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Differential CD4+ cell count increase and CD4+ : CD8+ ratio normalization with maraviroc compared with tenofovir
- Publication Year :
- 2016
- Publisher :
- The University of North Carolina at Chapel Hill University Libraries, 2016.
-
Abstract
- Objective Studies exploring the immunologic effects of maraviroc (MVC) have produced mixed results; hence, it remains unclear whether MVC has unique immunologic effects in comparison with other antiretroviral drugs. We sought to determine whether MVC has differential effects compared with tenofovir disoproxil fumarate (TDF) during initial antiretroviral therapy. Design Prospective study in AIDS Clinical Trials Group A5303, a double-blind, placebo-controlled trial (N = 262) of MVC vs. TDF, each combined with boosted darunavir and emtricitabine. Methods A total of 31 cellular and soluble biomarkers were assayed at weeks 0 and 48. Polychromatic flow cytometry was performed on cryopreserved peripheral blood mononuclear cells. Soluble markers were assayed in plasma using ELISA kits. Analyses were as treated. Results Analyses included 230 participants (119 in MVC arm and 111 in TDF arm). Over 48 weeks of treatment, no significant differences were detected in declines in markers of inflammation and activation with MVC vs. TDF. A greater CD4 T-cell count increase (median +234 vs. +188 cells/μl, P = 0.036), a smaller CD8 T-cell count decrease (-6 vs. -109 cells/μl, P = 0.008), and a smaller CD4 : CD8 ratio increase (0.26 vs. 0.39, P = 0.003) occurred with MVC. Among participants with a baseline CD4 : CD8 ratio less than 1, a smaller proportion of MVC group normalized to a ratio greater than 1 at week 48 (15 and 36%, P Conclusion MVC resulted in less improvement in the CD4 : CD8 ratio driven by greater increase in CD4 cell count but smaller decline in CD8 cell count. Changes in soluble or cellular biomarkers of inflammation and immune activation were not different between MVC and TDF.
- Subjects :
- Adult
Male
0301 basic medicine
medicine.medical_specialty
Anti-HIV Agents
030106 microbiology
Immunology
CD4-CD8 Ratio
HIV Infections
Emtricitabine
Peripheral blood mononuclear cell
Gastroenterology
Article
Flow cytometry
Maraviroc
Placebos
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
Double-Blind Method
Cyclohexanes
Internal medicine
medicine
Humans
Immunology and Allergy
Prospective Studies
030212 general & internal medicine
Tenofovir
Prospective cohort study
Darunavir
medicine.diagnostic_test
business.industry
Triazoles
Flow Cytometry
musculoskeletal system
CD4 Lymphocyte Count
body regions
Treatment Outcome
Infectious Diseases
chemistry
Female
business
human activities
CD8
medicine.drug
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....867e5363fd69a3165f0bf152d90b1e0a
- Full Text :
- https://doi.org/10.17615/492w-e493