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01-02-2018

CSF inflammatory markers and neurocognitive function after addition of maraviroc to monotherapy darunavir/ritonavir in stable HIV patients: the CINAMMON study

Authors: T. J. Barber, A. Imaz, M. Boffito, J. Niubó, A. Pozniak, R. Fortuny, J. Alonso, N. Davies, S. Mandalia, D. Podzamczer, B. Gazzard

Published in: Journal of NeuroVirology | Issue 1/2018

Abstract

CINAMMON is a phase IV, open-label, single-arm, pilot study assessing maraviroc (MVC) in the central nervous system (CNS) when added to darunavir/ritonavir monotherapy (DRV/r) in virologically suppressed HIV-infected subjects. CCR5 tropic participants on DRV/r were recruited. Participants remained on DRV/r for 12 week (w) (control phase). MVC 150 mg qd was added w12–w36 (intervention phase). Lumbar puncture (LP) and neurocognitive function (Cogstate) examinations scheduled at baseline, w12 and w36; MRI before w12, again at w36. Primary endpoint was CSF inflammatory marker changes during intervention phase. Secondary endpoints included changes in NC function and MRI parameters. CSF/plasma DRV/r concentrations measured at w12 and w36, MVC at w36. Nineteen patients recruited, 15 completed (17M, 2F). Dropouts: headache (2), knee problem (could not attend, 1), personal reasons (1). Mean age (range) 45.4 years (27.2–65.1), 13/19 white, 10/19 MSM. No changes in selected CSF markers were seen w12–w36. Overall NC function did not improve w12–w36: total age adjusted z score improved by 0.27 (weighted paired t test; p = 0.11); for executive function only, age adjusted z score improved by 0.54 (p = 0.03). MRI brain parameters unchanged. DRV plasma:CSF concentration ratio unchanged between w12 (132) and w36 (112; p = 0.577, Wilcoxon signed-rank). MVC plasma:CSF concentration ratio was 35 at w36. No changes in neuroinflammatory markers seen. In this small study, addition of 24w MVC 150 mg qd to stable DRV/r monotherapy showed possible improvement in executive function with no global NC effect. Learning effect cannot be excluded. This effect should be further evaluated.

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Title: CSF inflammatory markers and neurocognitive function after addition of maraviroc to monotherapy darunavir/ritonavir in stable HIV patients: the CINAMMON study
Authors: T. J. Barber
A. Imaz
M. Boffito
J. Niubó
A. Pozniak
R. Fortuny
J. Alonso
N. Davies
S. Mandalia
D. Podzamczer
B. Gazzard
Publication date: 01-02-2018
Publisher: Springer International Publishing
Published in: Journal of NeuroVirology / Issue 1/2018
Print ISSN: 1355-0284
Electronic ISSN: 1538-2443
DOI: https://doi.org/10.1007/s13365-017-0600-6

At a glance: The STEP trials

Springer Medicine

CSF inflammatory markers and neurocognitive function after addition of maraviroc to monotherapy darunavir/ritonavir in stable HIV patients: the CINAMMON study

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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