Efficacy and safety of long-term Maraviroc use in a heterogeneous group of HIV-infected patients: a retrospective cohort study

Abstract Introduction Since the registration of Maraviroc (MVC) as antiretroviral agent in 2008, only studies with a follow-up time shorter than five years were published. Therefore, little is known about its long-term safety and efficiency in clinical practice. In this cohort study, data on long-term follow-up of MVC-treatment in routine practice was analysed. Patients and methods A retrospective cohort study was conducted at the University Medical Centre Utrecht with a follow-up period up to almost ten years. The efficacy and tolerability of MVC-containing anti-retroviral therapy was analysed in HIV-patients. Results The cohort consisted of 111 HIV patient which were treated for a median of 11,0 years (IQR 4.0 – 15.0) and had 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+ counts continued to increase up to nine years after initiation of MVC. Patients with a detectable VL (≥50 copies/ml HIV-RNA) at start of MVC containing ART reached high proportions of viral suppression. Only three patients (2.7%) experienced a failure of treatment despite optimal therapy. Nine patients (8.1%) discontinued MVC due to intolerance of their ART regimen. Severe laboratory abnormalities were deemed to be unrelated to the use of MVC. During the 487 person years of follow up eighteen patients (5,2%) died. Conclusion The use of MVC in this heavily pre-treated cohort was generally well tolerated during long-term follow-up. Furthermore, the use of MVC resulted in a good immunological and virological response in clinical practice.