Renal Transplantation and Raltegravir in HIV-Infected Patients (ANRS153TREVE)

National, Multicenter, Phase III Prospective Trial About Clinical and Immunological Follow-up After Renal Transplantation in HIV-1 Infected Patients With End Stage Chronic Renal Insufficiency

The aim of this study is to evaluate the incidence of acute renal graft rejection 6 months after transplantation in HIV-infected patients under three antiretroviral drugs regimen including Raltegravir.

Study Overview

• Status: Completed
• Conditions: HIV-1 Infection; Chronic Renal Insufficiency
• Intervention / Treatment: Drug: Raltegravir

Detailed Description

Antiretroviral treatment of HIV-1 Infection might interact with immunosuppressive treatments which increase rejection of renal graft incidence.

In addition HIV infection may be modified together with cardiovascular risk. Patients participating to this study will receive after transplantation antiretroviral regimen including Raltegravir.

Raltegravir treatment does not interact with immunosuppressive drugs and thus seems to be the treatment of choice to be associated with immunosuppressive drugs.

• Study Type: Interventional
• Enrollment (Actual): 27
• Phase: Phase 3

Contacts and Locations

Study Locations

• France
  • Bordeaux, France, 33076
    • Hôpital Pellegrin, Service de Nephrologie, Transplantation Rénale, Dialyse
  • Caen, France, 14033
    • CHU De Caen, Service de Néphrologie Hémodialyse
  • Créteil, France, 94010
    • Hôpital Henri Mondor, Service de Néphrologie Transplantation
  • Le Kremlin-Bicêtre, France, 94275
    • Hôpital Kremlin Bicêtre, Service de Néphrologie
  • Lille, France, 59037
    • CHRU Lille, Service de néphrologie
  • Nantes, France, 44093
    • CHU de Nantes, Service de Néphrologie et Immunologie Clinique
  • Nice, France, 06002
    • Hôpital Pasteur, Service de Néphrologie - Transplantation
  • Paris, France, 75010
    • Hopital Saint Louis, Service de Néphrologie
  • Paris, France, 75743
    • Hôpital Necker, Service de Néphrologie adulte
  • Paris, France, 75970
    • Hôpital TENON, Urgences Néphrologiques et Transplantation Rénale
  • Strasbourg, France, 67091
    • Hôpital civil, Service de Néphrologie et Transplantation
  • Suresnes, France, 92151
    • Hôpital Foch, Service de Néphrologie Transplantation
  • Toulouse, France, 31059
    • Hôpital Rangueil, Service de Néphrologie, HTA, Dialyse, Transplantation
  • Tours, France, 37044
    • Hôpital Bretonneau, Service de Néphrologie

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 70 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Registration on the French national renal transplantation waiting list (Biomedicines Agency) for a living or cadaveric donor organ
• HIV-1-infected patients treated by a three-drug ARV regimen
• Immuno-virologic criteria at renal transplantation: undetectable viral load (<50 copies/mL) and CD4 >200/mm3 for at least three months on stable ARV
• Age >18 years and <70 years
• Effective contraception for women
• Written informed consent
• Patient with social security coverage

Exclusion Criteria:

• Permanent:

  • Hepatic cirrhosis
  • Serious psychiatric illness history
  • EBV or HHV8 lymphoproliferation (lymphoma, systemic Kaposi's sarcoma or multifocal Castleman's disease)
  • History of PML
  • HTLV-1 seropositivity
  • Severe pulmonary or cardiovascular disease with poor short-term vital prognosis
  • Patient with AgHBs+
  • History of cryptosporidiosis
  • History of fungal infection with multi resistant fungi not likely to respond to oral antifungal therapy
  • Impossibility or refusal of Raltegravir switch, decision made by doctor or patient

• Temporary:

  • Recent malignancy (between 2 and 5 years according to type)
  • HPV-related cervical or anal disease: carcinoma in situ, AIN III, CIN III in remission for less than three years
  • Active infection
  • HCV infection (PCR-positive)

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Raltegravir; Raltegravir associated to an antiretroviral regimen without ritonavir boosted antiprotease	Drug: Raltegravir; Introduction of Raltegravir 2 days after renal transplantation within an antiretroviral regimen without ritonavir boosted antiprotease; Other Names: Isentress

