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; Centre, Academic; 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: Funding Information: The authors thank S.F.L. Lelyveld for his contribution to this study. None. AMJW has received financial support for research, unrestricted educational activities or consultancies from ARK Diagnostics, BMS, Gilead, MSD, Pfizer, Janssen-Cilag and ViiV Healthcare and travel support and speaking fees from Conference Organiser Virology Education (all fees are paid to her institution; none of the fees were related to this paper); AIMH was a member of the Advisory Board for Gilead, ViiV and MSD (until 2016), received a ViiV grant 2008 for Netherlands Trial Registry (NTR1592), and additionally at ClinicalTrials.gov on 1 April 2009 [NCT00875368]; FWNMW has received financial support for speaking engagements and consultancies from Gilead and ViiV Healthcare; TM has received financial support for travel costs from MSD and for consultancy from Gilead. JW declares no competing interests. Not required. Publisher Copyright: © 2019 Elsevier B.V. and International Society of Chemotherapy Copyright: Copyright 2019 Elsevier B.V., All rights reserved.
(Peer reviewed)