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- Klinische proef 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
Studie Overzicht
Toestand
Conditie
Gedetailleerde beschrijving
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.
Studietype
Inschrijving (Werkelijk)
Contacten en locaties
Studie Locaties
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New South Wales
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Burwood, New South Wales, Australië, 2134
- Burwood Road Gen. Practice CRS
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Darlinghurst, New South Wales, Australië, 2010
- St. Vincent's Hospital CRS
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Westmead, New South Wales, Australië, 2145
- Westmead Hospital CRS
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Victoria
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Carlton,, Victoria, Australië
- Melbourne Sexual Health Ctr. CRS
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Melbourne, Victoria, Australië, 3004
- The Alfred Hosp., Clinical Research - Infectious Diseases Unit CRS
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Melbourne, Victoria, Australië, 3181
- Prahran Market Clinic CRS
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Sao Paulo, Brazilië, 01246-900
- Instituto de Infectologia Emilio Ribas CRS
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Bahia
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Salvador, Bahia, Brazilië, 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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Chiang Mai, Thailand
- Sanpatong Hosp. CRS
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Khon Kaen, Thailand, 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, Thailand
- Bamrasnaradura Institute CRS
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Ratchathewi
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Bangkok, Ratchathewi, Thailand
- Chulalongkorn University Hospital CRS
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Bangkok, Ratchathewi, Thailand
- Mahidol Univ., Ramathibodi Hosp., Div of Infectious Disease CRS
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California
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San Francisco, California, Verenigde Staten, 94114
- Castro-Mission Health Ctr. CRS
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Colorado
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Denver, Colorado, Verenigde Staten, 80204-4507
- Univ. of Colorado Health Science Ctr. CRS
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Denver, Colorado, Verenigde Staten, 80205
- Eastside Family Health Ctr. CRS
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Denver, Colorado, Verenigde Staten, 80204
- Denver Public Health CRS
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Denver, Colorado, Verenigde Staten, 80204-4507
- Kaiser Permanente of Denver CRS
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Wheat Ridge, Colorado, Verenigde Staten, 80033
- Western Infectious Disease Consultants CRS
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District of Columbia
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Washington, District of Columbia, Verenigde Staten, 20422
- Washington DC VAMC, Washington Regional AIDS Program, Infectious Diseases CRS
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Florida
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Jacksonville, Florida, Verenigde Staten, 32206
- Univ. of Florida, Div. of Infectious Diseases CRS
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Louisiana
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Baton Rouge, Louisiana, Verenigde Staten, 70805
- Earl K. Long Med. Ctr., LSU - Mid City EIC Clinic CRS
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Michigan
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Detroit, Michigan, Verenigde Staten, 48202
- Henry Ford Hosp. CRS
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Detroit, Michigan, Verenigde Staten, 48201
- Wayne State Univ. CRS
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Lansing, Michigan, Verenigde Staten, 48910
- Michigan State Univ., Infectious Disease Clinic CRS
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New York
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Bronx, New York, Verenigde Staten, 10457
- Bronx-Lebanon Hosp. Ctr. CRS
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Bronx, New York, Verenigde Staten, 10461
- Jacobi Med. Ctr., Ambulatory Care Pavillion CRS
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Bronx, New York, Verenigde Staten, 10467
- Montefiore Med. Ctr., AIDS Ctr. CRS
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Bronx, New York, Verenigde Staten, 10468
- Bronx VAMC CRS
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Brooklyn, New York, Verenigde Staten, 11203
- SUNY Downstate Med. Ctr., HIV Ctr. for Women & Children CRS
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New York, New York, Verenigde Staten, 10037-1802
- Harlem Hospital Ctr./Columbia University CRS (Gordin CTU)
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Oklahoma
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Oklahoma City, Oklahoma, Verenigde Staten, 73104
- Univ. of Oklahoma Health Sciences Ctr., Div. of Infectious Diseases CRS
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Oregon
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Portland, Oregon, Verenigde Staten, 97227
- Kaiser Immune Deficiency Clinic of Portland CRS
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Portland, Oregon, Verenigde Staten, 97239
- Oregon Health & Sciences Univ. Internal Medicine (L-475) CRS
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Portland, Oregon, Verenigde Staten, 97210
- The Research & Education Group-Portland CRS
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Portland, Oregon, Verenigde Staten, 97227
- Legacy Clinic Emanuel CRS
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Pennsylvania
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Philadelphia, Pennsylvania, Verenigde Staten, 19140
- Temple Univ. School of Medicine CRS
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Virginia
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Fredericksburg, Virginia, Verenigde Staten, 22401
- MediCorp, Infectious Disease Associates CRS
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Richmond, Virginia, Verenigde Staten, 23298
- Virginia Commonwealth Univ. Medical Ctr. CRS
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Richmond, Virginia, Verenigde Staten, 23224
- CrossOver Health Ctr. CRS
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Richmond, Virginia, Verenigde Staten, 23298
- VCU Health Systems, Infectious Disease Clinic CRS
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Richmond, Virginia, Verenigde Staten, 23223
- Vernon Harris East End Community Health Ctr. CRS
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Wisconsin
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Milwaukee, Wisconsin, Verenigde Staten, 53226
- Med. College of Wisconsin, Infectious Disease Clinic CRS
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Geslachten die in aanmerking komen voor studie
Beschrijving
Inclusion Criteria:
- Coenrollment in the SMART study
Exclusion Criteria:
- Unable to comply with all study requirements
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
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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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Secundaire uitkomstmaten
Uitkomstmaat |
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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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Medewerkers en onderzoekers
Onderzoekers
- Studie stoel: Edwina Wright, MBBS, FRACP, Infectious Disease Unit, the Alfred Hospital
Publicaties en nuttige links
Algemene publicaties
- 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.
Nuttige links
Studie record data
Bestudeer belangrijke data
Studie start
Primaire voltooiing (Werkelijk)
Studie voltooiing (Werkelijk)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Schatting)
Updates van studierecords
Laatste update geplaatst (Schatting)
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Aanvullende relevante MeSH-voorwaarden
- RNA-virusinfecties
- Virusziekten
- Infecties
- Door bloed overgedragen infecties
- Overdraagbare ziekten
- Seksueel overdraagbare aandoeningen, viraal
- Seksueel overdraagbare aandoeningen
- Lentivirus-infecties
- Retroviridae-infecties
- Immunologische deficiëntie syndromen
- Ziekten van het immuunsysteem
- HIV-infecties
Andere studie-ID-nummers
- CPCRA 065F
- CPCRA 065
- CPCRA 065F1
- 10115 (DAIDS-ES)
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