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Incidence of acute clinical renal graft rejection	Incidence of acute clinical renal graft rejection defined by 20% increase of serum creatinine, associated to histological features (Banff classification) 6 months after renal transplantation	6 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Incidence of acute clinical and subclinical renal graft rejection	Incidence of acute clinical and subclinical renal graft rejection up to 1 year after renal transplantation defined only by renal histology (without creatinine modification). Histology is performed on routine renal graft biopsy 3 months and 1 year after transplantation.	1 year
One year graft survival	One year graft survival, compared to non HIV-infected transplanted patients, using data provided by French Biomedicines Agency	1 year
Patients' survival	Patients survival, compared to: - chronic dialysis HIV patients still listed on the transplantation waiting list - transplanted non-HIV patients using data provide by French Biomedicine Agency	1 year
Phenotyping of lymphocytic infiltrates in case of acute rejection	The aim of the immunological phenotyping is to analyse the expression of activation markers between different TCD4 and TCD8 sub-population, this phenotyping will be compared to those observed in acute cell-mediated rejection occurring in the historical cohort of Non-HIV patients. In addition, the rate and expression of Treg population will be evaluated.	1 year
Incidence of AIDS defined diseases and severe morbidity diseases after renal transplantation	Severe morbidity diseases include: pathological infections, malignancies, metabolic and cardiovascular diseases.	1 year
Immunological and virologic status after renal transplantation	Immunological (lymphocyte activation and inflammatory parameters) and virologic status (kinetics of viral replication: HIV RNA in blood, total HIV DNA in PBMC) monitoring after renal transplantation. These parameters will be compared with pre-transplant status.	1 year
Evaluation of the switch by raltegravir at the time of renal transplantation	Assessment of ARV medications change and introduction of raltegravir at the time of renal transplantation in terms of reduction of pharmacokinetic interaction between antiretroviral regimen including raltegravir and immunosupressive treatments. In addition, virological efficacy of antiretroviral treatment including Raltegravir will be evaluated.	1 year
Viral load control after switch by antiretroviral treatment including raltegravir after renal transplantation	The aim of this study is to evaluate at the time of renal transplantation the virologic efficiency after the switch by an antiretroviral regimen including Raltegravir in terms of viral load control an virological failure as Raltegravir is known for its low genetic barrier.	1 year
Survival and waiting period of HIV patients registered on French biomedicine agency for renal transplantation	Assessment of HIV patients' waiting period until renal transplantation and survival of patients registered on French biomedicine agency waiting-list compared to Non-HIV population (data provided by French Biomedicine Agency )	1 year
Measurement of Area under plasma concentration (AUC) variability of immunosuppressive drugs after introduction of antiretroviral regimen containing Raltegravir	Area under plasma concentration (AUC) of Raltegravir and immunosuppressive drugs (Tacrolimus and Mycophenolate Mophetyl) will be measured as well as residual concentration of Tacrolimus. This study is performed in order to verify immunosupressive treatments dosage adaptation.	1 year

Collaborators and Investigators

• Sponsor: ANRS, Emerging Infectious Diseases
• Collaborators: Merck Sharp & Dohme LLC
• Investigators: Principal Investigator: Philippe GRIMBERT, MD, CHU Henri-Mondor; Study Director: Dominique COSTAGLIOLA, PHD, INSERM U943

Publications and helpful links

General Publications

• Matignon M, Lelievre JD, Lahiani A, Abbassi K, Desvaux D, Diallo A, Peraldi MN, Taburet AM, Saillard J, Delaugerre C, Costagliola D, Assoumou L, Grimbert P; ANRS 153 TREVE study group. Low incidence of acute rejection within 6 months of kidney transplantation in HIV-infected recipients treated with raltegravir: the Agence Nationale de Recherche sur le Sida et les Hepatites Virales (ANRS) 153 TREVE trial. HIV Med. 2019 Mar;20(3):202-213. doi: 10.1111/hiv.12700. Epub 2019 Jan 27.

Helpful Links

• French National Agency for Research on AIDS and viral Hepatitis

Study record dates

Study Major Dates

• Study Start: December 1, 2011
• Primary Completion (Actual): November 1, 2015
• Study Completion (Actual): November 1, 2015

Study Registration Dates

• First Submitted: October 3, 2011
• First Submitted That Met QC Criteria: October 13, 2011
• First Posted (Estimated): October 17, 2011

Study Record Updates

• Last Update Posted (Actual): April 13, 2026
• Last Update Submitted That Met QC Criteria: April 9, 2026
• Last Verified: July 1, 2016

More Information

Terms related to this study

• Keywords: HIV-1; Raltegravir; Renal transplantation; Acute renal graft rejection
• Additional Relevant MeSH Terms: Urogenital Diseases; Pathologic Processes; Male Urogenital Diseases; Kidney Diseases; Urologic Diseases; Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Chronic Disease; Disease Attributes; Renal Insufficiency; Pathological Conditions, Signs and Symptoms; Renal Insufficiency, Chronic; Heterocyclic Compounds, 1-Ring; Heterocyclic Compounds; Pyrrolidines; Pyrrolidinones; Raltegravir Potassium
• Other Study ID Numbers: ANRS 153 TREVE (ANRS); 2011-001004-35 (EudraCT Number)