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首页> 外文期刊>Medecine et maladies infectieuses >CCR5-antagonists: contribution of a new antiretroviral class to the management of HIV infection
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CCR5-antagonists: contribution of a new antiretroviral class to the management of HIV infection

机译：CCR5拮抗剂：新型抗逆转录病毒药类对HIV感染管理的贡献

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摘要

Maraviroc, the first approved CCR5-antagonist, is indicated for treatment-experienced adult patients infected with mainly detectable CCR5-tropic HIV-1, which predominates throughout infection. The antiretroviral effectiveness of maraviroc in combination with an optimized ARV therapy has been reported in clinical trials including previously treated patients. The significantly greater increase in CD4 cell counts in patients treated with maraviroc could result from a specific action as well as a better capacity to diffuse in deep compartments. According to available reports, a tropic switch from R5 to X4 induced by maraviroc treatment is not expected. These observations, combined with the predominance of R5-virus throughout the disease, support the early use of maraviroc as soon as patients fail their therapy. Provided genotypic tests assessing R5 tropism are available when the plasma viral load is not detectable, the good safety profile of maraviroc, which includes lipid parameters, could justify its use in patients with successful regimen in order to reduce the subsequent risk of major adverse events.
机译：Maraviroc是首个获得批准的CCR5拮抗剂，适用于治疗经验丰富的成年患者，这些患者主要感染了可检测到的CCR5嗜性HIV-1，在整个感染过程中占主导地位。在包括先前治疗过的患者在内的临床试验中，已经报道了maraviroc与优化的ARV治疗相结合的抗逆转录病毒效果。接受maraviroc治疗的患者CD4细胞计数显着增加可能是由于特定的作用以及更好的扩散至深层隔室的能力所致。根据可获得的报道，通过马拉维罗克治疗引起的从R5到X4的热带转换是不期望的。这些观察结果与整个疾病中R5病毒的优势相结合，支持了一旦患者治疗失败就尽早使用maraviroc。当无法检测到血浆病毒载量时，只要提供评估R5向性的基因型测试，maraviroc的良好安全性（包括脂质参数）就可以证明其在成功用药的患者中的使用是合理的，以减少随后发生重大不良事件的风险。

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