CCR5 Antagonism to Decrease the Incidence of the Immune Reconstitution Inflammatory Syndrome in HIV-Infected Patients

Inclusion Criteria:

- HIV-1 infection, as documented by any licensed rapid test kit and confirmed by
Western blot or ELISA test kit at any time prior to study enrollment.

Plasma HIV-1 RNA is acceptable as an alternative confirmatory test.

- Men and women age > 18 years.

- Have not received any antiretroviral treatment before entering the study.

- Patients who received Single dose nevirapine or any duration of AZT for PMTC will not
be considered ARV naïve.

- CD4+ cell count of
- HIV RNA level > 1,000 copies/mL obtained within 90 days prior to study entry.

- Patients with an opportunistic or HIV-related infection may be included according to
the clinical judgment of the main investigator in each center when the patient is
ready and able to start ARV therapy.

- Laboratory values obtained within 30 days prior to study entry:

- Absolute neutrophil count (ANC) > 500/mm3.

- Hemoglobin > 8.0 g/dL.

- Platelet count > 50,000/mm3.

- AST (SGOT), ALT (SGPT), and alkaline phosphatase minor of 5 times ULN.

- Total bilirubin minor of 2.5 times ULN.

- Creatinine clearance minor of 50* mL/min as estimated by the Cockcroft-Gault
equation or Creatinine Clearance > 50ml/min as calculated by a formal creatinine
clearance measurement

- All women of reproductive potential (have not reached menopause or undergone
hysterectomy, oophorectomy, or tubal ligation) must have a negative serum or urine
b-HCG pregnancy test performed within 7 days before study entry.

- Female subjects who are not of reproductive potential (have reached menopause or
undergone hysterectomy, oophorectomy, or tubal ligation) or whose male partner has
undergone successful vasectomy with resultant azoospermia or has azoospermia for any
other reason, are eligible without requiring the use of contraception. Documentation
of menopause, sterilization (hysterectomy, oophorectomy, tubal ligation, or
vasectomy) and azoospermia by patient-reported history is acceptable.

- All subjects must agree not to participate in a conception process (i.e., active
attempt to become pregnant or to impregnate, sperm donation, in vitro fertilization),
and if participating in sexual activity that could lead to pregnancy, the female
study volunteer/male partner must agree to use a form of contraception as specified
in the note below while receiving protocol-specified medication(s) and for one month
after stopping the medication(s).

- Ability and willingness of subject or legal guardian/representative to give written
informed consent.

Exclusion Criteria:

- Pregnancy and breast-feeding.

- Active neoplasia or previous history of neoplasia. (Except localized non visceral
Kaposi´s Sarcoma; localized squamous or basal cell carcinoma of the skin, or
intraepithelial cervical neoplasia grade III or less).

- Use of the following drugs within 180 days prior to study entry: systemic cancer
chemotherapy, systemic investigational agents, and immunomodulators (growth factors,
immune globulin, interleukins, interferons).

- Use of systemic corticosteroids in the last 2 weeks prior to randomization.

- Decompensated liver disease (defined as stage C of Child-Pugh classification) at the
beginning of the study.

- An altered mental status that in the opinion of the investigator, will compromise the
adherence to the protocol.

- Allergy/sensitivity to study drug(s) or their formulations that cannot be substituted
by another agent as described in section 5.1

- Active drug or alcohol use or dependence that, in the opinion of the investigator,
would interfere with adherence to study requirements.

- Serious illness that renders a subject unable to take the antiretroviral study
regimen.

- Serious medical illness that in the opinion of the investigator compromises the
adherence and/or follow up of the protocol.