Neurocognition with maraviroc compared with tenofovir in HIV. (24th September 2016)

• Record Type: Journal Article
• Authors: Robertson, Kevin R.; Miyahara, Sachiko; Lee, Anthony; Brown, Todd T.; Chan, Ellen S.; Berzins, Baiba; Rusin, David; Eron, Joseph J.; Taiwo, Babafemi O.
• Is Part Of: AIDS. Volume 30:Number 15(2016)
• Page Start: 2315
• Page End: 2321
• Publication Date: 2016-09-24
• Subjects: central nervous system -- HIV-associated neurocognitive disorders -- maraviroc -- neurocognitive -- neuropathogenesis -- tenofovir; AIDS (Disease) -- Periodicals; Acquired Immunodeficiency Syndrome; AIDS (Disease); Periodicals; Periodicals; 616.9792005
• DOI: 10.1097/QAD.0000000000001189
• Languages: English
• ISSNs: 0269-9370

Abstract

Abstract : Objective: The objective was to determine whether maraviroc (MVC) has unique neurocognitive benefits in the context of initial antiretroviral therapy (ART). Design: Randomized, double-blind, placebo-controlled, 48-week trial. Setting: Participants were enrolled in US AIDS Clinical Trials Group clinical trial sites. Participants: Total 262 ART-naive, chemokine coreceptor 5 tropic HIV, and HIV RNA greater than 1000 copies/ml participants were randomized, 230 participants completed the study. Intervention: Participants received MVC 150 mg or tenofovir disoproxil fumarate (TDF) 300 mg on a background of ritonavir-boosted darunavir and emtricitabine. Main outcome measure(s): The neuropsychological battery of 15 tests done at baseline, week 24 and week 48 assessed seven domains, and were standardized into z-scores then converted into deficit scores and a global deficit score. The 48-week changes from baseline in the neuropsychological scores and the global deficit score were compared by Wilcoxon or Kruskal–Wallis test between arms, and among baseline impairment groups [classified as normal, mild (2 deficit scores ≥1) and moderate (2 deficit scores ≥2)]. It was hypothesized that the MVC arm would have improved neuropsychological performance over TDF. Results: In this double-blind, randomized, placebo-controlled trial, there were no differences in neuropsychological performance between MVC and TDF. Those with moderate neuropsychological impairment at baseline experienced greater ART-mediated neuropsychological improvement than those with mild or no neuropsychological impairment. Conclusion: Improvement in neurocognitive functioning was greater with more baseline impairment but was comparable with MVC or TDF.