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The Safety and Effectiveness of Zidovudine in the Treatment of HIV-Infected Children With Mild to Moderate Symptoms

A Multicenter Placebo-Controlled Trial To Evaluate the Safety and Efficacy of Oral Zidovudine in the Treatment of Children Infected With Human Immunodeficiency Virus With Mild to Moderate Symptoms (Including LIP)

To determine the safety and usefulness of zidovudine (AZT) for the treatment of children 3 months to 12 years of age. This study is designed to determine if children who are infected with HIV and who have a special type of lung disease called lymphocytic interstitial pneumonitis (LIP) or other early symptoms of HIV infection may derive benefit from treatment with AZT. It is hoped that this drug will prevent children from developing additional symptoms and infections and will help resolve already existing symptoms.

AZT has been shown in the laboratory to inhibit the infection of cells by HIV. AZT has been shown to decrease the mortality and the frequency of opportunistic infections in certain adult patients with symptomatic HIV infection. It is, therefore, likely that symptomatic HIV-infected children may also benefit from specific antiviral therapy.

Studie Overzicht

Toestand

Voltooid

Conditie

Interventie / Behandeling

Gedetailleerde beschrijving

AZT has been shown in the laboratory to inhibit the infection of cells by HIV. AZT has been shown to decrease the mortality and the frequency of opportunistic infections in certain adult patients with symptomatic HIV infection. It is, therefore, likely that symptomatic HIV-infected children may also benefit from specific antiviral therapy.

Children who participate in the study are evaluated at a hospital outpatient clinic and are under the care of a specialist in pediatrics. Of the children who participate in the study, half receive AZT syrup and half receive a placebo (sugar solution). The investigator does not know which medication each child receives as this is decided by a random process. The children take the medication in a strawberry-flavored clear syrup every 6 hours (4 times a day), for a period of 2 years or 104 weeks. The children are monitored on an outpatient basis while receiving therapy and the tests performed on admission to the study are repeated several times during treatment. Blood samples are obtained once a week for the first 4 weeks, every other week for the next 4 weeks, and then monthly until the end of the study. At certain sites, Cerebrospinal fluid (CSF) is collected by lumbar puncture every 52 weeks to evaluate infection involving the brain and nervous system. An independent committee reviews the data collected on the children every 6 months. The drug is stopped or the dose reduced if unacceptable side effects develop. AMENDED: As of August 7, 1989 the study blind was broken, the placebo arm discontinued and the study closed to accrual as of September 25, 1989. The 6 children enrolled in the study have been offered AZT.

