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Maraviroc + metformin is a combination of two small molecule drugs, each with distinct mechanisms of action. Maraviroc is a CCR5 antagonist used primarily as an antiretroviral agent in HIV treatment, blocking the CCR5 co-receptor to prevent HIV entry into host cells and modulating inflammatory pathways. Metformin is an oral antihyperglycemic agent widely used for type 2 diabetes; it decreases hepatic glucose production, increases insulin sensitivity, and inhibits mitochondrial complex I activity leading to activation of AMP-activated protein kinase (AMPK). The combination has been investigated for metabolic dysfunction-associated fatty liver disease (MAFLD) in people with HIV due to their potential complementary effects on inflammation and metabolism. However, clinical trials have not demonstrated significant benefit over standard antiretroviral therapy alone in reducing liver fat content[1][2][3].
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