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Author Notes:

CORRESPONDENCE: Ellen S. Chan, M.Sc, Mailing address: Harvard Chan School of Public Health, 651 Huntington Ave, FXB 539, Boston, MA 02115, USA, echan@sdac.harvard.edu, Telephone: 617-432-4879, Fax: 617-432-2832

See publication for full list of author contributions.

See publication for full list of acknowledgements.

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Allergy and Infectious Diseases or the National Institutes of Health.

The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

See publication for full list of conflicts of interest.


Research Funding:

This work was supported by [Award Number U01AI068636] from the National Institute of Allergy and Infectious Diseases and supported by National Institute of Mental Health (NIMH), National Institute of Dental and Craniofacial Research (NIDCR).

This work was also supported by grants from the NIH ([grant numbers AI068634 and AI068636] to the ACTG Statistical Data Analysis Center [to E.S.C. and H.J.R.], [grant number AI068636] to the Rush University Medical Center [to A.L.L., P.M, J.M, and J.P.], and to the research sites that participated in the study [grant numbers UMAI069494, UMAI069432, UM1AI 069471, UM1AI069452, UM1 AI069501, 2UM1AI069432, UL1 TR001082, 1U01AI069477-01, P30AI073961, 5UM1 AI068636, 2UM1AI069503, UM1 AI069471, 2UM1AI069439-08, and UL1 TR000445 from the National Center for Advancing Translational Sciences/NIH, AI69439, UM1 AI069496, 5UM1AI069412, UM1 AI069423, 1UL1TR001111, P30 AI50410, 2UMIA1069423-08, 2UM1AI069418-08, 2P30 AI 50409-10, UL1TR000454, AI069501, 5UM1AI069415-10, 2UM1AI069412-08, AI069424, UL1 RR025780, 2UM1-AI069470-08, UM1AI069472, 2UMAI069432, AI 69501, UM1AI069471, UM1A 068636-09, 5 P30 AI-045008-15, U01AI069447, NO1-HD-3-3345, UMI AI069511, UM1 AI069465, UL1TR001079, UL1 RR024160, and UL1 TR000042]).

ViiV, Gilead, and AbbVie provided study drugs.


  • Science & Technology
  • Life Sciences & Biomedicine
  • Immunology
  • Infectious Diseases
  • Virology
  • CD4 lymphocyte count
  • CD4: CD8 ratio
  • HIV
  • inflammation
  • maraviroc
  • tenofovir

Differential CD4(+) cell count increase and CD4(+): CD8(+) ratio normalization with maraviroc compared with tenofovir

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Journal Title:



Volume 30, Number 13


, Pages 2091-2097

Type of Work:

Article | Post-print: After Peer Review


Objective: Studies exploring the immunologic effects of maraviroc (MVC) have produced mixed results; hence, it remains unclear whether MVC has unique immunologic effects in comparison with other antiretroviral drugs. We sought to determine whether MVC has differential effects compared with tenofovir disoproxil fumarate (TDF) during initial antiretroviral therapy. Design: Prospective study in AIDS Clinical Trials Group A5303, a double-blind, placebo-controlled trial (N=262) of MVC vs. TDF, each combined with boosted darunavir and emtricitabine. Methods: A total of 31 cellular and soluble biomarkers were assayed at weeks 0 and 48. Polychromatic flow cytometry was performed on cryopreserved peripheral blood mononuclear cells. Soluble markers were assayed in plasma using ELISA kits. Analyses were as treated. Results: Analyses included 230 participants (119 in MVC arm and 111 in TDF arm). Over 48 weeks of treatment, no significant differences were detected in declines in markers of inflammation and activation with MVC vs. TDF. A greater CD4 + T-cell count increase (median + 234 vs. + 188 cells/μl, P=0.036), a smaller CD8 + T-cell count decrease (-6 vs. -109 cells/μl, P=0.008), and a smaller CD4 + :CD8 + ratio increase (0.26 vs. 0.39, P=0.003) occurred with MVC. Among participants with a baseline CD4 + :CD8 + ratio less than 1, a smaller proportion of MVC group normalized to a ratio greater than 1 at week 48 (15 and 36%, P < 0.001). Conclusion: MVC resulted in less improvement in the CD4 + :CD8 + ratio driven by greater increase in CD4 + cell count but smaller decline in CD8 + cell count. Changes in soluble or cellular biomarkers of inflammation and immune activation were not different between MVC and TDF.

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© 2016 Wolters Kluwer Health, Inc.

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