Can Add-On Maraviroc Improve Clinical Outcomes of Advanced HIV?

Globally, many persons newly diagnosed with HIV have advanced disease, defined as the presence of AIDS or a CD4 count <200 cells/μL. Despite starting antiretroviral therapy (ART) immediately, these patients have significant excess mortality. Although HIV R-5 tropic viruses (those that use the C-C chemokine receptor

type 5 [CCR5] coreceptor) are more common in early infection than in advanced disease, adding a CCR5 antagonist (such as maraviroc) to initial ART has been postulated to potentially dampen immune activation and improve clinical outcomes by reducing T-cell activation. Investigators in Europe have now conducted a placebo-controlled, randomized clinical trial of maraviroc added to ART in advanced disease. The primary endpoint was fir…