Inflammation Clinical Trial
Official title:
Efficacy of Maraviroc in Modulating Atherosclerosis in HIV Patients.
The investigator tested the efficacy of maraviroc intensification on down-regulating atherosclerotic progression in HIV infected patients with optimal viro-immunologic control and at high cardiovascular risk.
Experimental CCR5 antagonism with maraviroc in atherosclerosis-prone mice and preliminary
data in humans suggest an anti-atherosclerotic effect of the drug. The investigators assessed
the impact of maraviroc treatment in HIV-infected patients on several subclinical indicators
of atherosclerosis and putative mechanisms for such an effect.
HIV-treated patients under effective antiretroviral (ART) therapy, with a Framingham risk
score >20% and a brachial flow-mediated dilation (bFMD) <4%, as indices of high
cardiovascular risk, were recruited. Maraviroc (300 mg per os for 24 weeks) was administered
on top of ART to all participants using a cross-over design. Brachial FMD, carotid-femoral
pulse wave velocity (cfPWV) and carotid intima-media thickness (cIMT) were measured as
non-invasive markers of atherosclerosis. Vascular competence, as expressed by the ratio of
circulating endothelial micro-particles (EMPs) to endothelial progenitor cells (EPCs), as
well as markers of systemic inflammation, monocyte activation and platelet activation were
assessed.
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