Accelerated Aging, HIV Infection, Antiretroviral Therapies (EP 45)

The main goal is to confirm, among HIV1-infected patients, data from in vitro studies showing that antiretroviral therapies induce an accelerated aging through the same mechanisms than genetic laminopathies or than "physiological " aging, that is through the synthesis and persistence of farnesylated prelamin A. The secondary goal is to measure the impact of HIV infection and of antiretroviral therapies on markers of cell ageing (proteasome, mitochondria, telomere). The perspective is to fix antiretroviral therapy side effects using the same drug combination that will be used in few weeks in Marseille to treat children suffering from progeria

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Protease inhibitors block viral protease, as well as various other cell enzymes : ZMPSTE24 cliping off prelamin A into mature lamin A ; at least one of the Golgi proteases involved in the release of SREBP, controlling the transcription of lipid metabolism regulating genes ; mitochondrial proteases involved in the importation and further maturation of nuclear genome encoded proteins ; proteasome regulating the transcription of several genes through NF-B ; P450 cytochromes. Nucleosides inhibitors of the viral reverse transcriptase exhibit nuclear and mitochondrial DNA toxicity, disrupt lipid and protein glycosylation and inhibit telomerase. Therefore antiretroviral therapies target several pathways involved in accelerated or normal aging. Their combined effects are added to viral infection direct symptoms or to cell abnormalities induced by viral proteins.

Our multicentric (the 3 CISIH from Marseille, Nice and Montpellier) 3 year- long study will analyse 50 HIV1-infected naive patients (A group), apparied to 50 age- and sex-matched seronegative control subjects (recruited by CIC-UPCET of Marseille) and 100 HIV1-infected patients in first line of antiretroviral therapy for at least 12 months (B group). Patients of group A and B will be recruited in the 3 clinical unit. The HIV1- infected patients will be evaluated four times, at baseline, then every 12 months during 3 years. In case of initiation or changing of antiretroviral therapy, patients will be evaluated once more. Control subjects will be only evaluated at baseline.

Peripheral blood biological tests will be the following [Laboratory designation] : i/ viral load measurement, PBMC isolation, DNA extraction, proviral DNA measurement, cell and DNA storage [Virology, Timone CHU, Marseille]; ii/ assays of CD4, CD8, glycemia, insulinemia, HOMA, total-, LDL- and HDL-cholesterol, triglycerides [Biochemistry labs from the 3 CHU] ; iii/ antiretroviral drug assay (mass spectrometry) [Pharmacokinetics, Timone CHU, Marseille]; iv/ detection (western blotting, immunocytochemistry combined to image analysis of nuclear abnormalities) of PBMC nuclear, cytosolic and mitochondrial targets of antiretroviral drugs : A and B lamins, NF-B + I-B and proteasome activity assay, CD36 (glycosylation), mitochondrial Hsp70, ROS mitochondrial production, mitochondrial inner membrane potential, cytochrome C oxidase subunits 2 and 4 [Cell Biology, Timone CHU, Marseille] ; v/ genotyping the antiretroviral targets : lamin A (ZMPSTE24) and B (Rce1) processing proteases, Golgi SREBP-releasing proteases (MBTPS1 and S2), mitochondrial deoxynucleoside transporters (SLC25A4 to A6), mitochondrial proteases (MPPA, paraplegin) involved in processing of nuclear encoded proteins during their mitochondrial import ; quantitative PCR measurement of telomere length [Molecular Genetics, Timone CHU, Marseille]. Marseille's CIC-UPCET collaborated to the protocol design, will recruit control subjects and will be responsible for statistical treatment of data.

Study Type

Observational

Enrollment (Anticipated)

200

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

      • country of French, France
        • ANRS center from Marseille, Timone and Montpellier and Nice

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 65 years (Adult, Older Adult)

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

All

Sampling Method

Non-Probability Sample

Study Population

50 HIV1-infected naive patients (A group), apparied to 50 age- and sex-matched seronegative control (C group) subjects and 100 HIV1-infected patients in first line of antiretroviral therapy for at least 12 months (B group)

Description

Inclusion Criteria:

Age ≥ 18 years and <65 years Able to give written consent Covered by French Social Security Non infected by HIV-2

  • - A group HIV1-infected naive patients
  • -B group infected patients in first line of antiretroviral therapy for at least 12 months
  • -C group HIV seronegative Confirmed by a fast test of screening of the HIV at day one of study

Exclusion Criteria:

  • Age < 18 years and > 65 years
  • Not Able to give written consent
  • Not Covered by French Social Security
  • Infected by HIV-2
  • treated by statin or biphosphonat amino
  • concomitant treatment: diabetic or testosteron

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
A HIV1-infected naive patients
A group and B group will be evaluated three times, at baseline, then every 12 months during 3 years. In case of initiation or changing of antiretroviral therapy, patients will be evaluated once more. Control subjects will be only evaluated at baseline.
B HIV1-infected patients
in 1st line of ARV therapy for at least 12 months
A group and B group will be evaluated three times, at baseline, then every 12 months during 3 years. In case of initiation or changing of antiretroviral therapy, patients will be evaluated once more. Control subjects will be only evaluated at baseline.
C= control Non infected HIV volunters
A group and B group will be evaluated three times, at baseline, then every 12 months during 3 years. In case of initiation or changing of antiretroviral therapy, patients will be evaluated once more. Control subjects will be only evaluated at baseline.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
lamin A measurement by western blotting

Secondary Outcome Measures

Outcome Measure
Peripheral blood biological tests (cellular, molecular genetic)

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Investigators

  • Principal Investigator: Isabelle POIZOT-MARTIN, CHU Sainte Marguerite -Marseille
  • Principal Investigator: Marie-Pierre DROGOUL, CHU Sainte Marguerite -Marseille
  • Principal Investigator: Olivia FAUCHER, CHU Sainte Marguerite -Marseille
  • Principal Investigator: Amélie MENARD, CHU Sainte Marguerite -Marseille
  • Principal Investigator: Joëlle MICALLEF-ROLL, Chu Timone
  • Principal Investigator: Jacques REYNES, CISIH CHRU Gui de Chauliac- Montpellier
  • Principal Investigator: Pierre DELLAMONICA, CISIH CHU Nice
  • Principal Investigator: Pierre CAU, INSERM UMR S910 MARSEILLE
  • Principal Investigator: Catherine TAMALET, Laboratoire Virologie Marseille
  • Principal Investigator: Bruno LACARELLE, Unité INSERM U911 Marseille
  • Principal Investigator: Nicolas LEVY, Laboratoire Génétique Moléculaire Marseille
  • Principal Investigator: Patrick ROLL, Laboratoire biologie cellulaire Marseille

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

April 1, 2009

Primary Completion (Actual)

April 1, 2010

Study Completion (Actual)

March 1, 2012

Study Registration Dates

First Submitted

December 23, 2009

First Submitted That Met QC Criteria

December 23, 2009

First Posted (Estimate)

December 24, 2009

Study Record Updates

Last Update Posted (Estimate)

December 27, 2012

Last Update Submitted That Met QC Criteria

December 26, 2012

Last Verified

December 1, 2012

More Information

Terms related to this study

Other Study ID Numbers

  • 2008-A00905-50

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