The Safety and Effectiveness of Zidovudine in the Treatment of HIV-Infected Children With Mild to Moderate Symptoms
A Multicenter Placebo-Controlled Trial To Evaluate the Safety and Efficacy of Oral Zidovudine in the Treatment of Children Infected With Human Immunodeficiency Virus With Mild to Moderate Symptoms (Including LIP)
To determine the safety and usefulness of zidovudine (AZT) for the treatment of children 3 months to 12 years of age. This study is designed to determine if children who are infected with HIV and who have a special type of lung disease called lymphocytic interstitial pneumonitis (LIP) or other early symptoms of HIV infection may derive benefit from treatment with AZT. It is hoped that this drug will prevent children from developing additional symptoms and infections and will help resolve already existing symptoms.
AZT has been shown in the laboratory to inhibit the infection of cells by HIV. AZT has been shown to decrease the mortality and the frequency of opportunistic infections in certain adult patients with symptomatic HIV infection. It is, therefore, likely that symptomatic HIV-infected children may also benefit from specific antiviral therapy.
Přehled studie
Postavení
Postavení
Podmínky
Podmínky
Intervence / Léčba
Intervence / Léčba
Detailní popis
AZT has been shown in the laboratory to inhibit the infection of cells by HIV. AZT has been shown to decrease the mortality and the frequency of opportunistic infections in certain adult patients with symptomatic HIV infection. It is, therefore, likely that symptomatic HIV-infected children may also benefit from specific antiviral therapy.
Children who participate in the study are evaluated at a hospital outpatient clinic and are under the care of a specialist in pediatrics. Of the children who participate in the study, half receive AZT syrup and half receive a placebo (sugar solution). The investigator does not know which medication each child receives as this is decided by a random process. The children take the medication in a strawberry-flavored clear syrup every 6 hours (4 times a day), for a period of 2 years or 104 weeks. The children are monitored on an outpatient basis while receiving therapy and the tests performed on admission to the study are repeated several times during treatment. Blood samples are obtained once a week for the first 4 weeks, every other week for the next 4 weeks, and then monthly until the end of the study. At certain sites, Cerebrospinal fluid (CSF) is collected by lumbar puncture every 52 weeks to evaluate infection involving the brain and nervous system. An independent committee reviews the data collected on the children every 6 months. The drug is stopped or the dose reduced if unacceptable side effects develop. AMENDED: As of August 7, 1989 the study blind was broken, the placebo arm discontinued and the study closed to accrual as of September 25, 1989. The 6 children enrolled in the study have been offered AZT.
Typ studie
Typ studie
Zápis
Zápis
Fáze
Fáze
- Fáze 2
Kontakty a umístění
Studijní místa
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California
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Downey, California, Spojené státy, 902422814
- Kaiser Permanente / UCLA Med Ctr
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Long Beach, California, Spojené státy, 90801
- Long Beach Memorial (Pediatric)
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Los Angeles, California, Spojené státy, 900276016
- Children's Hosp of Los Angeles/UCLA Med Ctr
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Los Angeles, California, Spojené státy, 905022004
- Harbor - UCLA Med Ctr / UCLA School of Medicine
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Los Angeles, California, Spojené státy, 900951752
- UCLA Med Ctr / Pediatric
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Los Angeles, California, Spojené státy, 900593019
- Martin Luther King Jr Gen Hosp / UCLA Med Ctr
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Menlo Park, California, Spojené státy, 94025
- Stanford Univ School of Medicine
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Oakland, California, Spojené státy, 946091809
- Children's Hosp of Oakland
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San Diego, California, Spojené státy, 92103
- UCSD Treatment Ctr
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San Francisco, California, Spojené státy, 94143
- Northern California Pediatric AIDS Treatment Ctr / UCSF
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Florida
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Miami, Florida, Spojené státy, 331361013
- Univ of Miami School of Medicine
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Miami, Florida, Spojené státy, 33136
- Univ of Miami School of Medicine
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Illinois
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Chicago, Illinois, Spojené státy, 60612
- Cook County Hosp
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Chicago, Illinois, Spojené státy, 606143394
- Chicago Children's Memorial Hosp
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Louisiana
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New Orleans, Louisiana, Spojené státy, 70112
- Tulane Univ School of Medicine
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New Orleans, Louisiana, Spojené státy, 70112
