Hepatic safety of maraviroc in HIV-1-infected patients with hepatitis C and/or B co-infection. The Maraviroc Cohort Spanish Group

Manuel Crespo, Jordi Navarro, Santiago Moreno, Jesus Sanz, Manuel Márquez, Javier Zamora, Antonio Ocampo, José A. Iribaren, Antonio Rivero, Josep M. Llibre

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    2 Citations (Scopus)

    Abstract

    © 2016 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica Introduction Limited data is available regarding the hepatic safety of maraviroc in patients co-infected with HIV and HCV and/or HBV. Our objective was to compare the hepatic safety profile and fibrosis progression in HIV-mono-infected patients and co-infected with HCV and/or HBV treated with maraviroc. Methods Retrospective multicentre cohort study of HIV-infected patients receiving treatment with a maraviroc-containing regimen in 27 hospitals in Spain. Results A total of 667 patients were analyzed, of whom 313 were co-infected with HCV (n = 282), HBV (n = 14), or both (n = 17). Maraviroc main indications were salvage therapy (52%) and drug toxicity (20%). Grade 3–4 hypertransaminasaemia (AST/ALT >5 times ULN) per 100 patient-years of maraviroc exposure, was 5.84 (95% CI, 4.04–8.16) and 1.23 (95% CI, 0.56–2.33) in co-infected and HIV-mono-infected patients, respectively (incidence rate ratio, 4.77; 95% CI, 2.35–10.5). However, the degree of aminotransferase abnormalities remained stable throughout the study in both groups, and no significant between-group differences were seen in the cumulative proportion of patients showing an increase in AST/ALT levels greater than 3.5 times baseline levels. No between-group differences were seen in liver fibrosis over time. With a maraviroc median exposure of 20 months (IQR, 12–41), two patients (0.3%) discontinued maraviroc because of grade 4 hepatitis, and other 2 died due to complications associated to end-stage-liver disease. Conclusions Maraviroc-containing regimens showed a low incidence of hepatitis in a large Spanish cohort of HIV-infected patients, including more than 300 patients co-infected with HCV and/or HBV. Co-infection did not influence the maximum liver enzyme level or the fibrosis progression throughout the study.
    Original languageEnglish
    Pages (from-to)493-498
    JournalEnfermedades Infecciosas y Microbiologia Clinica
    Volume35
    Issue number8
    DOIs
    Publication statusPublished - 1 Oct 2017

    Keywords

    • Co-infection
    • HBV
    • HCV
    • HIV
    • Hepatitis
    • Liver fibrosis
    • Maraviroc

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