Maraviroc can improve lipid profiles in dyslipidemic patients with HIV: Results from the MERIT trial

Purpose: We investigated the effects of maraviroc, the first approved CC-chemokine receptor 5 (CCR5) antagonist, on blood lipids in a post hoc analysis of the phase 3 MERIT study in treatment-naïve patients. Methods: Patients received maraviroc 300 mg twice daily (n = 360) or efavirenz 600 mg once daily (n = 361), both in combination with zidovudine/lamivudine, for up to 96 weeks. Baseline and on-treatment lipid profiles were analyzed according to National Cholesterol Education Program (NCEP) thresholds. Results: Baseline characteristics and lipid profiles were comparable between groups. Among patients with total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-c) below NCEP treatment thresholds at baseline, significantly more efavirenz-than maraviroc-treated patients exceeded those thresholds at 96 weeks (TC: 35% [74/209] vs 11% [20/188], P <.0001; LDL-c: 23% [47/197] vs 8% [15/183], P <.0001). Among patients exceeding NCEP thresholds at baseline, significantly more efavirenz-than maraviroc-treated patients exceeded the thresholds at 96 weeks (TC: 83% [24/29] vs 50% [17/34], P =.0084; LDL-c: 86% [19/22] vs 55% [16/29], P =.0314). Of those with baseline high-density lipoprotein cholesterol (HDL-c) < 40 mg/dL, 43% (56/130) of maravirocand 62% (86/139) of efavirenz-treated patients achieved HDL-c≥40 mg/dL at 96 weeks (P =.0020). Conclusions: Maraviroc was not associated with elevations in TC, LDL-c, or triglycerides and showed beneficial effects on lipid profiles of dyslipidemic patients.