris, France Infectious Diseases Department Pitié Salpêtrière Hospital, Paris, France. 7. Internal Medicine Department Pitié Salpêtrière Hospital, Paris, France. 8. Sorbonne Universités, UPMC Univ Paris 06-UMR_S 1136, Pierre Louis Institute of Epidemiology and Public Health, F-75005 Paris, France INSERM-UMR_S 1136, Pierre Louis Institute of Epidemiology and Public Health, F-75013 Paris, France AP-HP, Groupe Hospitalier Pitié Salpêtrière, Laboratoire de Virologie, Paris F-75013, France. 9. Sorbonne Universités, UPMC Univ Paris 06-UMR_S 1136, Pierre Louis Institute of Epidemiology and Public Health, F-75005 Paris, France INSERM-UMR_S 1136, Pierre Louis Institute of Epidemiology and Public Health, F-75013 Paris, France AP-HP, Groupe Hospitalier Pitié Salpêtrière, Laboratoire de Virologie, Paris F-75013, France cathia.soulie@psl.aphp.fr.
Abstract
OBJECTIVES: There are few data on clinical and virological factors associated with maraviroc virological response (VR) in clinical practice. This study aimed to identify factors associated with VR in 94 treatment-experienced, but CCR5 inhibitor-naive, HIV-1 patients switched to maraviroc-containing regimens. METHODS: Patients with HIV-1 RNA viral load (VL) <50 copies/mL switching to an antiretroviral treatment containing maraviroc were followed. VR was defined at month 3 as VL <50 copies/mL. The impact of age, baseline tropism, zenith VL, nadir CD4 cell count and CD4 cell count, HIV subtype (B versus non-B), genotypic susceptibility score of treatment, once- or twice-daily treatment and presence of raltegravir in optimized background therapy on VR was investigated. RESULTS: Baseline characteristics were: median age 49 years (range 25-73 years), median CD4 cell count 481 cells/mm(3) (range 57-1830 cells/mm(3)) and median nadir CD4 cell count 99 cells/mm(3) (range 3-585). Maraviroc was administered twice daily in 88 of 94 patients and once daily in 6 of 94 patients (300 mg/day for 4 of 6 and 150 mg/day for 2 of 6). At month 3, 89.4% of patients were responders. A better VR to a switch regimen containing maraviroc was associated with the B subtype (P = 0.0216) and a lower zenith VL (median of 5.24 and 5.70 log10 copies/mL for patients in success or in failure, respectively) in univariate analysis. Only B subtype was associated with a better VR in multivariate analysis. CONCLUSIONS: This study evidenced the efficacy of a switch regimen containing maraviroc in clinical practice. VR was better for patients with a lower zenith VL and B subtype.
OBJECTIVES: There are few data on clinical and virological factors associated with maraviroc virological response (VR) in clinical practice. This study aimed to identify factors associated with VR in 94 treatment-experienced, but CCR5 inhibitor-naive, HIV-1patients switched to maraviroc-containing regimens. METHODS:Patients with HIV-1 RNA viral load (VL) <50 copies/mL switching to an antiretroviral treatment containing maraviroc were followed. VR was defined at month 3 as VL <50 copies/mL. The impact of age, baseline tropism, zenith VL, nadir CD4 cell count and CD4 cell count, HIV subtype (B versus non-B), genotypic susceptibility score of treatment, once- or twice-daily treatment and presence of raltegravir in optimized background therapy on VR was investigated. RESULTS: Baseline characteristics were: median age 49 years (range 25-73 years), median CD4 cell count 481 cells/mm(3) (range 57-1830 cells/mm(3)) and median nadir CD4 cell count 99 cells/mm(3) (range 3-585). Maraviroc was administered twice daily in 88 of 94 patients and once daily in 6 of 94 patients (300 mg/day for 4 of 6 and 150 mg/day for 2 of 6). At month 3, 89.4% of patients were responders. A better VR to a switch regimen containing maraviroc was associated with the B subtype (P = 0.0216) and a lower zenith VL (median of 5.24 and 5.70 log10 copies/mL for patients in success or in failure, respectively) in univariate analysis. Only B subtype was associated with a better VR in multivariate analysis. CONCLUSIONS: This study evidenced the efficacy of a switch regimen containing maraviroc in clinical practice. VR was better for patients with a lower zenith VL and B subtype.
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