Effects of Two Anti-HIV Drug Combinations on the Immune Systems of HIV-Infected Patients Who Have Never Received Anti-HIV Drugs
A Randomized, Open-Label, Pilot Treatment Trial Evaluating Cellular Dynamics and Immune Restoration in Treatment-Naive HIV-Infected Subjects Receiving Either the Protease Inhibitor LPV/r or the Nucleoside Analogue Reverse Transcriptase Inhibitors d4T/3TC/Abacavir With the Non-Nucleoside Reverse Transcriptase Inhibitor Nevirapine
This study will compare an anti-HIV drug combination of protease inhibitor plus a nonnucleoside reverse transcriptase inhibitor (NNRTI) to one that includes three nucleoside reverse transcriptase inhibitors (NRTIs) plus an NNRTI. NNRTIs, NRTIs, and protease inhibitors are all types of anti-HIV drugs that block the virus in some way.
This study will try to find out if a treatment regimen containing a protease inhibitor plus an NNRTI has a different effect on the rise of CD4 cells compared to a treatment made up of three NRTIs plus an NNRTI. CD4 cells are cells of the immune system that fight infection. This study will also try to see if the combination of drugs used in this study is safe to use in HIV-positive patients.
調査の概要
詳細な説明
This study is designed to further define the dynamics and the mechanisms of the CD4 cell rise seen following administration of potent antiretroviral therapy. It will ascertain if treatment regimens containing nucleoside reverse transcriptase inhibitors (NRTIs) with a nonnucleoside reverse transcriptase inhibitor (NNRTI) have different effects on CD4 dynamics than regimens composed of a protease inhibitor with an NNRTI.
Patients are randomized to one of the two treatment arms listed below. They are stratified based on CD4 count and whether they choose to participate in substudy A5036s.
Arm A (protease inhibitor plus NNRTI regimen): At Day 0 (entry), patients begin taking LPV/RTV. At Day 3, patients add NVP, once daily for 2 weeks and then twice daily for the remainder of the study.
Arm B (triple reverse transcriptase inhibitors plus NNRTI regimen): At Day 0 (entry), patients begin taking 3TC plus d4T plus ABC. At Day 3, patients add NVP, once daily for 2 weeks and then twice daily for the remainder of the study.
HIV RNA analysis is performed at Weeks 4 and 5. If the mean is at least 1.0 log10 lower than the baseline HIV RNA, the patient may continue on study treatment. If the mean is not at least 1.0 log10 lower, however, patients are discontinued from the study by no later than Week 8. After 8 weeks of treatment, patients may change antiretroviral medications with permission of the protocol chair or vice chairs. Regular clinical evaluations are conducted. Blood is drawn to determine HIV RNA quantification, absolute CD4 and CD8 counts, immunological evaluations, telomere assays, and part is stored for future testing. Skin testing and return visits for delayed-type hypersensitivity to standard recall antigens are done on three occasions. Patients remain on the study for 48 weeks. Substudy A5036s evaluates viral dynamics during study treatment. Serial plasma samples are collected during the first 24 hours of treatment and at Day 3 and Week 4. Plasma HIV measurements are performed to differentiate between infectious and non-infectious particle production.
研究の種類
入学
段階
- 適用できない
連絡先と場所
研究場所
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California
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Los Angeles、California、アメリカ、900331079
- Univ of Southern California / LA County USC Med Ctr
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Colorado
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Denver、Colorado、アメリカ、80262
- Univ of Colorado Health Sciences Ctr
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Denver、Colorado、アメリカ、80262
- Denver Dept of Health and Hosps
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Hawaii
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Honolulu、Hawaii、アメリカ、96816
- Univ of Hawaii
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Illinois
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Chicago、Illinois、アメリカ、60611
- Northwestern Univ Med School
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Chicago、Illinois、アメリカ、60612
- Rush Presbyterian - Saint Luke's Med Ctr
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Chicago、Illinois、アメリカ、60612
- Cook County Hosp
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Indiana
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Indianapolis、Indiana、アメリカ、462025250
- Indiana Univ Hosp
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Indianapolis、Indiana、アメリカ、46202
- Methodist Hosp of Indiana / Life Care Clinic
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Indianapolis、Indiana、アメリカ、46202
- Division of Inf Diseases/ Indiana Univ Hosp
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Maryland
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Baltimore、Maryland、アメリカ、21287
- Johns Hopkins Hosp
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Massachusetts
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Boston、Massachusetts、アメリカ、02215
- Beth Israel Deaconess - West Campus
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New York
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New York、New York、アメリカ、10003
- Beth Israel Med Ctr
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New York、New York、アメリカ、10016
- Bellevue Hosp / New York Univ Med Ctr
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New York、New York、アメリカ、10029
- Mount Sinai Med Ctr
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Rochester、New York、アメリカ、14642
- Univ of Rochester Medical Center
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North Carolina
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Chapel Hill、North Carolina、アメリカ、275997215
- Univ of North Carolina
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Durham、North Carolina、アメリカ、27710
- Duke Univ Med Ctr
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Ohio
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Cincinnati、Ohio、アメリカ、452670405
- Univ of Cincinnati
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Cleveland、Ohio、アメリカ、44106
- Case Western Reserve Univ
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Cleveland、Ohio、アメリカ、441091998
- MetroHealth Med Ctr
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Rhode Island
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Providence、Rhode Island、アメリカ、02906
- Miriam Hosp / Brown Univ
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Texas
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Galveston、Texas、アメリカ、775550435
- Univ of Texas Galveston
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria
Patients may be eligible for this study if they:
- Are 18 years of age or older.
