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Maraviroc-Based Antiretroviral Treatment Appears Neutral in Effects on HIV Patient Lipids: Presented at CROI

By Ed Susman

BOSTON, MA -- February 6, 2008 -- An antiretroviral regimen that is anchored by the chemokine receptor 5 (CCR5) entry antagonist maraviroc appears to cause fewer alterations in lipid profiles in HIV patients than does efavirenz-based treatment, according to research presented here at the 15th Conference on Retroviruses and Opportunistic Infections (CROI).

At 48 weeks, increases from baseline in total cholesterol, low-density lipoprotein cholesterol, and triglycerides were significantly greater for patients who received efavirenz plus zidovudine and lamivudine than for those who received maraviroc plus zidovudine and lamivudine," said Edwin DeJesus, MD, Medical Director, Orlando Immunology Center, Orlando, Florida.

In addition, Dr. DeJesus and colleagues found that a higher proportion of efavirenz-treated patients compared with maraviroc-treated patients experienced lipid increases that exceeded levels recommended by National Cholesterol Education Program guidelines.

The study randomized 361 patients to the efavirenz regimen and 360 patients to a maraviroc regimen. Patients in both arms ranged in age from 30 to 43 years; about 71% were men; about 35% were black. CD4-positive cell counts averaged 259 cells/mcL in the efavirenz arm and 244 cells/mcL in the maraviroc arm.

"The use of lipid-lowering medication was infrequent and similar between the two treatment groups," Dr. DeJesus said in his poster presentation on February 4.

Results of this study showed an increase of 31.4 mg/dL in total cholesterol among patients receiving efavirenz and an increase of 8.2 mg/dL among those on maraviroc (P <.0001).

The researchers also observed an increase of 21.5 mg/dL in low-density lipoprotein cholesterol levels in the efavirenz group compared with a 4.6-mg/dL increase in the maraviroc group (P <.0001).

Triglyceride levels increased by 13.7 mg/dL in the efavirenz group and by 11.1 mg/dL in the maraviroc group (P <.05)

"Overall, maraviroc is at least as lipid neutral as efavirenz and may offer some advantages compared to efavirenz, for example, in those patients with elevated low-density lipoprotein cholesterol levels prior to treatment," Dr. De Jesus said.

Funding for this study was provided by Pfizer Inc.


[Presentation title: Fasted Lipid Changes After Administration of Maraviroc or Efavirenz in Combination With Zidovudine and Lamivudine for 48 Weeks to Treatment-Naive HIV-Infected Patients. Abstract 929]

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