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

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.

CCR5 drives NK cell–associated airway damage in pulmonary ischemia-reperfusion injury

“…We hypothesized that blockade of the CCR5 receptor would reduce NK cell trafficking to the lungs and airways during IRI. Maraviroc is an allosteric inhibitor of CCR5 that is gaining interest in the transplant community for its immunomodulatory properties and the potential to prevent graft rejection (29)(30)(31). Most studies focused on the ability of CCR5 to modulate T cell activity; our goal was to investigate NK cell migration (32,33).…”