Developing clinical role of a CCR5 co-receptor antagonist in HIV-1 infection
Maraviroc is the only approved CCR5 coreceptor antagonist on the market for treatment of HIV-1 infection. It uses a previously untargeted step in the HIV-1 replication cycle necessary for viral entry into the host cell. This review will describe and evaluate recent clinical literature regarding maraviroc, focusing on safety, efficacy, and mechanisms of treatment failure. A search of the primary literature and conference abstracts was conducted using the keywords CCR5 antagonist, maraviroc, and UK-427857. Resulting articles were then compiled and analyzed in this review. Maraviroc is a potent inhibitor of HIV-1 replication and contributes to effective viral suppression in combination with traditional antiretroviral medications. Due to its numerous drug interactions, potential for severe adverse events, and relative paucity of clinical data in long-term randomized, controlled trials, maraviroc should be one of the final agents utilized in salvage therapy in combination with other active antiretroviral agents.