WEAB0105 - Oral Abstract Session
Maraviroc (MVC) reduces liver stiffness (LS) in HIV-hepatitis C (HCV) co-infected patients
Presented by Paola Nasta (Italy).
P. Nasta, F. Gatti, F. Borghi, S. Amadasi, E. Chiari, A.M. Paderno, G. Carosi
University of Brescia, Institute of Infectious and Triopical Diseases, Brsecia, Italy
Background: In HIV/HCV patients (pts) LS is faster than in HCV-monoinfected.. The CC chemokines MIP-1alpha,MIP-1beta and RANTES and their receptors CCR1 and CCR5 are strongly upregulated in experimental mouse models of fibrogenesis. We investigated the influence of CCR5 inhibition due to MVC on LSP in HIV/HCV coinfected persons.
Methods: HIV/HCV pts, anti HCV treatment naïve,on stable effective HAART with atazanavir /ritonavir 300/100 mg + tenofovir/emtricitabina QD and Child-Pugh score < A6 were enrolled in a 96 weeks(W),prospective,randomized,pilot study.LS has been evaluated with biochemical markers of liver fibrosis and transient elastometry, performed by standard methods. Eligible subjects have been randomized 1:1 to maintain the current regimen (arm A) or to add MVC 150 mg BID (arm B). Clinical, virologic, immunologic, hepatic and metabolic parameters are recorded at baseline (BL) and every three months.LS was measured every 24W and staged following the standardized categories I:< 7.1 kPa; II:7.1-9.4; III:9.5-12.4; IV:≥12.5.A preliminary 24W analysis has been assessed.The Mann Whitney/Wilcoxon test has been used to compare the median of LS variations from BL through 24W in two groups.
Results: Up to September 2010, 54 pts were enrolled: 28 in arm B,77% males,median age 46 (IQR 43-48)years,CD4 506(405-654)cell/mm3, AST 43(31-59)IU/ml,ALT 68(45-92)IU/ml,HCV5,8(5,4-6,2)log10 IU/ml.LS was 7.2 kPa (4.2-10.2) in arm B and 5,7 kPa (4,7-7.4) in arm A (p=NS). Twenty four subjects achieved week 24 (12 patients in each arm).From BL to week 24 LS decreased [-0.5(-1.7;+0.3)] in subjects enrolled in arm B (p=0.03) and increased [+ 0.35 KPa(-0.2;+1.4)] in subjects enrolled arm A.Seven of 24 patients(3 in arm A and 4 in arm B) (29,1%) changed the stage of LS : three out of 4 pts enrolled in arm B had a LS improvement switching from stage III to stage II .In all 3(100%)patients enrolled in arm A,LS worsened, switching from stage I to stage II.
Conclusion: To add MVC to the current HAART may reduce LS in HIV/HCV coinfected subject.
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