- Charity Hosp / Tulane Univ Med School
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Maryland
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Baltimore, Maryland, Spojené státy, 21201
- Univ of Maryland at Baltimore / Univ Med Ctr
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Baltimore, Maryland, Spojené státy, 212874933
- Johns Hopkins Hosp - Pediatric
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Massachusetts
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Boston, Massachusetts, Spojené státy, 021155724
- Children's Hosp of Boston
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Minnesota
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Minneapolis, Minnesota, Spojené státy, 55455
- Univ of Minnesota
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New Jersey
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Newark, New Jersey, Spojené státy, 071072198
- Children's Hosp of New Jersey / UMDNJ - New Jersey Med Schl
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New York
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Bronx, New York, Spojené státy, 10465
- Jack Weiler Hosp / Bronx Municipal Hosp
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Elmhurst, New York, Spojené státy, 11373
- City Hosp Ctr at Elmhurst / Mount Sinai Hosp
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New York, New York, Spojené státy, 10016
- Bellevue Hosp / New York Univ Med Ctr
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New York, New York, Spojené státy, 10029
- Mount Sinai Med Ctr
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New York, New York, Spojené státy, 10037
- Harlem Hosp Ctr
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New York, New York, Spojené státy, 10003
- Beth Israel Med Ctr / Pediatrics
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New York, New York, Spojené státy, 10032
- Columbia Univ Babies' Hosp
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North Carolina
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Durham, North Carolina, Spojené státy, 277103499
- Duke Univ Med Ctr
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Ohio
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Columbus, Ohio, Spojené státy, 432052696
- Columbus Children's Hosp
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Pennsylvania
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Hershey, Pennsylvania, Spojené státy, 170330850
- Milton S Hershey Med Ctr
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Texas
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Houston, Texas, Spojené státy, 77030
- Baylor College of Medicine
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Houston, Texas, Spojené státy, 77030
- Hermann Hosp / Univ Texas Health Science Ctr
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Kritéria účasti
Kritéria způsobilosti
Kritéria způsobilosti
Věk způsobilý ke studiu
Přijímá zdravé dobrovolníky
Pohlaví způsobilá ke studiu
Popis
Inclusion Criteria
Concurrent Medication:
Allowed:
- Prophylaxis for Pneumocystis carinii pneumonia (PCP) in children with AIDS or CD4 cell count = or < 500 cells/mm3.
Children must demonstrate the following clinical and laboratory findings:
- Laboratory evidence of HIV infection as demonstrated by either a positive viral culture or detectable serum p24 antigen or = or > two positive tests for HIV antibody, which must be determined by a federally licensed ELISA test and confirmed by Western blot.
- Children < 15 months of age, who are thought to have acquired HIV through perinatal transmission and whose only laboratory evidence of HIV infection is a positive antibody test, must also have one or more of the following laboratory criteria indicative of immunologic abnormality:
- hypergammaglobulinemia (IgG or IgA) defined as greater than the upper limit of normal for age-adjusted normals; absolute depression in the CD4+ cells to = or < 500 cells/mm3; decreased helper/suppressor ratio < 1.0; depressed in vitro mitogen response to at least one antigen/mitogen.
- Absence of serious bacterial infections as defined in Exclusion Criteria requiring therapy at the time of entry.
- Hemophiliacs are included.
Exclusion Criteria
Co-existing Condition:
Children will be excluded for the following reasons:
- Recurrent or life-threatening toxicity. Several allergic reactions such as exfoliative erythroderma, anaphylaxis, or vascular collapse. The presence of one or more of the indicator diseases of AIDS, such as opportunistic infections, malignancy, recurrent bacterial infections, or encephalopathy. Development of two or more episodes of recurrent varicella zoster infection or chronic zoster defined as = or > 30 days duration. Development of AIDS related complex, with failure to thrive, persistent or recurrent oral candidiasis, plus at least one of the following:
- Diarrhea that is either persistent or recurrent, lymphadenopathy at two or more noncontiguous sites, organomegaly, nephropathy manifested by nephrotic syndrome without evidence of renal failure, two or more episodes of herpes stomatitis or one or more episodes of herpes zoster within a 1 year period; plus at least one of the following:
- hypergammaglobulinemia, depression in the CD4+ cells to = or < 500/mm3, decreased helper/suppressor ratio < 1.0, depressed in vitro mitogen response to at least one antigen/mitogen.
