Structured Treatment Interruptions in Chronic HIV Infection
Antiretroviral Treatment With Structured Treatment Interruptions (STI) Versus Continuous Antiretroviral Treatment in HIV+ Patients With Persistent Suppression of Viral Replication
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljeret beskrivelse
Patients are randomized in a 1 to 1 ratio to continue their current antiretroviral regimen (Arm A) or to undergo structured treatment interruptions (STI) (Arm B) according to the following scheme: STIs of 1, 1, 2, 2 and 3 months each followed by a 3-month therapy period.
During STIs, therapy is resumed in the presence of an HIV-RNA rebound > 50,000 copies/ml or of a CD4+ T cell decline > 25% of the baseline count (> 35% for patients with CD4+ > 500/mm3 at randomization). After the first cycle, subsequent STIs are performed only if an HIV-RNA level < 400 copies/ml is reached after 2 months of therapy resumption.
At the time of treatment interruptions patients in arm B who are on treatment with non-nucleoside reverse transcriptase inhibitors suspend these drugs first and continue the treatment with the other drugs of the combination for 3 days if nevirapine-treated and for 6 days in case of previous efavirenz-based regimen.
Patients are seen at the clinical site every three months for arm A and monthly for arm B. On these occasions, blood samples are obtained for biochemical and viro-immunological assessments.
The toxicity grading scale of the AIDS Clinical Trial Group (ACTG) is used for the reporting of clinical and laboratory adverse events.
In arm B, plasma genotype is obtained in samples taken after 15 or 30 days of drug suspension.
Patients will discontinue the study in case of : early therapy resumption for 2 consecutive times (only arm B patients); acute retroviral syndrome (only for arm B patients); AIDS-defining event; severe adverse event; pregnancy; non-compliance; patient' s request; physician's decision.
Undersøgelsestype
Undersøgelsestype
Tilmelding
Tilmelding
Fase
Fase
- Fase 3
Kontakter og lokationer
Studiesteder
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Rome, Italien, 00161
- Istituto Superiore di Sanità
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Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
- first-line antiretroviral therapy (3 or 4 drugs) for 6 to 18 months (one previous therapy change for toxicity or non-compliance is allowed)
- HIV-RNA level below 400 copies/ml for at least 6 months;
- CD4+ count > 350 /mm3;
- pre-HAART CD4+ > 100/mm3
- no previous AIDS diagnosis.
Exclusion Criteria:
- Previous antiretroviral therapy with 1 or 2 drugs (except ARV prophylaxis in pregnancy)
- Pregnancy or breastfeeding
- Previous diagnosis of AIDS
- Grade 3 or 4 adverse event in the 15 days before enrolment
- Neoplasia
- Previous therapy with IL-2, interferon (in the last 2 years) or experimental therapies
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Ingen (Åben etiket)
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
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proportion of patients with CD4+ cell count above 500/mm3 at the end of follow-up (2 years) in the two treatment arms.
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Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
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occurrence of grade 3 or 4 adverse events (clinical and laboratory)
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proportion of patients with HIV-RNA < 400 copies/ml at the end of follow-up
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proportion of patients with CD4+ cell count > 350/mm3 at the end of follow-up
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rate of virological failure
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emergence of resistance
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HIV-related events.
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Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Efterforskere
Efterforskere
- Studiestol: Stefano Vella, MD, Istituto Superiore di Sanità
Datoer for undersøgelser
Studer store datoer
Studiestart
Studiestart
Studieafslutning
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Skøn)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Skøn)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
- RNA-virusinfektioner
- Virussygdomme
- Blodbårne infektioner
- Overførbare sygdomme
- Seksuelt overførte sygdomme, virale
- Seksuelt overførte sygdomme
- Lentivirus infektioner
- Retroviridae infektioner
- Immunologiske mangelsyndromer
- Sygdomme i immunsystemet
- Langsomme virussygdomme
- HIV-infektioner
- Infektioner
- Erhvervet immundefektsyndrom
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- ISS PART
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