@article{Mccabe:2024:10.1097/QAD.0000000000003947,
author = {Mccabe, L and Burns, JE and Latifoltojar, A and Post, FA and Fox, J and Pool, E and Waters, A and Santana, B and Garvey, L and Johnson, M and Mcguinness, I and Chouhan, M and Edwards, J and Goodman, AL and Cooke, G and Murphy, C and Collaco-Moraes, Y and Webb, H and Gregory, A and Mohamed, F and Rauchenberger, M and Ryder, SD and Sandford, C and Baker, JV and Angus, B and Boesecke, C and Orkin, C and Punwani, S and Clark, A and Gilson, R and Dunn, D and Pett, SL and MAVMET, Study group},
doi = {10.1097/QAD.0000000000003947},
journal = {AIDS},
title = {MAVMET trial: maraviroc and/or metformin for metabolic dysfunction-associated fatty liver disease(MAFLD) in adults with suppressed HIV},
url = {http://dx.doi.org/10.1097/QAD.0000000000003947},
year = {2024}
}

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TY  - JOUR
AB  - OBJECTIVE: Metabolic dysfunction-associated fatty liver disease (MAFLD) is over-represented in people living with HIV (PLWH). Maraviroc (MVC) and/or metformin (MET) may reduce MAFLD by influencing inflammatory pathways and fatty acid metabolism. DESIGN: Open-label, 48-week randomised trial with a 2x2 factorial design. SETTING: Multicentre HIV clinics. PARTICIPANTS: Nondiabetic, virologically-suppressed PLWH, aged ≥35years, with confirmed/suspected MAFLD (≥1biochemical/anthropometric/radiological/histological features). INTERVENTION: Adjunctive MVC; MET; MVC+MET vs. antiretroviral therapy (ART) alone. PRIMARY OUTCOME: Change in liver fat fraction (LFF) between baseline and week-48 using Magnetic Resonance Proton Density Fat Fraction (MR PDFF). RESULTS: Six sites enrolled 90 participants (93% male; 81% white; median age 52 [interquartile range, IQR 47-57] years) between 19-Mar-2018 and 11-November-2019. 70% had imaging/biopsy plus ≥1 MAFLD criteria. The analysis included 82/90 with week-0 and -48 scans. Median baseline MR PDFF was 8.9 (4.6-17.1); 40%, 38%, 8%, and 14% had grade zero, one, two, and three steatosis respectively. Mean LFF increased slightly between baseline and follow-up scans: 2.22% MVC, 1.26% MET, 0.81% MVC+MET, and 1.39% ART alone. Prolonged intervention exposure (delayed week-48 scans) exhibited greater increases in MR PDFF (estimated difference 4.23% [95% CI 2.97, 5.48], P<0.001). There were no differences in predicted change for any intervention compared to ART alone: MVC (-0.42% [95% CI -1.53-0.68, P=0.45]), MET (-0.62 [-1.81-0.56, P=0.30]), and MVC+MET (-1.04 [-2.74-0.65, P=0.23]). Steatosis grade remained unchanged in 55% and increased in 24%. CONCLUSIONS: Baseline levels of liver fat were lower than predicted. Contrary to our hypothesis, neither MVC, MET, or the combination significantly reduced MR PDFF compared to ART alone.
AU  - Mccabe,L
AU  - Burns,JE
AU  - Latifoltojar,A
AU  - Post,FA
AU  - Fox,J
AU  - Pool,E
AU  - Waters,A
AU  - Santana,B
AU  - Garvey,L
AU  - Johnson,M
AU  - Mcguinness,I
AU  - Chouhan,M
AU  - Edwards,J
AU  - Goodman,AL
AU  - Cooke,G
AU  - Murphy,C
AU  - Collaco-Moraes,Y
AU  - Webb,H
AU  - Gregory,A
AU  - Mohamed,F
AU  - Rauchenberger,M
AU  - Ryder,SD
AU  - Sandford,C
AU  - Baker,JV
AU  - Angus,B
AU  - Boesecke,C
AU  - Orkin,C
AU  - Punwani,S
AU  - Clark,A
AU  - Gilson,R
AU  - Dunn,D
AU  - Pett,SL
AU  - MAVMET,Study group
DO  - 10.1097/QAD.0000000000003947
PY  - 2024///
SN  - 0269-9370
TI  - MAVMET trial: maraviroc and/or metformin for metabolic dysfunction-associated fatty liver disease(MAFLD) in adults with suppressed HIV
T2  - AIDS
UR  - http://dx.doi.org/10.1097/QAD.0000000000003947
UR  - https://www.ncbi.nlm.nih.gov/pubmed/38819839
UR  - https://journals.lww.com/aidsonline/abstract/9900/mavmet_trial__maraviroc_and_or_metformin_for.502.aspx
ER  - 

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