- ICH GCP
- Registro degli studi clinici negli Stati Uniti
- Sperimentazione clinica NCT00432003
Effects of Anti-HIV Therapy on Nervous System Function
Neurology: A Substudy of a Large, Simple Trial Comparing Two Strategies for Management of Anti-Retroviral Therapy (SMART) to Determine the Impact of the Strategies Upon Central and Peripheral Nervous System Function
Panoramica dello studio
Stato
Condizioni
Descrizione dettagliata
AIDS dementia complex (ADC) is a condition characterized by cognitive impairment, psychomotor slowing, and behavioral change. A milder form of ADC, called HIV minor cognitive/motor disorder (MCMD), is characterized by similar symptoms but has less of an impact on daily functioning. The neurocognitive impairment that results from ADC and MCMD carries an increased risk of poor drug adherence, morbidity, and mortality. It is unclear if highly active antiretroviral therapy (HAART) is effective in preserving neurocognitive function or in preventing or treating neurocognitive impairment. Distal symmetric sensory polyneuropathy (DSPN) and nucleoside-related neuropathy are two other serious conditions that HIV patients are at high risk for. DSPN is thought to be caused by active HIV infection; nucleoside-related neuropathy is thought to be caused by mitochondrial toxicity related to the use of certain antiretrovirals. These 2 conditions may lead to severe pain and discomfort in the feet. It is unknown what connection, if any, there is between DSPN and nucleoside-related neuropathy and the use of HAART. More data are needed on the natural history of these conditions.
This trial is a substudy of a study of management of antiretroviral therapy (SMART). In the SMART study, patients will participate in one of two strategies: a drug conservation (DC) strategy and a viral suppression (VS) strategy. Participants in the DC group will stop or defer HAART, then receive episodic HAART treatment for the minimum time needed to maintain a CD4 cell count of at least 250 cells/mm3. Participants in the VS group will receive HAART to maintain a viral load as low as possible, regardless of CD4 count. The purpose of this study is to compare changes in neurocognitive functioning and peripheral neuropathy symptoms between the 2 strategies of the SMART study.
Patients will participate in this substudy and the main SMART study at the same time. Within 45 days prior to randomization into the main SMART study, participants will have baseline data collected for this substudy. This data will include peripheral neuropathy assessments, treatments for symptoms of peripheral neuropathy. At selected study sites, additional measures will assess neurocognitive function, depression, alcohol and drug use, and education. At 6 months, 12 months, and every 12 months thereafter, peripheral neuropathy symptoms and treatment for the symptoms will be assessed; a pain questionnaire will also be completed. Participants will be followed until the SMART study ends.
Tipo di studio
Iscrizione (Effettivo)
Contatti e Sedi
Luoghi di studio
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New South Wales
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Burwood, New South Wales, Australia, 2134
- Burwood Road Gen. Practice CRS
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Darlinghurst, New South Wales, Australia, 2010
- St. Vincent's Hospital CRS
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Westmead, New South Wales, Australia, 2145
- Westmead Hospital CRS
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Victoria
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Carlton,, Victoria, Australia
- Melbourne Sexual Health Ctr. CRS
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Melbourne, Victoria, Australia, 3004
- The Alfred Hosp., Clinical Research - Infectious Diseases Unit CRS
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Melbourne, Victoria, Australia, 3181
- Prahran Market Clinic CRS
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Sao Paulo, Brasile, 01246-900
- Instituto de Infectologia Emilio Ribas CRS
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Bahia
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Salvador, Bahia, Brasile, 40110-160
- Hosp. Universitario Prof. Edgard SantosCRS
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Nova Scotia
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Halifax, Nova Scotia, Canada, B3H 2Y9
- Q.E. II Health Sciences Ctr., Captial District Authority, Victoria Gen. Hosp. CRS
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Ontario
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Windsor, Ontario, Canada, N8W 1E3
- Windsor Regional Hosp., HIV Care Program CRS
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California
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San Francisco, California, Stati Uniti, 94114
- Castro-Mission Health Ctr. CRS
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Colorado
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Denver, Colorado, Stati Uniti, 80204-4507
- Univ. of Colorado Health Science Ctr. CRS
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Denver, Colorado, Stati Uniti, 80205
- Eastside Family Health Ctr. CRS
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Denver, Colorado, Stati Uniti, 80204
- Denver Public Health CRS
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Denver, Colorado, Stati Uniti, 80204-4507
- Kaiser Permanente of Denver CRS
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Wheat Ridge, Colorado, Stati Uniti, 80033
- Western Infectious Disease Consultants CRS
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District of Columbia
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Washington, District of Columbia, Stati Uniti, 20422
- Washington DC VAMC, Washington Regional AIDS Program, Infectious Diseases CRS
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Florida
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Jacksonville, Florida, Stati Uniti, 32206
- Univ. of Florida, Div. of Infectious Diseases CRS
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Louisiana
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Baton Rouge, Louisiana, Stati Uniti, 70805
- Earl K. Long Med. Ctr., LSU - Mid City EIC Clinic CRS
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Michigan
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Detroit, Michigan, Stati Uniti, 48202
- Henry Ford Hosp. CRS
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Detroit, Michigan, Stati Uniti, 48201
- Wayne State Univ. CRS
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Lansing, Michigan, Stati Uniti, 48910
- Michigan State Univ., Infectious Disease Clinic CRS
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New York
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Bronx, New York, Stati Uniti, 10457
- Bronx-Lebanon Hosp. Ctr. CRS
