Introduction
NAFLD, inflammation, MVC, fibrosis
INFLAMMATION, SECONDARY, FIBROSIS, NON-ALCOHOLIC FATTY LIVER DISEASE
Non-alcoholic fatty liver disease (NAFLD), defined as fat accumulation in ≥5% of hepatocytes without a secondary cause, [Lifestyle changes, including physical activity and dietary modification, are the mainstay of therapy [Chemokine (C-C motif) ligand 5 (CCL5)/ Regulated upon Activation, Normal T cell Expressed and Secreted (RANTES), the ligand for C-C chemokine receptor type 5 (CCR5), plays a key role in hepatic inflammation. CCR5 mediates intrahepatic immune cell interactions which promote activation and migration of Kupffer cells and hepatic stellate cells; these in turn promote inflammation and fibrosis [The CCR5 receptor antagonist, maraviroc (MVC), is licensed for HIV-1 treatment as part of combination antiretroviral therapy (cART) in therapy-naïve and -experienced individuals, where the infecting strain is CCR5 tropic [MVC therefore represents a potential treatment for HIV-NAFLD. However, dosing is usually twice daily, unlike currently recommended antiretrovirals. We therefore aimed to conduct a RCT to evaluate the safety, acceptability and feasibility of MVC add-on therapy to cART in HIV-NAFLD in preparation for conducting a larger RCT in the future. The RCT was successfully completed and findings are presented below.