- Are HIV-positive.
- Have a CD4 count of 500 cells/mm3 or less.
- Have a viral load greater than 5,000 and less than 100,000 copies/ml.
- Are willing to use barrier methods of birth control (such as condoms) during the study and for 12 weeks after stopping treatment.
- Will most likely respond well to nevirapine. This is determined by the results of a test.
Exclusion Criteria
Patients will not be eligible for this study if they:
- Have ever taken any anti-HIV drugs. (Seven days or less of treatment will be allowed if it was received more than 30 days before study entry.)
- Have pancreatitis (an inflamed pancreas) or hepatitis within 2 weeks of study entry.
- Are pregnant or breast-feeding.
- Actively abuse drugs or alcohol which their doctor feels would interfere with the ability to fulfill study requirements.
- Have taken any medications within 14 days of study entry that would interfere with the study drugs.
- Are receiving or need to receive chemotherapy.
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
協力者と研究者
捜査官
- スタディチェア:Alan Landay
出版物と役立つリンク
研究記録日
主要日程の研究
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
追加の関連 MeSH 用語
- RNAウイルス感染症
- ウイルス病
- 感染症
- 血液感染症
- 伝染病
- 性感染症、ウイルス
- 性感染症
- レンチウイルス感染症
- レトロウイルス感染症
- 免疫不全症候群
- 免疫系疾患
- HIV感染症
- 薬理作用の分子機構
- 抗感染剤
- 抗ウイルス剤
- 逆転写酵素阻害剤
- 核酸合成阻害剤
- 酵素阻害剤
- 抗HIV薬
- 抗レトロウイルス剤
- 代謝拮抗剤
- プロテアーゼ阻害剤
- シトクロム P-450 CYP3A 阻害剤
- シトクロム P-450 酵素阻害剤
- シトクロム P-450 酵素誘導剤
- シトクロム P-450 CYP3A インデューサー
- HIVプロテアーゼ阻害剤
- ウイルスプロテアーゼ阻害剤
- ネビラピン
- リトナビル
- ロピナビル
- ラミブジン
- スタブジン
- アバカビル
その他の研究ID番号
- A5014
- 10866 (レジストリ識別子:DAIDS ES)
- ACTG A5014
- AACTG A5014
- Substudy ACTG AA5036s
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。
HIV感染症の臨床試験
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University of Alabama at BirminghamMobile County Health Deparment; Alabama Department of Public Health募集HIV | HIV検査 | HIV とケアの関係 | HIV治療アメリカ
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French National Agency for Research on AIDS and...Elizabeth Glaser Pediatric AIDS Foundation完了パートナーの HIV 検査 | カップルの HIV カウンセリング | カップルのコミュニケーション | HIV の発生率カメルーン, ドミニカ共和国, グルジア, インド
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University of Minnesota引きこもったHIV感染症 | HIV/エイズ | HIV | AIDS | エイズ・HIV問題 | エイズと感染症アメリカ
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Africa Health Research InstituteLondon School of Hygiene and Tropical Medicine; University College, London; University of Southampton と他の協力者募集
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ANRS, Emerging Infectious DiseasesHopital Universitaire Robert-Debre; Institut de Recherche pour le Developpement; Centre Pasteur... と他の協力者わからないHIV | HIVに感染していない子供たち | HIVにさらされた子供たちカメルーン
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Erasmus Medical Centerまだ募集していません
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University of Maryland, Baltimore引きこもった
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Hospital Clinic of Barcelona完了
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University of WashingtonNational Institute of Mental Health (NIMH)募集