Almost two-thirds of patients whose infection with HIV was diagnosed late had virus that uses the CCR5 co-receptor, and could therefore potentially benefit from taking a treatment regimen that includes maraviroc (Celsentri), Austrian investigators report in the 24th August edition of AIDS.
Maraviroc was recently approved for use in first-line HIV treatment, although it is most widely used in extensively treated patients. However, the investigators believe that the drug could be especially beneficial for patients who are diagnosed late. Some research suggests that the drug can boost CD4 cell count, even when viral load is not suppressed.
HIV uses one of two co-receptors to attach to human cells: CCR5 or CXCR4. Additionally, patients may sometimes have what is called mixed or dual tropism virus, and this occurs when both co-receptors are present.
The presence of CXCR4 and dual/mixed tropism-using virus is associated with late-stage HIV disease and a low CD4 cell count.
The researchers concluded, “treatment with CCR5 antagonists in ART [antiretroviral therapy]-naive patients, even if newly diagnosed at a late stage of HIV infection, should be of value and needs further evaluation”.
HIV coreceptor tropism in antiretroviral treatment-naïve patients newly diagnosed at a late stage of HIV infection.
Simon, Benedikt; Grabmeier-Pfistershammer, Katharina; Rieger, Armin; Sarcletti, Mario; Schmied, Brigitte; Puchhammer-Stöckl, Elisabeth
AIDS. 24(13):2051-2058, August 24, 2010. doi: 10.1097/QAD.0b013e32833c93e6
Link to AIDS abstract