Lovastatin: Immunomodulatory Value Evaluation (LIVE)

September 30, 2011 updated by: Carlos Julio Montoya Guarin, Universidad de Antioquia

Antiretroviral Effect of Lovastatin on HIV-1-infected Individuals Without Highly Active Antiretroviral Therapy (HAART): A Phase-II Randomized Clinical Trial (RCT)

The purpose of this study is to determine whether the long-term administration of statins may benefit the clinical and immunological evolution in HIV-1-infected individuals before the use of antiretroviral therapy is required.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Despite the fact that HAART produces a decrease in HIV-1 replication and plasma HIV-1 RNA levels, and allows an increase in the CD4 T-cell count that leads to a diminution in the incidence of opportunistic infections and mortality, the cost and complexity of HAART regimens, the growing list of long-term side effects, and the eventual development of resistance have underscored the immediate need for additional therapeutic approaches. Statins exert pleiotropic effects through a variety of mechanisms, among which there are several immunological effects that are related and unrelated to their cholesterol-lowering activity. HIV-1 requires cholesterol and lipid rafts for several key stages of its replication cycle; statins-mediated depletion of cholesterol alters the capacity of a cell to form lipid rafts and decreases the HIV-1 infectivity. On the other hand, statins may exert significant modulator effects in the balance of the cytokine network, and alter the activity of Rho GTPases and LFA-1 and ICAM-1 adhesion molecules. Preliminary studies showed that statins (Lovastatin) had anti HIV-1 activity, and that its administration was safe and efficient to control HIV-1 infection in chronically infected individuals who did not receive HAART (in terms of decreasing viral load and increasing CD4 T-cell count). Because very limited clinical data are available on this topic, this study will be conducted.

Study Type

Interventional

Enrollment (Actual)

112

Phase

  • Phase 2

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

  • Colombia
    • Antioquia
      • Medellin, Antioquia, Colombia
        • Group of Immunovirology, Research Universitary Center, University of Antioquia

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 and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Asymptomatic HIV-1 seropositive individuals, with age ≥ 18 years, who are HAART naive

  • HIV-1 infection confirmed by:

    • positive Western-blot test dated at least six months before admission to the study;
    • a Western-blot test within the last six months, which was also positive for the p31 and p66 bands
  • Detectable viral load < 100,000 copies/ml
  • CD4+ T cell count ≥ 350 cells/ul

Exclusion Criteria:

  • Inability or unwillingness of patients to give written informed consent.
  • Main residence outside Medellin and its metropolitan area, or any indication of difficulties in the follow-up period
  • Participation in other clinical trials
  • Evidence that the patient will exhibit low adherence to intervention and follow-up (Morisky-Green test)
  • Pregnancy or breastfeeding
  • Any type of antiretroviral treatment before admission to the study, and therapy with lipid-lowering drugs during the last six months
  • Antecedents of allergy, contraindications or intolerance to statins
  • Patients receiving medications which can generate relevant interactions with lovastatin: clarithromycin, erythromycin, azithromycin, itraconazole, ketoconazole, nefodozone, cimetidine, rifampin, phenobarbital, carbamazepine, phenytoin.
  • Unwillingness to avoid the consumption of Citrus paradise (grapefruit juice) or Saint John's Wort (Hypericum)
  • Opportunistic infections or any type of AIDS-defining disease
  • Chronic active hepatitis (B or C)
  • Any hepatocellular disease, indicated by elevation of liver enzymes (AST or ALT) more than twice the reference value
  • Renal failure, indicated by serum creatinine ≥ 2 mg/dl
  • Myopathy, indicated by an elevation of creatine phosphokinase (CPK) more than five times the reference values
  • Infection or acute disease that requires in-patient treatment
  • Active substance-related disorders

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

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Triple

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: 1
In this arm, subjects will receive 40 mg of Lovastatin (2 tablets of 20 mg each, p.o.), in a daily doses, during twelve months
Drug: Lovastatin
Lovastatin 40 mg daily (2 tablets of 20 mg each, p.o.), during twelve months until the end of the study, or before the end of the study if any AIDS defining disease or toxicity appear
Other Names:
  • statin
Placebo Comparator: 2
In this arm, subjects will receive placebo (2 tablets which will look externally identical to lovastatin: wrapped in the same way, with the same size, shape and color)
Other: placebo
Placebo will be administered daily (2 tablets which will look externally identical to intervention: wrapped in the same way, with the same size, shape and color), during twelve months until the end of the study, or before the end of the study if any AIDS defining disease or toxicity appear

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
1. HIV-1 viral load measured as RNA copies per ml of peripheral blood 2. CD4 T-cell count measured as cells per ul of peripheral blood
Time Frame: Before, 6 and twelve months after the intervention
Before, 6 and twelve months after the intervention

Secondary Outcome Measures

Outcome Measure
Time Frame
CD8+ T cell count, CD4/CD8 ratio, Expression of CD38 and HLA-DR, Total serum cholesterol, Cellular cholesterol, Activity of LFA-1 and ICAM-1, Activity of Rho GTPases, Monthly frequency of AIDS defining diseases, hospitalization and mortality
Time Frame: Before, 6 and twelve months after the intervention
Before, 6 and twelve months after the intervention

Collaborators and Investigators

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

Sponsor

Universidad de Antioquia

Collaborators

Instituto Colombiano para el Desarrollo de la Ciencia y la Tecnología (COLCIENCIAS)
Laboratorio Clínico Congregación Mariana
Laboratorios Laproff S.A.
Humax Pharmaceutical

Investigators

  • Principal Investigator: Carlos J Montoya, MD, PhD, Universidad de Antioquia
  • Study Chair: Maria T Rugeles, PhD, Universidad de Antioquia
  • Study Director: Fabian A Jaimes, MD, PhD, Universidad de Antioquia

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.

General Publications

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

August 1, 2008

Primary Completion (Actual)

July 1, 2011

Study Completion (Actual)

July 1, 2011

Study Registration Dates

First Submitted

July 22, 2008

First Submitted That Met QC Criteria

July 23, 2008

First Posted (Estimate)

July 24, 2008

Study Record Updates

Last Update Posted (Estimate)

October 4, 2011

Last Update Submitted That Met QC Criteria

September 30, 2011

Last Verified

September 1, 2011

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • COLCIENCIAS 111540820508

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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