Evidence map›Paper›PMID 27858912›Full record

Trial reportMedicine2016

A randomized controlled clinical trial on the impact of CCR5 blockade with maraviroc in early infection on T-cell dynamics.

Maile Y Karris, Anya Umlauf, Florin Vaida, Douglas Richman, Susan Little, Davey Smith

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Trial
  2. Trial
  3. Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Maile Y KarrisUniversity of California San Diego Veterans Affairs Medical Center, San Diego, CA.
Anya Umlauf
Florin Vaida
Douglas Richman
Susan Little
Davey Smith

Funding

VirologyP30AI036214 · NIAID · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI David Mitchell Smith · 1994 to 2026
$78.4M
STRUCTURAL NEUROIMAGING COREP30MH062512 · NIMH · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI DAVID J MOORE · 2001 to 2026
$50.4M
Using NK Cells to eliminate the latent HIV reservoirU19AI096113 · NIAID · UNIV OF NORTH CAROLINA CHAPEL HILL · PI LUCIW, PAUL · 2011 to 2015
$39.5M
Primary Infection Resource Consortium (PIRC)R24AI106039 · NIAID · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI LITTLE, SUSAN JANET · 2013 to 2021
$23.1M
HOPE Training GrantT32AI007384 · NIAID · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI Sara Gianella Weibel, Scott L Letendre · 1990 to 2026
$9.7M
Viral correlates of neutralizing antibody responseU19AI090970 · NIAID · INTERNATIONAL AIDS VACCINE INITIATIVE · PI POIGNARD, PASCAL · 2010 to 2014
$9.3M
Molecular Epidemiology for HIV Prevention for Drug Users and Other Risk Groups DP1DA034978 · NIDA · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI SMITH, DAVID MITCHELL · 2012 to 2016
$4.1M
Perturbing the HIV Reservoir with Immune StimulationR01AI118422 · NIAID · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI SMITH, DAVID MITCHELL · 2016 to 2020
$3.8M
High-throughput Deep Sequencing Assay to Reliably Measure the HIV Reservoir during Antiretroviral TherapyR01AI120009 · NIAID · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI SMITH, DAVID MITCHELL · 2015 to 2019
$3.4M
A Multi-Site Investigation into the Effect of HIV Clade on Neurocognitive ImpairmR01MH083552 · NIMH · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI SMITH, DAVID MITCHELL · 2008 to 2012
$3.3M
Efficacy of ART to Interrupt HIV Transmission NetworksR01MH100974 · NIMH · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI LITTLE, SUSAN JANET · 2014 to 2018
$3.2M
Biomathematical analysis of viral dynamics/evolutionR01AI047745 · NIAID · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI RICHMAN, DOUGLAS D · 2001 to 2011
$3.2M
NIAID NIH HHS K24 AI100665NIAID NIH HHS P30 AI036214NIAID NIH HHS R01 AI047745NIAID NIH HHS R01 AI118422NIAID NIH HHS R01 AI120009NIAID NIH HHS R21 AI047745NIAID NIH HHS R24 AI106039NIAID NIH HHS R56 AI047745NIAID NIH HHS T32 AI007384NIAID NIH HHS U19 AI090970NIAID NIH HHS U19 AI096113NICHD NIH HHS R01 HD083042NIDA NIH HHS DP1 DA034978NIDA NIH HHS R21 DA041007NIMH NIH HHS P30 MH062512NIMH NIH HHS R01 MH083552NIMH NIH HHS R01 MH097520NIMH NIH HHS R01 MH100974
6 · The paper itself

Abstract

backgroundInitiation of antiretroviral therapy (ART) in early HIV infection demonstrates clinical benefits including enhanced CD4 T-lymphocyte recovery and minimization of the latent HIV reservoir. Whether ART intensification with CCR5 blockade provides additional benefits is unknown. TRIAL

designThis randomized controlled trial evaluated the impact of maraviroc (MVC) intensification in persons starting ART in acute and early HIV (AEH, within 3 months of estimated date of infection).

methodsTwenty persons in AEH in San Diego underwent double-blind randomization to receive either standard of care (SOC) ART or SOC + MVC to evaluate the hypothesis that early CCR5 blockage with a CCR5-containing ART regimen may provide immunologic and clinical benefit. The primary outcome of this study was the difference from baseline to week 48 in the proportion of CCR5 CD4 memory T cells. Blood was drawn at baseline and weeks 12, 24, and 48 to evaluate CCR5 CD4 and CD8 T-cell dynamics using multicolor flow cytometry.

resultsMVC intensification (n = 10) did not significantly alter CCR5 T-cell dynamics at week 48 of study compared to SOC (n = 9) in this fully recruited study (mean 1.12 vs 0.63, t = 0.36, df = 16, P = 0.727). Exploratory analyses of additional T-cell subsets suggest that MVC intensification in AEH trended to early greater increases in naïve and activated and proliferating CD4 T cells (P = 0.11, 0.19), and greater decreases in senescent memory CD4 T cells (P = 0.06), but these differences did not remain by week 48. CD8 T-cell evaluations did demonstrate trends to differences at week 48 with slower increases in naïve cells and slower decreases in activated memory cells (P = 0.16, 0.09). There were no reported harms or significantly different adverse events.

conclusionsWe did observe a few trends, but did not find compelling evidence that MVC intensification during AEH significantly impacts CD4 and CD8 T-cell dynamics. Diagnosing and starting persons in AEH on ART may be of greater clinical importance than the regimen initiated.

Indexed as

AdultCCR5 Receptor AntagonistsCyclohexanesDouble-Blind MethodFemaleHIV InfectionsHumansMaleMaravirocTime FactorsT-LymphocytesTriazolesCCR5 Receptor AntagonistsCyclohexanesMaravirocTriazoles

Identifiers

PMID27858912
PMCPMC5591160

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.