Studietype

Ingrijpend

Inschrijving

224

Fase

  • Fase 2

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studie Locaties

    • California
      • Downey, California, Verenigde Staten, 902422814
        • Kaiser Permanente / UCLA Med Ctr
      • Long Beach, California, Verenigde Staten, 90801
        • Long Beach Memorial (Pediatric)
      • Los Angeles, California, Verenigde Staten, 900276016
        • Children's Hosp of Los Angeles/UCLA Med Ctr
      • Los Angeles, California, Verenigde Staten, 905022004
        • Harbor - UCLA Med Ctr / UCLA School of Medicine
      • Los Angeles, California, Verenigde Staten, 900951752
        • UCLA Med Ctr / Pediatric
      • Los Angeles, California, Verenigde Staten, 900593019
        • Martin Luther King Jr Gen Hosp / UCLA Med Ctr
      • Menlo Park, California, Verenigde Staten, 94025
        • Stanford Univ School of Medicine
      • Oakland, California, Verenigde Staten, 946091809
        • Children's Hosp of Oakland
      • San Diego, California, Verenigde Staten, 92103
        • UCSD Treatment Ctr
      • San Francisco, California, Verenigde Staten, 94143
        • Northern California Pediatric AIDS Treatment Ctr / UCSF
    • Florida
      • Miami, Florida, Verenigde Staten, 331361013
        • Univ of Miami School of Medicine
      • Miami, Florida, Verenigde Staten, 33136
        • Univ of Miami School of Medicine
    • Illinois
      • Chicago, Illinois, Verenigde Staten, 60612
        • Cook County Hosp
      • Chicago, Illinois, Verenigde Staten, 606143394
        • Chicago Children's Memorial Hosp
    • Louisiana
      • New Orleans, Louisiana, Verenigde Staten, 70112
        • Tulane Univ School of Medicine
      • New Orleans, Louisiana, Verenigde Staten, 70112
        • Charity Hosp / Tulane Univ Med School
    • Maryland
      • Baltimore, Maryland, Verenigde Staten, 21201
        • Univ of Maryland at Baltimore / Univ Med Ctr
      • Baltimore, Maryland, Verenigde Staten, 212874933
        • Johns Hopkins Hosp - Pediatric
    • Massachusetts
      • Boston, Massachusetts, Verenigde Staten, 021155724
        • Children's Hosp of Boston
    • Minnesota
      • Minneapolis, Minnesota, Verenigde Staten, 55455
        • Univ of Minnesota
    • New Jersey
      • Newark, New Jersey, Verenigde Staten, 071072198
        • Children's Hosp of New Jersey / UMDNJ - New Jersey Med Schl
    • New York
      • Bronx, New York, Verenigde Staten, 10465
        • Jack Weiler Hosp / Bronx Municipal Hosp
      • Elmhurst, New York, Verenigde Staten, 11373
        • City Hosp Ctr at Elmhurst / Mount Sinai Hosp
      • New York, New York, Verenigde Staten, 10016
        • Bellevue Hosp / New York Univ Med Ctr
      • New York, New York, Verenigde Staten, 10029
        • Mount Sinai Med Ctr
      • New York, New York, Verenigde Staten, 10037
        • Harlem Hosp Ctr
      • New York, New York, Verenigde Staten, 10003
        • Beth Israel Med Ctr / Pediatrics
      • New York, New York, Verenigde Staten, 10032
        • Columbia Univ Babies' Hosp
    • North Carolina
      • Durham, North Carolina, Verenigde Staten, 277103499
        • Duke Univ Med Ctr
    • Ohio
      • Columbus, Ohio, Verenigde Staten, 432052696
        • Columbus Children's Hosp
    • Pennsylvania
      • Hershey, Pennsylvania, Verenigde Staten, 170330850
        • Milton S Hershey Med Ctr
    • Texas
      • Houston, Texas, Verenigde Staten, 77030
        • Baylor College of Medicine
      • Houston, Texas, Verenigde Staten, 77030
        • Hermann Hosp / Univ Texas Health Science Ctr

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

3 maanden tot 12 jaar (Kind)

Accepteert gezonde vrijwilligers

Nee

Geslachten die in aanmerking komen voor studie

Allemaal

Beschrijving

Inclusion Criteria

Concurrent Medication:

Allowed:

  • Prophylaxis for Pneumocystis carinii pneumonia (PCP) in children with AIDS or CD4 cell count = or < 500 cells/mm3.

Children must demonstrate the following clinical and laboratory findings:

  • Laboratory evidence of HIV infection as demonstrated by either a positive viral culture or detectable serum p24 antigen or = or > two positive tests for HIV antibody, which must be determined by a federally licensed ELISA test and confirmed by Western blot.
  • Children < 15 months of age, who are thought to have acquired HIV through perinatal transmission and whose only laboratory evidence of HIV infection is a positive antibody test, must also have one or more of the following laboratory criteria indicative of immunologic abnormality:
  • hypergammaglobulinemia (IgG or IgA) defined as greater than the upper limit of normal for age-adjusted normals; absolute depression in the CD4+ cells to = or < 500 cells/mm3; decreased helper/suppressor ratio < 1.0; depressed in vitro mitogen response to at least one antigen/mitogen.
  • Absence of serious bacterial infections as defined in Exclusion Criteria requiring therapy at the time of entry.
  • Hemophiliacs are included.

