Imperial College London
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ProfessorDeborahAshby

Faculty of Medicine, School of Public Health

Dean of the Faculty of Medicine
 
 
 
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Contact

 

+44 (0)20 7594 8704deborah.ashby Website

 
 
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Location

 

2.15Faculty BuildingSouth Kensington Campus

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Summary

 

Publications

Citation

BibTex format

@article{Mora-Peris:2018:10.1097/QAD.0000000000001786,
author = {Mora-Peris, B and Bouliotis, G and Kulasegaram, R and Clarke, A and Post, FA and Nelson, M and Burgess, L and Tiraboschi, J and Khoo, S and Taylor, S and Ashby, D and Winston, A},
doi = {10.1097/QAD.0000000000001786},
journal = {AIDS},
pages = {1007--1015},
title = {Changes in cerebral function parameters with maraviroc intensified antiretroviral therapy in treatment naïve HIV-Positive individuals; A randomised controlled study},
url = {http://dx.doi.org/10.1097/QAD.0000000000001786},
volume = {32},
year = {2018}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background: Maraviroc-intensified antiretroviral therapy (ART) may be associated with cognitive benefits.Methods: Therapy-naive, cognitively asymptomatic, HIV-positive individuals were randomly allocated on a 1 : 1 basis to standard ART (Arm1: tenofovir-emtricitabine and atazanavir/ritonavir) or maraviroc intensified ART (Arm2: abacavir-lamivudine and darunavir/ritonavir/maraviroc). Over 48 weeks, detailed assessments of cognitive function tests were undertaken and cerebral metabolites measured using proton magnetic resonance spectroscopy. Our primary endpoint was mean change in cognitive function across treatment arms with factors associated with cognitive function changes also assessed.Results: Of 60 individuals randomized (30 Arm1 and 30 Arm2), 58 were men and 44 of white ethnicity. Treatment groups had similar disease characteristics including overall mean (SD) baseline CD4+ cell count 428 (209) and 414 (229) cells/μl, Arms1 and 2, respectively. At week 48, plasma HIV RNA was less than 50 copies/ml in 55 of 56 of those completing study procedures. Cognitive function improved over 48 weeks [mean change z-score (SD) 0.16 (0.09) Arm1 and 0.25 (0.08) Arm2, P = 0.96 for differences between study arms]. A greater increase in frontal grey matter N-acetyl aspartate/creatine ratio was observed in Arm1 [ratio change of 0.071 (SD 0.16)] versus Arm2 [change −0.097 (SD 0.18), P = 0.009], although this was not associated with changes in cognitive function (P = 0.17).Conclusion: Maraviroc-intensified ART had no demonstrable benefit on cognitive function in individuals initiating ART. Greater improvement in neuronal metabolites (N-acetyl aspartate/creatine) was observed with standard ART. Future work should focus on maraviroc-intensified ART in individuals with cognitive impairment.
AU  - Mora-Peris,B
AU  - Bouliotis,G
AU  - Kulasegaram,R
AU  - Clarke,A
AU  - Post,FA
AU  - Nelson,M
AU  - Burgess,L
AU  - Tiraboschi,J
AU  - Khoo,S
AU  - Taylor,S
AU  - Ashby,D
AU  - Winston,A
DO  - 10.1097/QAD.0000000000001786
EP  - 1015
PY  - 2018///
SN  - 0269-9370
SP  - 1007
TI  - Changes in cerebral function parameters with maraviroc intensified antiretroviral therapy in treatment naïve HIV-Positive individuals; A randomised controlled study
T2  - AIDS
UR  - http://dx.doi.org/10.1097/QAD.0000000000001786
UR  - http://hdl.handle.net/10044/1/56858
VL  - 32
ER  -
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