Maraviroc

Mechanism of action
Maraviroc blocks HIV entry into human cells by acting as
an antagonist at the chemokine receptor 5 (CCR5). CCR5
is a chemokine receptor present on the surface of some
immune cells. It is a co-receptor used by HIV-1 to enter
uninfected cells. The drug has no effect for HIV-1 strains that
use the other co-receptor, CXCR-4, to gain cell entry. Before initiating maraviroc in a
patient, tropism testing of the
HIV strain is necessary (e.g., to identify which receptor CCR5 or CXCR-4) to determine
whether the drug will be ofbenefit.
Pharmacokinetics
Maraviroc is a P450 substrate and the dose may need to be
adjusted if taken with drugs that induce or inhibit hepatic
P450 enzymes.
Adverse effects
Maraviroc has been associated with liver toxicity, which is
often preceded by evidence of a systemic allergic reaction
(e.g., pruritic rash).