HIV Infections Clinical Trial
Official title:
Efficacy of Treatment Intensification With Maraviroc on HIV-1 Viral Latency in Recently Infected Hiv-1 naïve Patients Starting Raltegravir Plus Tenofovir/Emtricitabine.
The intensification with maraviroc in recently HIV-1-infected patients of a preferred
gold-standard triple therapy composed of raltegravir plus tenofovir/emtricitabine could
accelerate the decay of the HIV-1 reservoir in latently infected cells established early in
HIV-1 infection.
This could provide further insight into this area, decrease the size of latent reservoir, and
translate into clinical benefits for patients.
A reservoir of latently infected cells established early in infection may be involved in the
maintenance of viral persistence despite continuous highly active antiretroviral therapy
(HAART). This is likely to represent the major barrier to virus eradication in patients on
successful combination antiretroviral therapy.
The majority of the viruses in the latent reservoir use CCR5 receptor during entry.
More recently, clear evidences for decay of this HIV-1 reservoir in patients who initiated
antiretroviral therapy early in infection have been demonstrated. The treatment of acute
infection may set the stage for subsequent attempts at eradication. To achieve this, more
potent antiretroviral therapy and/or more potent antilatency therapies may be needed.
In contrast to previous antiretroviral drugs, maraviroc does not need to cross the cell
membrane, nor does not require intracellular processing in order to exert its activity. In
addition, there is no cross-resistance between entry inhibitors and agents that act on
intracellular targets.
Maraviroc has demonstrated potent antiviral activity against all CCR5-tropic HIV-1 viruses
tested. Maraviroc could thus fulfil the requirements for an optimal candidate for treatment
intensification in HIV-1 infected patients with a recent HIV-1 infection.
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