The Pharmaceutical Journal
Vol 279 No 7478 p554
17 November 2007

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New HIV medicine set for launch

Patients with HIV who have been heavily treated with antiretrovirals may be eligible for treatment with maraviroc, a new type of medicine for HIV, available next week from Pfizer as Celsentri.

The drug has a unique mechanism of action — it selectively binds to the human chemokine receptor CCR5, preventing CCR5-tropic HIV-1 from entering cells.

Neal Marshall, specialist HIV pharmacist, Royal Free Hospital, London, explained that the HIV virus attaches to CD4 receptors as well as a co-receptor, usually CCR5 or CXCR4, in order to enter cells. Within patients the virus can exist in forms that use CCR5 or CXCR4 exclusively, or a mixture of both. For this reason, not all patients with the virus will be suitable to receive maraviroc.

The medicine is licensed for treatment-experienced adult patients with only CCR5-tropic HIV-1 detectable. According to the manufacturer, CCR5 tropism should be confirmed using Monogram Trofile assay — the only adequately validated assay currently available.

Speaking on behalf of the HIV Pharmacy Association, Mr Marshall said: “In combination with other new therapies, the goal of an undetectable HIV viral load is now achievable in highly treatment-experienced patients.

Due to the complicated nature of drug-drug interactions, particularly for patients starting on maraviroc, HIV pharmacists play a key role in deciding the most appropriate antiretrovial regimen for individual patients.”