Journal
JOURNAL OF INFECTIOUS DISEASES
Volume 206, Issue 4, Pages 534-542Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/infdis/jis376
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Funding
- National Institute of Allergy and Infectious Diseases [U01 AI68636, AI068634, AI045008, AI050409, AI050410, AI060354, AI082151, K24 AI51966, R01 AI066992-04A1]
- National Institute of Allergy and Infectious Diseases (Virology Support Laboratory) [204VC009]
- National Institute of Allergy and Infectious Diseases (Statistical and Data Analysis Center) [AI069418, AI069419, AI069423, AI069424, AI069432, AI069439, AI069447, AI069452, AI069465, AI069471, AI069472, AI069474, AI069477, AI069484, AI069494, AI069495, AI69501, AI069502, AI069503, AI069511, AI069532, AI069556]
- National Center for Research Resources [RR023561, RR024160, RR 025747, RR024975, RR024996]
- National Library of Medicine [G08LM008830-01]
- Pfizer
- Tibotec
- Gilead Sciences
- Merck
- ViiV
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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/mu L 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/mu L. The median increase in CD4(+) T-cell count from baseline to week 22/24 was 12 cells/mu L (90% confidence interval, 1-22). A CD4(+) T-cell count increase of at least 20 cells/mu L 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/mu L. Further studies of CCR5 antagonists in the dampening of immune activation associated with HIV infection are warranted.
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