The effect of maraviroc on liver fibrosis progression

In the GUSTA trial HIV-positive patients with R5 tropic virus
on antiretroviral therapy with <50 copies/ml were enrolled in
a switch study. Patients were randomized to remain on their
present 3 drug regimen or to switch to maraviroc in combination
with ritonavir-boosted darunavir. Patients with hepatitis B
coinfection and Child-Pugh B and C were excluded. Fibrosis-4
Index (FIB-4) and aspartate aminotransferase to Platelet Ratio
Index (APRI) scores were retrospectively evaluated after 12,
24, 48 and 96 weeks. 150 patients were included in the study.
At baseline patients randomized to maraviroc were somewhat
younger (median 47 vs 50 years) and FIB-4 median value was
higher in the maraviroc arm (1.15 vs 0.91). During follow up a
more prominent APRI-score decrease was observed at week 96
in the maraviroc arm (-0.03 vs + 0.02, p=0.053). FIB-4 showed
a non-significant trend towards larger reductions in the maraviroc
arm.

Ref; Rosetti et al. JAIDS Journal of Acquired Immune Deficiency Syndromes:
May 1, 2019 – Volume 81 – Issue 1 – p e17–e21 doi: 10.1097/QAI.0000000000001986

Comment: It has been shown before that maraviroc may have
a beneficial effect on the development of liver fibrosis. It is
however doubtful that this is of any clinical significance and
from a virological point of view, the combination of maraviroc
and boosted darunavir has been shown to be inferior to a standard
3 drug regimen.