Impact of prolonged maraviroc treatment on non-AIDS-related comorbidities in HIV-positive patients: a retrospective cohort study.
J Antimicrob Chemother
; 74(9): 2723-2731, 2019 09 01.
Article
em En
| MEDLINE
| ID: mdl-31139818
ABSTRACT
OBJECTIVES:
This retrospective study evaluates the effect of maraviroc, the first CCR5 receptor antagonist, on non-AIDS-related comorbidity incidence and its impact on inflammatory and lipid parameters.METHODS:
Seventy-four HIV patients on maraviroc treatment were compared with 312 patients never exposed to maraviroc (matched for sex, age and CD4 nadir).RESULTS:
At baseline (T0), maraviroc patients presented a longer duration of HIV infection, a higher prevalence of comorbidities and a greater frequency of polypharmacy. Non-AIDS-defining disease incidence was lower in the maraviroc group than in the non-maraviroc group (without achieving statistical significance). Except triglycerides (TGL), which dropped only in the maraviroc group, inflammatory and immunological parameters did not significantly change in either group by the end of the study period (T3). At T3, high-sensitivity C-reactive protein (hsCRP) and high-density lipoprotein were inversely correlated in both groups (Spearman's rho maraviroc -0.30, Pâ=â0.05; non-maraviroc -0.23, Pâ=â0.0003). Only in the non-maraviroc group was the positive correlation between hsCRP and lipids observed both at T0 (hsCRP/low-density lipoprotein (LDL) +0.17, Pâ=â0.004; hsCRP/total cholesterol +0.20, Pâ=â0.0007; hsCRP/TGL +0.12, Pâ=â0.04) and T3 (hsCRP/LDL +0.26, Pâ<â0.0001; hsCRP/total cholesterol +0.24, Pâ=â0.0001; hsCRP/TGL +0.15, Pâ=â0.02). These correlations were not found in the maraviroc group. A significant positive correlation was found at T0 and at T3 between hsCRP and D-dimer in both groups (maraviroc T0 +0.46, Pâ=â0.0007; T3 +0.41, Pâ=â0.006; non-maraviroc T0 +0.17, Pâ=â0.02; T3 +0.17, Pâ=â0.017).CONCLUSIONS:
These data suggest a possible protective role of maraviroc in the incidence of non-AIDS-related comorbidities in a population with longer-lasting infection and allow us to hypothesize its role in the modulation of lipid-dependent inflammation.
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
2_ODS3
Base de dados:
MEDLINE
Assunto principal:
Infecções por HIV
/
Fármacos Anti-HIV
/
Maraviroc
Tipo de estudo:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
J Antimicrob Chemother
Ano de publicação:
2019
Tipo de documento:
Article