Department of Internal Medicine and Infectious Diseases, University Medical Centre Utrecht, Utrecht, the Netherlands.
Virology, Department of Medical Microbiology, University Medical Centre Utrecht, Utrecht, the Netherlands.
Int J Antimicrob Agents. 2019 Aug;54(2):215-222. doi: 10.1016/j.ijantimicag.2019.02.018. Epub 2019 Mar 1.
Since the registration of maraviroc (MVC) as an antiretroviral agent in 2008, only studies with a follow-up time of <5 years have been published. Therefore, little is known about its long-term safety and efficacy in clinical practice. In this cohort study, data on long-term follow-up of MVC treatment in routine practice were analysed. A retrospective cohort study was conducted at University Medical Centre Utrecht with a follow-up period up to almost 10 years. The efficacy and tolerability of MVC-containing antiretroviral therapy (ART) was analysed in human immunodeficiency virus type 1 (HIV-1)-infected patients. The cohort consisted of 111 HIV patients who were treated for a median of 11.0 years (IQR 4.0-15.0 years) and with a median of 4 (IQR 2-6) previous ART regimens. The median time of MVC use was 49 months (IQR 21-82 months). Mean CD4 T-cell counts continued to increase up to 9 years following initiation of MVC. Patients with a detectable viral load (≥50 copies/mL HIV-RNA) at the start of MVC-containing ART reached high proportions of viral suppression. Only three patients (2.7%) experienced treatment failure despite optimal therapy. Nine patients (8.1%) discontinued MVC owing to intolerance of their ART regimen. Severe laboratory abnormalities were deemed to be unrelated to MVC use. During the 487 person-years of follow-up, 18 patients (16.2%) died. MVC use in this heavily pre-treated cohort was generally well tolerated during long-term follow-up. Furthermore, use of MVC resulted in a good immunological and virological response in clinical practice.
自 2008 年马拉维若（MVC）注册为抗逆转录病毒药物以来，仅发表了随访时间<5 年的研究。因此，在临床实践中，对其长期安全性和疗效知之甚少。在这项队列研究中，分析了 MVC 治疗常规实践中长期随访的数据。乌得勒支大学医学中心进行了一项回顾性队列研究，随访时间接近 10 年。分析了含 MVC 的抗逆转录病毒治疗（ART）在人类免疫缺陷病毒 1 型（HIV-1）感染患者中的疗效和耐受性。该队列包括 111 名 HIV 患者，他们接受治疗的中位数时间为 11.0 年（IQR 4.0-15.0 年），中位数接受过 4（IQR 2-6）种既往 ART 方案。MVC 使用中位数时间为 49 个月（IQR 21-82 个月）。自开始使用 MVC 以来，中位 CD4 T 细胞计数持续增加，最高可达 9 年。开始含 MVC ART 时病毒载量可检测（≥50 拷贝/ml HIV-RNA）的患者达到了较高的病毒抑制比例。尽管进行了最佳治疗，但仅 3 名患者（2.7%）发生治疗失败。由于不耐受其 ART 方案，有 9 名患者（8.1%）停用了 MVC。严重的实验室异常被认为与 MVC 使用无关。在 487 人年的随访期间，有 18 名患者（16.2%）死亡。在长期随访中，在这个大量预处理的队列中，MVC 的使用通常耐受性良好。此外，在临床实践中，MVC 的使用导致了良好的免疫和病毒学反应。
