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A Comparison of Two Tests for Anti-HIV Drug Resistance

24. september 2008 opdateret af: National Institute of Allergy and Infectious Diseases (NIAID)

HIV-1 Resistance Testing During Antiretroviral Failure: Comparison of Sequencing Versus Phenotyping

The purpose of this study is to compare 2 different types of tests of the HIV virus to see which specific anti-HIV drugs would work the best.

Drug resistance is a major reason for therapy failure in HIV patients. Two types of tests can detect resistance to drugs: 1) genotyping (sequencing), which looks at the DNA sequence of a virus to see whether it has developed any genetic resistance; 2) phenotyping, which looks at the ability of different drugs to suppress virus growth in the laboratory. Genotyping and phenotyping can help doctors give patients the most effective drug therapy.

Studieoversigt

Status

Afsluttet

Betingelser

Detaljeret beskrivelse

The emergence of drug resistance is a major factor contributing to the failure of antiretroviral therapy in HIV-infected patients. Drug resistance can be detected by genotypic or phenotypic assays, both having distinct advantages and disadvantages. Results from genotypic and phenotypic testing are helpful in excluding from the subsequent regimen drugs to which the resistance is identified, and both tests predict virologic response to salvage therapy in patients who have failed a previous regimen. Resistance testing is likely to be beneficial as an aid in selecting a salvage regimen.

At entry, patients are randomized to Arm A (sequencing) or Arm B (phenotyping) and have a resistance test drawn while still receiving the current regimen even though regimen failure is suspected. The test results are available between Weeks 1 and 4, inclusive. There are weekly visits for the first 4 weeks after entry to monitor viral load and maintenance of the current failing (prestudy) regimen. If virologic failure is confirmed, a new regimen is chosen and prescribed at the first visit after resistance test results are available. [AS PER AMENDMENT 12/6/00: If the resistance assay fails to yield results, another regimen is chosen and prescribed based on the patient's medical and medication history.] If virologic failure is not confirmed, the current drug regimen is not changed. Otherwise, on-site study visits occur every 4 weeks until Week 24 and then every 8 weeks thereafter through Week 48. [AS PER AMENDMENT 12/6/00: on-site study visits occur every 4 weeks until Week 24 and then every 8 weeks thereafter]. Medical resource use is assessed at baseline and then every 8 weeks through Week 48. Quality of life is assessed at baseline and then every 16 weeks through Week 48.

