Pujari Sanjay, Gaikwad Sunil, Bele Vivek, Joshi Kedar, Dabhade Digamber
1 Institute of Infectious Diseases, Mukund Nagar, Pune, Maharashtra, India.
J Int Assoc Provid AIDS Care. 2018 Jan-Dec;17:2325958218759211. doi: 10.1177/2325958218759211.
There is no information on the clinical effectiveness of Maraviroc (MVC) amongst People Living with HIV (PLHIV) in India infected with HIV-1 Subtype C viruses.
We conducted a retrospective chart review of adult PLHIV on MVC based Antiretroviral (ARV) regimens for at least 6 months. Maraviroc was initiated amongst PLHIV with documented R5 tropic viruses (determined by in-house population sequencing of the V3 loop in triplicate and interpreted using the Geno2Pheno algorithm) in combination with an Optimized Background regimen (designed using genotypic resistance testing and past ARV history). Plasma viral loads (PVL) are performed 6 months post-initiation and annually thereafter. Primary outcome d. Median duration on MVC treatment was 1.8 years (range 1-2.9 years) while median duration of ART prior to switching to MVC was 13 years. Maraviroc was combined with Darunavir/ritonavir (DRV/r) (n=10), Atazanavir/r (ATV/r) (n=2) and Lopinavir/r (LPV/r) (n=1). All PLHIV were infected with HIV-1 Subtype C. Only 23.3% PLHIV achieved virologic suppression at 6 months and sustained it for 2.3 years. Median CD4 count change from baseline was +117 (n=13), +228 (n=10), +253 (n=9), and +331 (n=4) at 6, 12, 18 and 24 months respectively. Repeat tropism among patients with virologic failure demonstrated R5 virus.
High rates of virologic failure was seen when MVC was used amongst treatment experienced PLHIV infected with HIV-1 Subtype C in India. was the proportion of PLHIV with virologic success (PVL<50 copies/ml) at last follow up visit.
Data on 13 PLHIV were analyze.
在印度感染HIV-1 C亚型病毒的艾滋病病毒感染者（PLHIV）中，没有关于马拉维罗（MVC）临床疗效的信息。
我们对接受基于MVC的抗逆转录病毒（ARV）方案治疗至少6个月的成年PLHIV进行了回顾性病历审查。在记录有R5嗜性病毒的PLHIV中启动马拉维罗（通过对V3环进行三次内部群体测序并使用Geno2Pheno算法进行解读来确定），并与优化背景方案（使用基因型耐药性检测和既往ARV治疗史设计）联合使用。在开始治疗6个月后及之后每年进行血浆病毒载量（PVL）检测。主要结局……MVC治疗的中位持续时间为1.8年（范围1 - 2.9年），而在改用MVC之前ART的中位持续时间为13年。马拉维罗与达芦那韦/利托那韦（DRV/r）（n = 10）、阿扎那韦/利托那韦（ATV/r）（n = 2）和洛匹那韦/利托那韦（LPV/r）（n = 1）联合使用。所有PLHIV均感染HIV-1 C亚型。只有23.3%的PLHIV在6个月时实现病毒学抑制并持续2.3年。在6、12、18和24个月时，CD4细胞计数从基线的中位变化分别为+117（n = 13）、+228（n = 10）、+253（n = 9）和+331（n = 4）。病毒学失败患者中的重复嗜性检测显示为R5病毒。
在印度，接受过治疗的感染HIV-1 C亚型的PLHIV使用MVC时，病毒学失败率很高。是最后一次随访时病毒学成功（PVL<50拷贝/毫升）的PLHIV比例。
分析了13例PLHIV的数据。