Concurrent Medication:
Excluded:
- Hepatotoxic drugs.
- Steroids for lymphocytic interstitial pneumonitis (LIP).
- Prophylaxis for oral candidiasis, or otitis media.
- Immunoglobulin therapy.
- Chronic use of drugs that are metabolized by hepatic glucuronidation.
Concurrent Treatment:
Excluded:
- Supplemental oxygen treatment for lymphocytic interstitial pneumonitis (LIP).
Children will be excluded from the study for the following reasons:
- AIDS-defining opportunistic infection or neoplasm.
- Unexplained recurrent, serious bacterial infections (= or > 2 within a 2-year period) including sepsis, meningitis, pneumonia, abscess of an internal organ, and bone/joint infections caused by Haemophilus, Streptococcus, or other pyogenic bacteria.
- Encephalopathy.
- One or both of the following:
- Failure to thrive, defined as a child who crosses two percentile lines on the growth chart or a child who is less than the fifth percentile and does not follow the curve; and/or persistent (= or > 2 months) oral candidiasis despite appropriate topical therapy.
- Children with lymphocytic interstitial pneumonitis (LIP) who are steroid dependent or requiring supplemental oxygen or who have a pretreatment PaO2 < 70 mmHg.
- Children who qualify for the entrance criteria to open-label zidovudine (AZT) or AZT plus or minus gammaglobulin.
Prior Medication:
Excluded:
- Rifampin or rifampin derivatives.
- Antiretroviral agents.
- Zidovudine (AZT).
- Excluded within 2 weeks of study entry:
- Other experimental therapy.
- Drugs which cause prolonged neutropenia or significant nephrotoxicity.
- Excluded within 4 weeks of study entry:
- Immunomodulating agents including immunoglobulin, interferon, isoprinosine, and IL-2.
Prior Treatment:
Excluded within 4 weeks of study entry:
- Lymphocyte transfusions.
Active alcohol or drug abuse.
Studijní plán
Jak je studie koncipována?
Detaily designu
- Primární účel: Léčba
- Maskování: Dvojnásobek
Spolupracovníci a vyšetřovatelé
Sponzor
Sponzor
Vyšetřovatelé
Vyšetřovatelé
- Studijní židle: P Weintrub
Termíny studijních záznamů
Hlavní termíny studia
Dokončení studie (Aktuální)
Dokončení studie
Termíny zápisu do studia
První předloženo
První předloženo
První předloženo, které splnilo kritéria kontroly kvality
První předloženo, které splnilo kritéria kontroly kvality
První zveřejněno (Odhad)
První zveřejněno
Aktualizace studijních záznamů
Poslední zveřejněná aktualizace (Aktuální)
Poslední zveřejněná aktualizace
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Naposledy ověřeno
Naposledy ověřeno
Více informací
Termíny související s touto studií
Klíčová slova
Další relevantní podmínky MeSH
- RNA virové infekce
- Virová onemocnění
- Infekce
- Infekce přenášené krví
- Přenosné nemoci
- Pohlavně přenosné choroby, virové
- Pohlavně přenosné nemoci
- Lentivirové infekce
- Retroviridae infekce
- Syndromy imunologické nedostatečnosti
- Onemocnění imunitního systému
- HIV infekce
- Molekulární mechanismy farmakologického působení
- Antiinfekční látky
- Antivirová činidla
- Inhibitory reverzní transkriptázy
- Inhibitory syntézy nukleových kyselin
- Inhibitory enzymů
- Anti-HIV činidla
- Antiretrovirová činidla
- Antimetabolity
- Zidovudin
Další identifikační čísla studie
Další identifikační čísla studie
- ACTG 052
- 11026 (Identifikátor registru: DAIDS ES Registry Number)
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