Role of Maraviroc in minimizing the risk of graft rejection in HIV-infected kidney transplant recipients

Transpl Infect Dis. 2020 Aug;22(4):e13294. doi: 10.1111/tid.13294. Epub 2020 May 5.

Abstract

Background: Kidney transplantation in HIV-infected patients is characterized by a concerning high rate of allograft rejections. The etiological mechanisms leading to this increased immunoreactivity are still unknown. Maraviroc is a new antiretroviral agent that has been associated with immunomodulatory proprieties; therefore, its use may be a promising strategy to minimize the rate of rejections in HIV-infected kidney transplant (KT) recipients.

Methods: We conducted a retrospective study in our cohort of HIV-KT recipients with the aim to explore the effects of maraviroc in reducing the risk of graft rejection.

Results: Twenty-two HIV-infected KT recipients predominantly of Caucasian origin (86%) and with a median age of 49 (IQR, 51.9-42.2) years were evaluated. Ten HIV-infected patients were treated with maraviroc and 12 with a maraviroc-free antiretroviral regimen. After a median follow-up of 3.01 years, half of the maraviroc-treated patients (n = 5) developed seven episodes of graft rejection, most of them were T cell-mediated rejections (85.7%). Five episodes were recorded in the maraviroc-free group. The difference in the rate of graft rejections was not statistically significant (P = .23).

Conclusions: The administration of maraviroc was ineffective in preventing graft rejections in our cohort of patients.

Keywords: C-C chemokine receptor 5; HIV; antiretroviral therapy; kidney transplantation; maraviroc; rejection.

MeSH terms

  • Adult
  • Anti-Retroviral Agents / administration & dosage
  • Female
  • Graft Rejection / prevention & control*
  • Graft Survival
  • HIV Infections / complications*
  • HIV Infections / drug therapy
  • Humans
  • Immunosuppressive Agents / administration & dosage*
  • Kidney Transplantation / adverse effects*
  • Male
  • Maraviroc / administration & dosage*
  • Middle Aged
  • Retrospective Studies
  • Transplant Recipients / statistics & numerical data*
  • Treatment Outcome

Substances

  • Anti-Retroviral Agents
  • Immunosuppressive Agents
  • Maraviroc