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Safety and Effectiveness of Short-Term Anti-HIV Drug Therapy for Recent HIV-1 Infection

16. januar 2013 oppdatert av: University of Colorado, Denver

An Open-Label Randomized Clinical Trial to Evaluate the Efficacy and Safety of Short Course Antiretroviral Therapy for Acute or Recent HIV-1 Infection in Zimbabwe and the United States

The purpose of this study is to determine the safety and effectiveness of an anti-HIV drug regimen followed by treatment interruption in people recently infected with HIV. This study will also compare the effects of a treatment regimen including treatment interruption with a treatment plan based on clinical indicators.

Studieoversikt

Status

Fullført

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

About 6 months after infection, HIV viral load reaches a temporarily stable level known as virus set point. Virus set point is different for each patient and can be a predictor for disease progression. Preliminary studies indicate that early, short-term antiretroviral therapy (ART) given to people newly infected with HIV may lead to lower virus set points and preserved CD4 counts. However, the length of short-term treatment needed to balance the possible adverse effects of ART with the achievement of lower virus set point is not yet known. By lowering the virus set point and maintaining CD4 counts, the need for long-term ART may be postponed. The purpose of this study is to determine the safety and efficacy of a short course of ART on producing a lower virus set point in adults recently infected with HIV.

This study will last at least 28 weeks. Participants will be randomly assigned to one of two arms. Arm A will receive ART for 12 weeks as emtricitabine/tenofovir disoproxil fumarate (TDF/FTC) daily and lopinavir/ritonavir (LPV/RTV) in tablet form twice daily. After 12 weeks, treatment will be interrupted unless the CD4 count is measured to be less than 350 cells/mm^3 on two consecutive occasions during treatment interruption. If that occurs therapy will be resumed. Participants in Arm B will receive no treatment until cluster of differentiation 4 (CD4) counts drop below 350 cells/mm^3, indicating ART is needed. Study visits will occur at study entry, at Weeks 2 and 4, and every 4 weeks thereafter. At each study visit, a physical exam, blood collection, and completion of an adherence questionnaire will occur. Participants are encouraged to enroll in a related substudy that will evaluate HIV viral load in genital secretions.

Studietype

Intervensjonell

Registrering (Faktiske)

16

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

  • Forente stater
    • Colorado
      • Denver, Colorado, Forente stater, 80262
        • University of Colorado Health Sciences Center
    • Georgia
      • Atlanta, Georgia, Forente stater, 30308
        • AIDS Research Consortium of Atlanta
  • Zimbabwe
      • Harare, Zimbabwe
        • University of Zimbabwe College of Health Sciences

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år og eldre (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

Inclusion Criteria:

  • Acute or recent HIV-1 infection. More information about this criterion can be found in the protocol.
  • CD4 count 500 cells/mm3 or greater
  • No evidence of prior or current AIDS-defining illness
  • No signs or symptoms of HIV infection or AIDS-defining illness that, in the opinion of the investigator, requires ART
  • Willing to use acceptable forms of contraception

Exclusion Criteria:

  • Prior treatment with any antiretroviral drug for more than 7 days
  • Use of certain drugs within 21 days of study entry
  • Prior receipt of investigational anti-HIV-1 vaccine
  • Ongoing therapy with systemic corticosteroids, chemotherapeutic agents, nephrotoxic systemic agents, immunomodulatory treatments, or investigational agents
  • Known allergy/sensitivity to study drugs or their formulations
  • Current drug or alcohol use or abuse that, in the opinion of the investigator, may interfere with the study
  • Serious medical or psychiatric illness that may interfere with the study
  • Hepatitis B infected
  • Pregnancy or breastfeeding

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Ingen (Open Label)

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: Treatment interruption
Oral Tenofovir disoproxil fumarate/Emtricitabine and Lopinavir/Ritonavir for 12 weeks followed by treatment interruption if CD4 count is 450 mm^3 or higher. When CD4 count is less than 350 mm^3 on two separate, consecutive measurements during treatment interruption, therapy will be resumed.
Legemiddel: Tenofovir disoproxil fumarate/Emtricitabine
300 mg Tenofovir disoproxil fumarate/ 200 mg emtricitabine tablet taken orally once daily
Andre navn:
  • TDF/FTC
Legemiddel: Lopinavir/Ritonavir
Three 400 mg lopinavir/ 100 mg ritonavir soft gel capsules taken orally twice daily
Andre navn:
  • LPV/RTV
Eksperimentell: CD4 T cell guided therapy
Anti Retroviral Therapy initiated when AIDS-defining illness occurs or if CD4 count is confirmed at less than 350 mm^3 at two separate, consecutive measurements
Legemiddel: Tenofovir disoproxil fumarate/Emtricitabine
300 mg Tenofovir disoproxil fumarate/ 200 mg emtricitabine tablet taken orally once daily
Andre navn:
  • TDF/FTC
Legemiddel: Lopinavir/Ritonavir
Three 400 mg lopinavir/ 100 mg ritonavir soft gel capsules taken orally twice daily
Andre navn:
  • LPV/RTV

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Plasma HIV-1 Viral Load (Copies/ml) at Week 24 as Compared Between the Two Arms
Tidsramme: At Week 24
At Week 24
Number of Participants Experiencing Either an AIDS-defining Event, a Grade 3 or 4 Adverse Event, or Acute Retroviral Syndrome
Tidsramme: At Week 24
At Week 24
Viral Set Point
Tidsramme: Throughout study
set point is reached after the immune system has developed HIV antibodies and begins to attempt to fight the virus
Throughout study

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

University of Colorado, Denver

Samarbeidspartnere

National Institute of Allergy and Infectious Diseases (NIAID)

Etterforskere

  • Studiestol: Michelle A. Barron, MD, Division of Infectious Disease, University of Colorado Health Sciences Center
  • Studiestol: Margaret Borok, MRCP, Department of Medicine, University of Zimbabwe

Publikasjoner og nyttige lenker

Den som er ansvarlig for å legge inn informasjon om studien leverer frivillig disse publikasjonene. Disse kan handle om alt relatert til studiet.

Generelle publikasjoner

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart

1. januar 2007

Primær fullføring (Faktiske)

1. februar 2010

Studiet fullført (Faktiske)

1. februar 2010

Datoer for studieregistrering

Først innsendt

19. desember 2006

Først innsendt som oppfylte QC-kriteriene

19. desember 2006

Først lagt ut (Anslag)

21. desember 2006

Oppdateringer av studieposter

Sist oppdatering lagt ut (Anslag)

20. februar 2013

Siste oppdatering sendt inn som oppfylte QC-kriteriene

16. januar 2013

Sist bekreftet

1. januar 2013

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • 06-0757
  • P01AI055356 (U.S. NIH-stipend/kontrakt)

Denne informasjonen ble hentet direkte fra nettstedet clinicaltrials.gov uten noen endringer. Hvis du har noen forespørsler om å endre, fjerne eller oppdatere studiedetaljene dine, vennligst kontakt register@clinicaltrials.gov. Så snart en endring er implementert på clinicaltrials.gov, vil denne også bli oppdatert automatisk på nettstedet vårt. .

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