Exclusion Criteria

Co-existing Condition:

Children will be excluded for the following reasons:

  • Recurrent or life-threatening toxicity. Several allergic reactions such as exfoliative erythroderma, anaphylaxis, or vascular collapse. The presence of one or more of the indicator diseases of AIDS, such as opportunistic infections, malignancy, recurrent bacterial infections, or encephalopathy. Development of two or more episodes of recurrent varicella zoster infection or chronic zoster defined as = or > 30 days duration. Development of AIDS related complex, with failure to thrive, persistent or recurrent oral candidiasis, plus at least one of the following:
  • Diarrhea that is either persistent or recurrent, lymphadenopathy at two or more noncontiguous sites, organomegaly, nephropathy manifested by nephrotic syndrome without evidence of renal failure, two or more episodes of herpes stomatitis or one or more episodes of herpes zoster within a 1 year period; plus at least one of the following:
  • hypergammaglobulinemia, depression in the CD4+ cells to = or < 500/mm3, decreased helper/suppressor ratio < 1.0, depressed in vitro mitogen response to at least one antigen/mitogen.

Concurrent Medication:

Excluded:

  • Hepatotoxic drugs.
  • Steroids for lymphocytic interstitial pneumonitis (LIP).
  • Prophylaxis for oral candidiasis, or otitis media.
  • Immunoglobulin therapy.
  • Chronic use of drugs that are metabolized by hepatic glucuronidation.

Concurrent Treatment:

Excluded:

  • Supplemental oxygen treatment for lymphocytic interstitial pneumonitis (LIP).

Children will be excluded from the study for the following reasons:

  • AIDS-defining opportunistic infection or neoplasm.
  • Unexplained recurrent, serious bacterial infections (= or > 2 within a 2-year period) including sepsis, meningitis, pneumonia, abscess of an internal organ, and bone/joint infections caused by Haemophilus, Streptococcus, or other pyogenic bacteria.
  • Encephalopathy.
  • One or both of the following:
  • Failure to thrive, defined as a child who crosses two percentile lines on the growth chart or a child who is less than the fifth percentile and does not follow the curve; and/or persistent (= or > 2 months) oral candidiasis despite appropriate topical therapy.
  • Children with lymphocytic interstitial pneumonitis (LIP) who are steroid dependent or requiring supplemental oxygen or who have a pretreatment PaO2 < 70 mmHg.
  • Children who qualify for the entrance criteria to open-label zidovudine (AZT) or AZT plus or minus gammaglobulin.

Prior Medication:

Excluded:

  • Rifampin or rifampin derivatives.
  • Antiretroviral agents.
  • Zidovudine (AZT).
  • Excluded within 2 weeks of study entry:
  • Other experimental therapy.
  • Drugs which cause prolonged neutropenia or significant nephrotoxicity.
  • Excluded within 4 weeks of study entry:
  • Immunomodulating agents including immunoglobulin, interferon, isoprinosine, and IL-2.

Prior Treatment:

Excluded within 4 weeks of study entry:

  • Lymphocyte transfusions.

Active alcohol or drug abuse.

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Behandeling
  • Masker: Dubbele

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Sponsor

Onderzoekers

  • Studie stoel: P Weintrub

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie voltooiing (Werkelijk)

1 september 1992

Studieregistratiedata

Eerst ingediend

2 november 1999

Eerst ingediend dat voldeed aan de QC-criteria

30 augustus 2001

Eerst geplaatst (Schatting)

31 augustus 2001

Updates van studierecords

Laatste update geplaatst (Werkelijk)

1 november 2021

Laatste update ingediend die voldeed aan QC-criteria

28 oktober 2021

Laatst geverifieerd

1 oktober 2021

Meer informatie

Termen gerelateerd aan deze studie

Andere studie-ID-nummers

  • ACTG 052
  • 11026 (Register-ID: DAIDS ES Registry Number)

Deze informatie is zonder wijzigingen rechtstreeks van de website clinicaltrials.gov gehaald. Als u verzoeken heeft om uw onderzoeksgegevens te wijzigen, te verwijderen of bij te werken, neem dan contact op met register@clinicaltrials.gov. Zodra er een wijziging wordt doorgevoerd op clinicaltrials.gov, wordt deze ook automatisch bijgewerkt op onze website .

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