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The Effects of Anti-HIV Drugs in HIV-Infected Patients Who Do Not Have AIDS

A Multicenter, Open-Label Study of Viral Burden in Peripheral Blood Versus Lymphoid Tissue Before and After Antiretroviral Therapy in HIV-Infected Individuals Without AIDS (NOTE: One Arm Receives no Treatment)

Immunopathogenesis objectives: To compare and quantitatively determine HIV burden and HIV replication in peripheral blood (PB) and lymphoid tissue (LT). To determine the degree to which antiretroviral therapy alters HIV replication in LT.

Clinical objectives: To gain insight into the degree of correlation between immunologic surrogate markers for HIV disease (e.g., CD4, beta-2 microglobulin) as compared to measures of HIV replication in PB and LT. To assess changes in PB and LT viral burden after antiretroviral therapy and to determine its ability to predict an antiviral response.

One of the major problems in defining the immunopathogenic changes in HIV infections has been the inability to correlate the extent of loss of immunologic function with the number of HIV-infected CD4+ cells in the peripheral blood. Few studies exist that measure viral burden in lymph nodes of HIV-infected individuals. Researchers hope to find out whether the amount of HIV virus or markers for the virus in the body's lymph tissue is a better measure of disease progression than the amount of virus or markers for the virus in the blood.

Descripción general del estudio

Estado

Terminado

Condiciones

Intervención / Tratamiento

Descripción detallada

One of the major problems in defining the immunopathogenic changes in HIV infections has been the inability to correlate the extent of loss of immunologic function with the number of HIV-infected CD4+ cells in the peripheral blood. Few studies exist that measure viral burden in lymph nodes of HIV-infected individuals. Researchers hope to find out whether the amount of HIV virus or markers for the virus in the body's lymph tissue is a better measure of disease progression than the amount of virus or markers for the virus in the blood.

Sixteen antiretroviral-naive patients are randomized to either remain antiretroviral-naive (no treatment) or receive zidovudine daily (treatment). Additionally, 16 patients with 26 or more weeks of ongoing zidovudine (AZT) therapy are randomized to either continue on their prestudy AZT regimen or add didanosine (ddI) daily to their baseline AZT dose. Patients remain on their assigned treatment arms for 8 weeks. A lymph node biopsy is performed on day 0 and at week 8. Patients are evaluated at weeks 2, 4, 6, 8 and 9.

Tipo de estudio

Intervencionista

Inscripción

32

Fase

  • No aplica

Contactos y Ubicaciones

Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.

Ubicaciones de estudio

    • California
      • Palo Alto, California, Estados Unidos, 94304
        • Palo Alto Veterans Affairs Health Care System
      • San Francisco, California, Estados Unidos, 94115
        • Kaiser Permanente Med Ctr
      • San Francisco, California, Estados Unidos, 94115
        • Mount Zion Med Ctr / UCSF
    • Illinois
      • Chicago, Illinois, Estados Unidos, 60612
        • Univ of Illinois
    • Maryland
      • Baltimore, Maryland, Estados Unidos, 21201
        • Univ of Maryland at Baltimore
    • New York
      • Stony Brook, New York, Estados Unidos, 117948153
        • SUNY / Health Sciences Ctr at Stony Brook
    • North Carolina
      • Durham, North Carolina, Estados Unidos, 27710
        • Duke Univ Med Ctr
    • Pennsylvania
      • Pittsburgh, Pennsylvania, Estados Unidos, 15261
        • Univ of Pittsburgh

Criterios de participación

Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.

Criterio de elegibilidad

Edades elegibles para estudiar

18 años y mayores (Adulto, Adulto Mayor)

Acepta Voluntarios Saludables

No

Géneros elegibles para el estudio

Todos

Descripción

Inclusion Criteria

Concurrent Medication:

Allowed:

  • Chemoprophylaxis against M. tuberculosis, therapy for oral candidiasis, and short courses (up to 10 days) of acyclovir for herpes lesions.
  • Antibiotics as clinically indicated.
  • Pneumococcal vaccine and hepatitis B vaccine as medically indicated.
  • Regularly prescribed medications such as antipyretics, analgesics, allergy medications, antidepressants, sleep medications, oral contraceptives, or other medications deemed appropriate by the patient's primary care provider.

