- ICH GCP
- Registr klinických studií v USA
- Klinická studie NCT00001069
A Study of Two Methods of Determining When to Begin or Change Anti-HIV Treatment
A Randomized Study of the Clinical Effects of Initiating or Changing Antiretroviral Therapy Based on Plasma HIV RNA Quantitation Compared With Initiating or Changing Therapy Based on Current Clinical Practice Alone
PRIMARY: To compare the clinical efficacy of two decision making strategies for initiating or changing antiretroviral therapy: decision making based on current clinical practice alone (i.e., initiating or changing therapy based on CD4 count decline and/or clinical progression) versus decision making based on plasma HIV RNA quantitation in addition to current clinical practice.
SECONDARY: To evaluate toxicity, biological markers, and patient management in the two arms.
Although changing therapies is a common strategy in the treatment of HIV disease, guidelines are needed to help clinicians and patients decide when a change in antiretroviral therapy is indicated. The technology of measuring HIV RNA in plasma has been suggested as a tool for monitoring clinical drug efficacy. However, uncertainty remains about whether aggressive antiretroviral treatment to lower HIV RNA and maintain low levels for as long as possible will confer clinical benefit in comparison with management based on monitoring CD4 counts and HIV-related symptoms.
Přehled studie
Postavení
Podmínky
Detailní popis
Although changing therapies is a common strategy in the treatment of HIV disease, guidelines are needed to help clinicians and patients decide when a change in antiretroviral therapy is indicated. The technology of measuring HIV RNA in plasma has been suggested as a tool for monitoring clinical drug efficacy. However, uncertainty remains about whether aggressive antiretroviral treatment to lower HIV RNA and maintain low levels for as long as possible will confer clinical benefit in comparison with management based on monitoring CD4 counts and HIV-related symptoms.
Patients are randomized to a decision making strategy for initiating or changing therapy based on current clinical practice alone vs. decision making based on plasma HIV RNA quantitation in addition to current clinical practice in patients with <= 300 CD4+ cells/mm3. All patients in the RNA arm as well as a subset (n = 183) of those in the CCP arm will have a plasma HIV RNA quantitation drawn every 4 months. The results of these quantitations will be blinded until the end of the study. CD4 counts will be obtained at least every 4 months if the previous count was > 20 cells/mm3. The remaining patients in the CCP arm will have CD4 counts obtained according to their clinicians' current clinical practices. Medications, clinical status, and changes in antiretroviral therapy will be recorded for all patients in the study. Patients are stratified by CD4+ cell count (<100 cells/mm3 [200 patients] vs. 100-300 cells/mm3 [900 patients]).
Typ studie
Zápis
Kontakty a umístění
Studijní místa
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California
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San Francisco, California, Spojené státy, 94110
- Community Consortium of San Francisco
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Colorado
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Denver, Colorado, Spojené státy, 802044507
- Denver CPCRA / Denver Public Hlth
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District of Columbia
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Washington, District of Columbia, Spojené státy, 20422
- Veterans Administration Med Ctr / Regional AIDS Program
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Georgia
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Atlanta, Georgia, Spojené státy, 30308
- AIDS Research Consortium of Atlanta
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Illinois
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Chicago, Illinois, Spojené státy, 60657
- AIDS Research Alliance - Chicago
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Louisiana
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New Orleans, Louisiana, Spojené státy, 70112
- Louisiana Comm AIDS Rsch Prog / Tulane Univ Med
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Maryland
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Baltimore, Maryland, Spojené státy, 21201
- Baltimore Trials
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Michigan
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Detroit, Michigan, Spojené státy, 48202
- Henry Ford Hosp
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Detroit, Michigan, Spojené státy, 48201
- Comprehensive AIDS Alliance of Detroit
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New Jersey
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Camden, New Jersey, Spojené státy, 08103
- Southern New Jersey AIDS Cln Trials / Dept of Med
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Newark, New Jersey, Spojené státy, 071032842
- North Jersey Community Research Initiative
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New Mexico
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Albuquerque, New Mexico, Spojené státy, 871315271
- Partners Research
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New York
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New York, New York, Spojené státy, 10037
- Harlem AIDS Treatment Group / Harlem Hosp Ctr
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Oregon
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Portland, Oregon, Spojené státy, 97210
- The Research and Education Group
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Portland, Oregon, Spojené státy, 972109951
- Portland Veterans Adm Med Ctr / Rsch & Education Grp
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Pennsylvania
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Philadelphia, Pennsylvania, Spojené státy, 19107
- Philadelphia FIGHT
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Virginia
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Richmond, Virginia, Spojené státy, 23298
- Richmond AIDS Consortium
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Kritéria účasti
Kritéria způsobilosti
Věk způsobilý ke studiu
Přijímá zdravé dobrovolníky
Pohlaví způsobilá ke studiu
Popis
Inclusion Criteria
Patients must have:
- HIV infection.
- CD4 count <= 300 cells/mm3.
- NO stage 2 or worse AIDS dementia complex.
- Life expectancy of at least 6 months.
- Reasonably good health.
- age >= 13yrs.
- signed informed consent.
Exclusion Criteria
Co-existing Condition:
Patients with the following symptoms or conditions are excluded:
- Disorders or conditions that may prevent adequate compliance with study requirements.
Patients with the following prior conditions are excluded:
- Stage 2 >= AIDS dementia complex.
Studijní plán
Jak je studie koncipována?
Detaily designu
Spolupracovníci a vyšetřovatelé
Vyšetřovatelé
- Studijní židle: Perez G
- Studijní židle: Thompson M
Publikace a užitečné odkazy
Obecné publikace
- Doepel LK. Volunteers needed for study of HIV viral load test. NIAID AIDS Agenda. 1995 Dec:3.
- James JS. Viral load: new "strategy" trial in 15 U.S. cities. AIDS Treat News. 1995 Oct 20;(no 233):1-3.
- Raghavan S, Grant LB, Barisch G, Thompson M, Williams B, Matoe N, el-Sadr WM. Change in log10 HIV RNA and protease inhibitor use associated with weight change in HIV+ men in a national clinical trial. Int Conf AIDS. 1998;12:556 (abstract no 32180)
Termíny studijních záznamů
Termíny zápisu do studia
První předloženo
První předloženo, které splnilo kritéria kontroly kvality
První zveřejněno (Odhad)
Aktualizace studijních záznamů
Poslední zveřejněná aktualizace (Odhad)
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Naposledy ověřeno
Více informací
Termíny související s touto studií
Klíčová slova
Další relevantní podmínky MeSH
Další identifikační čísla studie
- CPCRA 036
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