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
調査の概要
状態
条件
詳細な説明
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.
研究の種類
入学 (実際)
連絡先と場所
研究場所
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California
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San Francisco、California、アメリカ、94114
- Castro-Mission Health Ctr. CRS
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Colorado
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Denver、Colorado、アメリカ、80204-4507
- Univ. of Colorado Health Science Ctr. CRS
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Denver、Colorado、アメリカ、80205
- Eastside Family Health Ctr. CRS
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Denver、Colorado、アメリカ、80204
- Denver Public Health CRS
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Denver、Colorado、アメリカ、80204-4507
- Kaiser Permanente of Denver CRS
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Wheat Ridge、Colorado、アメリカ、80033
- Western Infectious Disease Consultants CRS
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District of Columbia
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Washington、District of Columbia、アメリカ、20422
- Washington DC VAMC, Washington Regional AIDS Program, Infectious Diseases CRS
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Florida
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Jacksonville、Florida、アメリカ、32206
- Univ. of Florida, Div. of Infectious Diseases CRS
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Louisiana
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Baton Rouge、Louisiana、アメリカ、70805
- Earl K. Long Med. Ctr., LSU - Mid City EIC Clinic CRS
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Michigan
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Detroit、Michigan、アメリカ、48202
- Henry Ford Hosp. CRS
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Detroit、Michigan、アメリカ、48201
- Wayne State Univ. CRS
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Lansing、Michigan、アメリカ、48910
- Michigan State Univ., Infectious Disease Clinic CRS
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New York
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Bronx、New York、アメリカ、10457
- Bronx-Lebanon Hosp. Ctr. CRS
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Bronx、New York、アメリカ、10461
- Jacobi Med. Ctr., Ambulatory Care Pavillion CRS
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Bronx、New York、アメリカ、10467
- Montefiore Med. Ctr., AIDS Ctr. CRS
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Bronx、New York、アメリカ、10468
- Bronx VAMC CRS
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Brooklyn、New York、アメリカ、11203
- SUNY Downstate Med. Ctr., HIV Ctr. for Women & Children CRS
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New York、New York、アメリカ、10037-1802
- Harlem Hospital Ctr./Columbia University CRS (Gordin CTU)
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Oklahoma
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Oklahoma City、Oklahoma、アメリカ、73104
- Univ. of Oklahoma Health Sciences Ctr., Div. of Infectious Diseases CRS
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Oregon
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Portland、Oregon、アメリカ、97227
- Kaiser Immune Deficiency Clinic of Portland CRS
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Portland、Oregon、アメリカ、97239
- Oregon Health & Sciences Univ. Internal Medicine (L-475) CRS
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Portland、Oregon、アメリカ、97210
- The Research & Education Group-Portland CRS
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Portland、Oregon、アメリカ、97227
- Legacy Clinic Emanuel CRS
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Pennsylvania
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Philadelphia、Pennsylvania、アメリカ、19140
- Temple Univ. School of Medicine CRS
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Virginia
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Fredericksburg、Virginia、アメリカ、22401
- MediCorp, Infectious Disease Associates CRS
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Richmond、Virginia、アメリカ、23298
- Virginia Commonwealth Univ. Medical Ctr. CRS
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Richmond、Virginia、アメリカ、23224
- CrossOver Health Ctr. CRS
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Richmond、Virginia、アメリカ、23298
- VCU Health Systems, Infectious Disease Clinic CRS
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Richmond、Virginia、アメリカ、23223
- Vernon Harris East End Community Health Ctr. CRS
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Wisconsin
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Milwaukee、Wisconsin、アメリカ、53226
- Med. College of Wisconsin, Infectious Disease Clinic CRS
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New South Wales
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Burwood、New South Wales、オーストラリア、2134
- Burwood Road Gen. Practice CRS
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Darlinghurst、New South Wales、オーストラリア、2010
- St. Vincent's Hospital CRS
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Westmead、New South Wales、オーストラリア、2145
- Westmead Hospital CRS
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Victoria
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Carlton,、Victoria、オーストラリア
- Melbourne Sexual Health Ctr. CRS
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Melbourne、Victoria、オーストラリア、3004
- The Alfred Hosp., Clinical Research - Infectious Diseases Unit CRS
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Melbourne、Victoria、オーストラリア、3181
- Prahran Market Clinic CRS
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Nova Scotia
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Halifax、Nova Scotia、カナダ、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、カナダ、N8W 1E3
- Windsor Regional Hosp., HIV Care Program CRS
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Chiang Mai、タイ
- Sanpatong Hosp. CRS
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Khon Kaen、タイ、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、タイ
- Bamrasnaradura Institute CRS
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Ratchathewi
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Bangkok、Ratchathewi、タイ
- Chulalongkorn University Hospital CRS
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Bangkok、Ratchathewi、タイ
- Mahidol Univ., Ramathibodi Hosp., Div of Infectious Disease CRS
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Sao Paulo、ブラジル、01246-900
- Instituto de Infectologia Emilio Ribas CRS
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Bahia
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Salvador、Bahia、ブラジル、40110-160
- Hosp. Universitario Prof. Edgard SantosCRS
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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:
- Coenrollment in the SMART study
Exclusion Criteria:
- Unable to comply with all study requirements
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
この研究は何を測定していますか?
主要な結果の測定
結果測定 |
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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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二次結果の測定
結果測定 |
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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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協力者と研究者
捜査官
- スタディチェア:Edwina Wright, MBBS, FRACP、Infectious Disease Unit, the Alfred Hospital
出版物と役立つリンク
一般刊行物
- 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.
研究記録日
主要日程の研究
研究開始
一次修了 (実際)
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 (見積もり)
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
キーワード
追加の関連 MeSH 用語
その他の研究ID番号
- CPCRA 065F
- CPCRA 065
- CPCRA 065F1
- 10115 (DAIDS-ES)
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。