Undersøgelsestype

Observationel

Tilmelding

600

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

  • Forenede Stater
    • Alabama
      • Birmingham, Alabama, Forenede Stater, 35294
        • Univ of Alabama at Birmingham
    • California
      • Los Angeles, California, Forenede Stater, 90095
        • UCLA CARE Ctr
      • Los Angeles, California, Forenede Stater, 900331079
        • Univ of Southern California / LA County USC Med Ctr
      • Menlo Park, California, Forenede Stater, 94025
        • Willow Clinic
      • San Francisco, California, Forenede Stater, 94110
        • Univ of California San Francisco
      • San Francisco, California, Forenede Stater, 941104206
        • University of California San Francisco
      • San Jose, California, Forenede Stater, 951282699
        • Santa Clara Valley Med Ctr / AIDS Community Rsch Consortium
      • Stanford, California, Forenede Stater, 943055107
        • San Mateo AIDS Program / Stanford Univ
      • Stanford, California, Forenede Stater, 943055107
        • Stanford Univ Med Ctr
      • Torrance, California, Forenede Stater, 90502
        • Harbor UCLA Med Ctr
    • Colorado
      • Denver, Colorado, Forenede Stater, 80262
        • Univ of Colorado Health Sciences Ctr
      • Denver, Colorado, Forenede Stater, 80262
        • Denver Dept of Health and Hosps
    • Florida
      • Miami, Florida, Forenede Stater, 331361013
        • Univ of Miami School of Medicine
    • Georgia
      • Atlanta, Georgia, Forenede Stater, 30308
        • Emory Univ
    • Hawaii
      • Honolulu, Hawaii, Forenede Stater, 96816
        • Univ of Hawaii
    • Illinois
      • Chicago, Illinois, Forenede Stater, 60612
        • The CORE Ctr
      • Chicago, Illinois, Forenede Stater, 60611
        • Northwestern Univ Med School
      • Chicago, Illinois, Forenede Stater, 60612
        • Rush Presbyterian - Saint Luke's Med Ctr
    • Maryland
      • Baltimore, Maryland, Forenede Stater, 21287
        • Johns Hopkins Hosp
    • Massachusetts
      • Boston, Massachusetts, Forenede Stater, 02114
        • Harvard (Massachusetts Gen Hosp)
      • Boston, Massachusetts, Forenede Stater, 02215
        • Beth Israel Deaconess - West Campus
      • Boston, Massachusetts, Forenede Stater, 02215
        • Brigham and Women's Hosp
    • New York
      • Buffalo, New York, Forenede Stater, 14215
        • SUNY / Erie County Med Ctr at Buffalo
      • New York, New York, Forenede Stater, 10003
        • Beth Israel Med Ctr
      • New York, New York, Forenede Stater, 10021
        • Cornell Univ Med Ctr
      • New York, New York, Forenede Stater, 10016
        • Bellevue Hosp / New York Univ Med Ctr
      • New York, New York, Forenede Stater, 10029
        • Mount Sinai Med Ctr
      • New York, New York, Forenede Stater, 10032
        • Columbia Presbyterian Med Ctr
      • New York, New York, Forenede Stater, 10011
        • Cornell Clinical Trials Unit - Chelsea Clinic
    • North Carolina
      • Chapel Hill, North Carolina, Forenede Stater, 275997215
        • Univ of North Carolina
      • Charlotte, North Carolina, Forenede Stater, 28203
        • Carolinas Med Ctr
      • Durham, North Carolina, Forenede Stater, 27710
        • Duke Univ Med Ctr
      • Greensboro, North Carolina, Forenede Stater, 27401
        • Moses H Cone Memorial Hosp
    • Ohio
      • Cincinnati, Ohio, Forenede Stater, 452670405
        • Univ of Cincinnati
      • Cleveland, Ohio, Forenede Stater, 44106
        • Case Western Reserve Univ
      • Cleveland, Ohio, Forenede Stater, 441091998
        • MetroHealth Med Ctr
      • Columbus, Ohio, Forenede Stater, 432101228
        • Ohio State Univ Hosp Clinic
    • Pennsylvania
      • Philadelphia, Pennsylvania, Forenede Stater, 19104
        • Univ of Pennsylvania
      • Philadelphia, Pennsylvania, Forenede Stater, 19104
        • Philadelphia Veterans Administration Med Ctr
      • Pittsburgh, Pennsylvania, Forenede Stater, 15213
        • Univ of Pittsburgh
    • Rhode Island
      • Providence, Rhode Island, Forenede Stater, 02906
        • Brown Univ / Miriam Hosp
      • Providence, Rhode Island, Forenede Stater, 02906
        • Miriam Hosp / Brown Univ
    • South Carolina
      • West Columbia, South Carolina, Forenede Stater, 29169
        • Julio Arroyo
    • Tennessee
      • Nashville, Tennessee, Forenede Stater, 37203
        • Vanderbilt Univ Med Ctr
    • Texas
      • Dallas, Texas, Forenede Stater, 75390
        • Univ of Texas, Southwestern Med Ctr of Dallas
    • Washington
      • Seattle, Washington, Forenede Stater, 98104
        • Univ of Washington
  • Puerto Rico
      • San Juan, Puerto Rico, 009365067
        • Univ of Puerto Rico

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

14 år og ældre (Barn, Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria

Patients may be eligible for this study if they:

  • Are HIV-positive.
  • Have failed 2 to 4 anti-HIV regimens containing 3 or more combinations of drugs. A patient has failed his/her current regimen if he/she has, within 30 days of study entry, either a viral load (level of HIV in the blood) of at least 10,000 copies/ml or 2 tests which show a viral load between 1,000 and 10,000 copies/ml.
  • Have taken 3 or more anti-HIV drugs for 8 or more weeks before the study.
  • Are at least 14 years old.
  • Have consent of parent or guardian if less than 18 years old.

Exclusion Criteria

Patients will not be eligible for this study if they:

  • Have failed only 1 anti-HIV drug combination.
  • Have failed 5 or more anti-HIV drug combinations, each containing 3 to 5 drugs.
  • Have had and received the results of prior resistance tests.
  • Have had treatment with a combination of 6 or more anti-HIV drugs.
  • Have problems absorbing food in the intestine.
  • Have had HIV vaccines.
  • Have taken drugs that affect the immune system or investigational drugs.
  • Are taking medications not allowed with protease inhibitors (PIs) if PIs would be part of their anti-HIV treatment during the study.
  • Have failed anti-HIV therapy due to nonadherence to medication.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

National Institute of Allergy and Infectious Diseases (NIAID)

Efterforskere

  • Studiestol: Richard D'Aquila
  • Studiestol: Daniel Kuritzkes

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Datoer for studieregistrering

Først indsendt

8. november 2000

Først indsendt, der opfyldte QC-kriterier

30. august 2001

Først opslået (Skøn)

31. august 2001

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Skøn)

25. september 2008

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

24. september 2008

Sidst verificeret

1. juli 2004

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • ACTG A5076
  • AACTG A5076

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .

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Sponsorer og samarbejdspartnere

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Betingelser

Sjældne sygdomme

Narkotikainterventioner

Kosttilskud

Sponsor / samarbejdspartnere

Placeringer

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