We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
A Pilot Trial of Adding Maraviroc to Suppressive Antiretroviral Therapy for Suboptimal CD4+ T-Cell Recovery Despite Sustained Virologic Suppression: ACTG A5256.
- Authors
Wilkin, Timothy J.; Lalama, Christina M.; McKinnon, John; Gandhi, Rajesh T.; Lin, Nina; Landay, Alan; Ribaudo, Heather; Fox, Lawrence; Currier, Judith S.; Mellors, John W.; Gulick, Roy; Tenorio, Allan R.
- Abstract
Background. Despite viral suppression, antiretroviral therapy (ART) does not restore CD4+ T-cell counts in many patients infected with human immunodeficiency virus type 1 (HIV-1).Methods. In a single-arm pilot trial involving ART recipients with suppressed plasma levels of HIV-1 RNA for at least 48 weeks and stable suboptimal CD4+ T-cell recovery, subjects added maraviroc, a CCR5 antagonist, to their existing ART for 24 weeks. After stopping maraviroc, they were followed for an additional 24 weeks. A Wilcoxon signed-rank test was used to evaluate whether maraviroc was associated with an increase of at least 20 cells/µL in the CD4+ T-cell count.Results. A total of 34 subjects were enrolled. The median age was 50 years, and the median baseline CD4+ T-cell count was 153 cells/µL. The median increase in CD4+ T-cell count from baseline to week 22/24 was 12 cells/µL (90% confidence interval, 1–22). A CD4+ T-cell count increase of at least 20 cells/µL was not detected (P = .97). Markers of immune activation and apoptosis decreased during maraviroc intensification; this decline partially reversed after discontinuing maraviroc.Conclusions. Adding maraviroc to suppressive ART for 24 weeks was not associated with an increase in CD4+ T-cell counts of at least 20 cells/µL. Further studies of CCR5 antagonists in the dampening of immune activation associated with HIV infection are warranted.Clinical Trials Registration. NCT 00709111.
- Subjects
HIV infections; THERAPEUTICS; MARAVIROC (Drug); CLINICAL trials; ANTIRETROVIRAL agents; CD4 antigen; T cells; VIROLOGY
- Publication
Journal of Infectious Diseases, 2012, Vol 206, Issue 4, p534
- ISSN
0022-1899
- Publication type
Article
- DOI
10.1093/infdis/jis376