Recommended:

  • PCP prophylaxis if patient's CD4 count falls below 200 cells/mm3 during the study.

Concurrent Treatment:

Allowed:

  • Alternative therapies such as vitamins and acupuncture.

Patients must have:

  • Documented HIV infection.
  • At least two palpable lymph nodes above the waist.
  • CD4 counts >= 350 cells/mm3 (if previously antiretroviral-naive) or >= 250 cells/mm3 (if receiving ongoing AZT therapy).

Patients with prior AZT therapy must have received a stable dose of 300-600 mg daily for 26 or more weeks.

Prior Medication:

Required in patients with prior ongoing therapy:

  • AZT at dose of 300-600 mg daily for at least 26 weeks.

Exclusion Criteria

Co-existing Condition:

Patients with the following symptoms and conditions are excluded:

  • Severe malabsorption.
  • Current AIDS-related opportunistic infection, AIDS dementia, AIDS-wasting syndrome, or an AIDS-related malignancy other than minimal Kaposi's sarcoma disease.
  • Current medical problems that may interfere with the evaluation of AZT or increase the potential toxicity of AZT (e.g., significant liver disease, diabetes, significant cardiovascular disease, seizure disorders, lymphoma, acute or chronic pancreatitis, or febrile illness).
  • Current diagnosis of malignancy for which systemic therapy would be required during study.

Concurrent Medication:

Excluded:

  • Ganciclovir, foscarnet, chronic acyclovir, or probenecid.
  • Other proven or alleged antiretroviral or anti-HIV drugs.
  • Biologic response modifiers.
  • Valproic acid.
  • Systemic cytotoxic chemotherapy.
  • Steroids.

Concurrent Treatment:

Excluded:

  • Radiation therapy.

Patients with the following prior conditions are excluded:

  • Prior AIDS-related opportunistic infection, AIDS dementia, AIDS-wasting syndrome, or an AIDS-related malignancy other than minimal Kaposi's sarcoma disease.
  • History of medical problems that may interfere with the evaluation of AZT or increase the potential toxicity of AZT (e.g., significant liver disease, diabetes, significant cardiovascular disease, seizure disorders, lymphoma, acute or chronic pancreatitis, or febrile illness).
  • History of peripheral neuropathy (patients with prior AZT treatment only).

Prior Medication:

Excluded:

  • Prior ddI therapy.
  • Less than 26 weeks of prior AZT (in patients with ongoing AZT therapy only).
  • Ganciclovir, foscarnet, chronic acyclovir, or probenecid.
  • Cytotoxic chemotherapy within 1 month prior to study entry.
  • Acute therapy for an infection or other medical illness within 14 days prior to study entry.

History of alcohol abuse (patients with prior AZT treatment).

Plan de estudios

Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.

¿Cómo está diseñado el estudio?

Detalles de diseño

  • Propósito principal: Tratamiento

Colaboradores e Investigadores

Aquí es donde encontrará personas y organizaciones involucradas en este estudio.

Investigadores

  • Silla de estudio: M Niu
  • Silla de estudio: J Cohn

Publicaciones y enlaces útiles

La persona responsable de ingresar información sobre el estudio proporciona voluntariamente estas publicaciones. Estos pueden ser sobre cualquier cosa relacionada con el estudio.

Publicaciones Generales

  • Cohen OJ, Pantaleo G, Graziosi C, Niu M, Fauci AS. Effect of antiretroviral therapy on HIV burden and replication in lymphoid tissue. DATRI 003 Study Group. Int Conf AIDS. 1994 Aug 7-12;10(1):7 (abstract no 001B)

Fechas de registro del estudio

Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados ​​por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.

Fechas importantes del estudio

Finalización del estudio (Actual)

1 de junio de 2002

Fechas de registro del estudio

Enviado por primera vez

2 de noviembre de 1999

Primero enviado que cumplió con los criterios de control de calidad

30 de agosto de 2001

Publicado por primera vez (Estimar)

31 de agosto de 2001

Actualizaciones de registros de estudio

Última actualización publicada (Actual)

1 de noviembre de 2021

Última actualización enviada que cumplió con los criterios de control de calidad

28 de octubre de 2021

Última verificación

1 de octubre de 2021

Más información

Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .

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