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Bronx, New York, Stati Uniti, 10461
- Jacobi Med. Ctr., Ambulatory Care Pavillion CRS
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Bronx, New York, Stati Uniti, 10467
- Montefiore Med. Ctr., AIDS Ctr. CRS
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Bronx, New York, Stati Uniti, 10468
- Bronx VAMC CRS
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Brooklyn, New York, Stati Uniti, 11203
- SUNY Downstate Med. Ctr., HIV Ctr. for Women & Children CRS
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New York, New York, Stati Uniti, 10037-1802
- Harlem Hospital Ctr./Columbia University CRS (Gordin CTU)
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Oklahoma
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Oklahoma City, Oklahoma, Stati Uniti, 73104
- Univ. of Oklahoma Health Sciences Ctr., Div. of Infectious Diseases CRS
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Oregon
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Portland, Oregon, Stati Uniti, 97227
- Kaiser Immune Deficiency Clinic of Portland CRS
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Portland, Oregon, Stati Uniti, 97239
- Oregon Health & Sciences Univ. Internal Medicine (L-475) CRS
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Portland, Oregon, Stati Uniti, 97210
- The Research & Education Group-Portland CRS
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Portland, Oregon, Stati Uniti, 97227
- Legacy Clinic Emanuel CRS
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Pennsylvania
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Philadelphia, Pennsylvania, Stati Uniti, 19140
- Temple Univ. School of Medicine CRS
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Virginia
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Fredericksburg, Virginia, Stati Uniti, 22401
- MediCorp, Infectious Disease Associates CRS
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Richmond, Virginia, Stati Uniti, 23298
- Virginia Commonwealth Univ. Medical Ctr. CRS
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Richmond, Virginia, Stati Uniti, 23224
- CrossOver Health Ctr. CRS
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Richmond, Virginia, Stati Uniti, 23298
- VCU Health Systems, Infectious Disease Clinic CRS
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Richmond, Virginia, Stati Uniti, 23223
- Vernon Harris East End Community Health Ctr. CRS
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Wisconsin
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Milwaukee, Wisconsin, Stati Uniti, 53226
- Med. College of Wisconsin, Infectious Disease Clinic CRS
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Chiang Mai, Tailandia
- Sanpatong Hosp. CRS
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Khon Kaen, Tailandia, 40002
- Khon Kaen Univ., Srinagarind Hosp., Div. of Infectious Diseases & Tropical Medicine, Dept. of Medici
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Nonthaburi
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Muang, Nonthaburi, Tailandia
- Bamrasnaradura Institute CRS
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Ratchathewi
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Bangkok, Ratchathewi, Tailandia
- Chulalongkorn University Hospital CRS
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Bangkok, Ratchathewi, Tailandia
- Mahidol Univ., Ramathibodi Hosp., Div of Infectious Disease CRS
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Criteri di partecipazione
Criteri di ammissibilità
Età idonea allo studio
Accetta volontari sani
Sessi ammissibili allo studio
Descrizione
Inclusion Criteria:
- Coenrollment in the SMART study
Exclusion Criteria:
- Unable to comply with all study requirements
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
Cosa sta misurando lo studio?
Misure di risultato primarie
Misura del risultato |
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Change in QNPZ-5 scores
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time to development of symptomatic peripheral neuropathy
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change in peripheral neuropathy symptoms
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Misure di risultato secondarie
Misura del risultato |
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Time to neurocognitive impairment
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time to development of ADC, stage 2 or greater
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chage in peripheral neuropathy symptoms
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time to development of asymptomatic or symptomatic peripheral neuropathy
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time to resolution of symptomatic peripheral neuropathy
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Collaboratori e investigatori
Investigatori
- Cattedra di studio: Edwina Wright, MBBS, FRACP, Infectious Disease Unit, the Alfred Hospital
Pubblicazioni e link utili
Pubblicazioni generali
- Morgello S, Estanislao L, Simpson D, Geraci A, DiRocco A, Gerits P, Ryan E, Yakoushina T, Khan S, Mahboob R, Naseer M, Dorfman D, Sharp V; Manhattan HIV Brain Bank. HIV-associated distal sensory polyneuropathy in the era of highly active antiretroviral therapy: the Manhattan HIV Brain Bank. Arch Neurol. 2004 Apr;61(4):546-51. doi: 10.1001/archneur.61.4.546.
- Sacktor N. The epidemiology of human immunodeficiency virus-associated neurological disease in the era of highly active antiretroviral therapy. J Neurovirol. 2002 Dec;8 Suppl 2:115-21. doi: 10.1080/13550280290101094.
- Antunes F. Central nervous system AIDS--related diseases. Acta Neurochir (Wien). 2004 Oct;146(10):1071-4. doi: 10.1007/s00701-004-0334-0.
- Verma S, Estanislao L, Simpson D. HIV-associated neuropathic pain: epidemiology, pathophysiology and management. CNS Drugs. 2005;19(4):325-34. doi: 10.2165/00023210-200519040-00005.
Collegamenti utili
Studiare le date dei record
Studia le date principali
Inizio studio
Completamento primario (Effettivo)
Completamento dello studio (Effettivo)
Date di iscrizione allo studio
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Stima)
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Stima)
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
Parole chiave
Termini MeSH pertinenti aggiuntivi
- Infezioni da virus a RNA
- Malattie virali
- Infezioni
- Infezioni a trasmissione ematica
- Malattie trasmissibili
- Malattie sessualmente trasmissibili, virali
- Malattie trasmesse sessualmente
- Infezioni da lentivirus
- Infezioni da retroviridae
- Sindromi da deficit immunologico
- Malattie del sistema immunitario
- Infezioni da HIV
Altri numeri di identificazione dello studio
- CPCRA 065F
- CPCRA 065
- CPCRA 065F1
- 10115 (DAIDS-ES)
Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .
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