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CD4+ T-cell restoration after 48 weeks in the maraviroc treatment-experienced trials MOTIVATE 1 and 2

Asmuth, David M.
Goodrich, James
Cooper, David A.
Haubrich, Richard
Rajicic, Natasa
Mayer, Howard
Valdez, Hernan
Published in Journal of acquired immune deficiency syndromes. 2010, vol. 54, no. 4, p. 394-397
Abstract OBJECTIVES: To determine factors associated with CD4 responses to maraviroc (MVC)-containing regimens in treatment-experienced patients. METHODS: Forty-eight-week data from MOTIVATE 1 and 2 was used to assess MVC once or twice daily versus placebo (PBO), each with optimized background therapy (N = 1047). A repeated measures model evaluated longitudinal CD4 changes, multivariate linear regression evaluated predictors of week 48 increases, and Cox proportional hazard modeling evaluated time to category C events. RESULTS: Median CD4 increases were greater on MVC once or twice daily than PBO (92, 103, and 24 cells/mm3, respectively; P < 0.05), and the difference remained significant among patients achieving less than 50 HIV-1 RNA copies/mL (126, 125, and 96 cells/mm3; P < 0.05) or when adjusted for other predictors of CD4 increase including change in HIV-1 RNA. Time to a category C event was longer on MVC; in multivariate models, higher on-treatment CD4 count, but not MVC treatment, was protective against new events (hazard ratio 0.8 per +25 cells/mm3; 95% confidence interval 0.78-0.87). CONCLUSIONS: MOTIVATE patients receiving MVC had larger CD4+ T-cell increases than those receiving PBO, even after adjusting for the greater virologic potency of MVC-containing regimens. This additional CD4 response was associated with a longer time to the development of AIDS-defining events on MVC.
Keywords CD4 Lymphocyte CountCD4-Positive T-Lymphocytes/drug effects/immunologyClinical Trials as TopicCyclohexanes/adverse effects/*therapeutic useDrug Resistance, ViralHIV Fusion Inhibitors/adverse effects/*therapeutic useHumansOpportunistic Infections/epidemiologyT-Lymphocytes/drug effects/virologyTime FactorsTreatment OutcomeTriazoles/adverse effects/*therapeutic use
PMID: 20009949
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Research group Unité HIV (46)
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ASMUTH, David M. et al. CD4+ T-cell restoration after 48 weeks in the maraviroc treatment-experienced trials MOTIVATE 1 and 2. In: Journal of acquired immune deficiency syndromes, 2010, vol. 54, n° 4, p. 394-397. doi: 10.1097/QAI.0b013e3181c5c83b https://archive-ouverte.unige.ch/unige:20748

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Deposited on : 2012-05-23

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