Efficacy and safety of long-term Maraviroc use in a heterogeneous group of HIV-infected patients : a retrospective cohort study
Weehuizen, J M; Wensing, A M J; Mudrikova, T; Wit, F W N M; Hoepelman, A I M
(2019) International Journal of Antimicrobial Agents, volume 54, issue 2, pp. 215 - 222
(Article)
Abstract
Since the registration of maraviroc (MVC) as an antiretroviral agent in 2008, only studies with a follow-up time of <5 years have been published. Therefore, little is known about its long-term safety and efficacy in clinical practice. In this cohort study, data on long-term follow-up of MVC treatment in routine
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practice were analysed. A retrospective cohort study was conducted at University Medical Centre Utrecht with a follow-up period up to almost 10 years. The efficacy and tolerability of MVC-containing antiretroviral therapy (ART) was analysed in human immunodeficiency virus type 1 (HIV-1)-infected patients. The cohort consisted of 111 HIV patients who were treated for a median of 11.0 years (IQR 4.0–15.0 years) and with a median of 4 (IQR 2–6) previous ART regimens. The median time of MVC use was 49 months (IQR 21–82 months). Mean CD4 + T-cell counts continued to increase up to 9 years following initiation of MVC. Patients with a detectable viral load (≥50 copies/mL HIV-RNA) at the start of MVC-containing ART reached high proportions of viral suppression. Only three patients (2.7%) experienced treatment failure despite optimal therapy. Nine patients (8.1%) discontinued MVC owing to intolerance of their ART regimen. Severe laboratory abnormalities were deemed to be unrelated to MVC use. During the 487 person-years of follow-up, 18 patients (16.2%) died. MVC use in this heavily pre-treated cohort was generally well tolerated during long-term follow-up. Furthermore, use of MVC resulted in a good immunological and virological response in clinical practice.
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Keywords: AIDS, Antiretroviral therapy, CCR5 antagonist, HIV, MVC, Maraviroc, Drug-Related Side Effects and Adverse Reactions/epidemiology, Follow-Up Studies, Humans, Middle Aged, Male, Viral Load, HIV Infections/drug therapy, Maraviroc/administration & dosage, Young Adult, Netherlands, Time Factors, Aged, 80 and over, Adult, Female, Retrospective Studies, Hospitals, University, Treatment Outcome, CD4 Lymphocyte Count, HIV Fusion Inhibitors/administration & dosage, Adolescent, Aged, Microbiology (medical), Infectious Diseases, Pharmacology (medical), Journal Article
ISSN: 0924-8579
Publisher: Elsevier
Note: Copyright © 2019 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.
(Peer reviewed)