Maraviroc 150 mg daily plus lopinavir/ritonavir, a nucleoside/nucleotide reverse transcriptase inhibitor-sparing regimen for HIV-infected naive patients: 48-week final results of VEMAN study
| Autor: | S, Nozza, L, Galli, A, Antinori, S, Chiappetta, F, Mazzotta, M, Zaccarelli, S, Ottou, D, De Battista, M, Pogliaghi, M, Di Pietro, M, Malnati, M, Ripa, S, Bonora, A, Lazzarin, Mauro, Zaccarelli |
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| Přispěvatelé: | Nozza, S., Galli, L., Antinori, A., Chiappetta, S., Mazzotta, F., Zaccarelli, M., Ottou, S., De Battista, D., Pogliaghi, M., Di Pietro, M., Malnati, M., Ripa, M., Bonora, S., Lazzarin, A. |
| Rok vydání: | 2015 |
| Předmět: |
Male
Lopinavir/ritonavir HIV Infections Pharmacology Gastroenterology Lopinavir Maraviroc chemistry.chemical_compound Drug Combination Antiretroviral Therapy Highly Active HIV Infection Prospective Studies Antiretroviral therapy Human immunodeficiency virus Naive patients Nucleoside/nucleotide reverse transcriptase inhibitor-sparing regimen Microbiology (medical) Infectious Diseases Reverse-transcriptase inhibitor virus diseases General Medicine Viral Load Drug Combinations Treatment Outcome Female Human medicine.drug Adult medicine.medical_specialty Anti-HIV Agents Emtricitabine Virus Cyclohexane Cyclohexanes Internal medicine medicine Humans Human immunodeficiency viru Ritonavir business.industry Anti-HIV Agent Triazoles CD4 Lymphocyte Count Prospective Studie Regimen chemistry DNA Viral HIV-1 Triazole Naive patient business |
| Zdroj: | Clinical Microbiology and Infection. 21:510.e1-510.e9 |
| ISSN: | 1198-743X |
| Popis: | Non-conventional strategies with nucleoside/nucleotide reverse transcriptase inhibitor-sparing regimens in antiretroviral naive human immunodeficiency virus (HIV) -infected patients have been explored in clinical trials. A prospective, open-label, randomized (1:1), multicentre, proof-of-concept trial (VEMAN study, EUDRACT number 2008-006287-11) was conducted assigning HIV-infected naive patients to once-daily maraviroc plus lopinavir/ritonavir (MVC group) or to tenofovir/emtricitabine plus lopinavir/ritonavir (TDF/FTC group). Clinical and laboratory data were collected at baseline, and after 4, 12, 24, 36 and 48 weeks with the objective to evaluate the 48-week virological and immunological efficacy. HIV-1 DNA load and CD4(+) T-cell subsets were analysed on frozen peripheral blood mononuclear cells collected at baseline, 4 and 48 weeks to explore the trend in HIV reservoirs. Fifty patients were randomized and included in the analysis. During follow up, HIV-1 RNA decreased similarly in both groups and, at week 48, all patients in the MVC group and 22/24 (96%) in the TDF/FTC group had < 50 copies/ml of HIV-1 RNA. CD4(+) trend during follow up was higher in maraviroc-treated patients (MVC group: 286 (183-343) versus TDF/FTC group: 199 (125-285); Mann-Whitney U-test: p 0.033). A significant 48-week increase of CCR5(+) CD4(+) T cells and CD4(+) effector memory cells was observed among maraviroc-treated patients (Wilcoxon signed rank test: p 0.016 and p 0.007, respectively). No significant variations were found in naive and central memory CD4(+) T cells. Among naive patients with an R5 virus, treatment with maraviroc and lopinavir/ritonavir was shown to provide a virological response compared to a triple therapy and a greater immunological benefit. |
| Databáze: | OpenAIRE |
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