Evaluation of first-line maraviroc therapy for HIV infection is examined on pages 252-254 of this issue, even though this is an off-licence use in Europe. We took this unusual step because first-line use of recent antiretroviral drugs is controversial.We have very little follow-up with these new drugs, whereas the efficacy of older anti-retrovirals on viral load and CD4+ T lymphocytes is known to correlate with a marked reduction in morbidity and overall mortality. In particular, nothing is known of the long-term adverse effects of recent antiretroviral drugs, which could potentially outweigh their benefits compared to existing options.
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