- ICH GCP
- Amerikanska kliniska prövningsregistret
- Klinisk prövning NCT00001069
A Study of Two Methods of Determining When to Begin or Change Anti-HIV Treatment
A Randomized Study of the Clinical Effects of Initiating or Changing Antiretroviral Therapy Based on Plasma HIV RNA Quantitation Compared With Initiating or Changing Therapy Based on Current Clinical Practice Alone
PRIMARY: To compare the clinical efficacy of two decision making strategies for initiating or changing antiretroviral therapy: decision making based on current clinical practice alone (i.e., initiating or changing therapy based on CD4 count decline and/or clinical progression) versus decision making based on plasma HIV RNA quantitation in addition to current clinical practice.
SECONDARY: To evaluate toxicity, biological markers, and patient management in the two arms.
Although changing therapies is a common strategy in the treatment of HIV disease, guidelines are needed to help clinicians and patients decide when a change in antiretroviral therapy is indicated. The technology of measuring HIV RNA in plasma has been suggested as a tool for monitoring clinical drug efficacy. However, uncertainty remains about whether aggressive antiretroviral treatment to lower HIV RNA and maintain low levels for as long as possible will confer clinical benefit in comparison with management based on monitoring CD4 counts and HIV-related symptoms.
Studieöversikt
Status
Betingelser
Detaljerad beskrivning
Although changing therapies is a common strategy in the treatment of HIV disease, guidelines are needed to help clinicians and patients decide when a change in antiretroviral therapy is indicated. The technology of measuring HIV RNA in plasma has been suggested as a tool for monitoring clinical drug efficacy. However, uncertainty remains about whether aggressive antiretroviral treatment to lower HIV RNA and maintain low levels for as long as possible will confer clinical benefit in comparison with management based on monitoring CD4 counts and HIV-related symptoms.
Patients are randomized to a decision making strategy for initiating or changing therapy based on current clinical practice alone vs. decision making based on plasma HIV RNA quantitation in addition to current clinical practice in patients with <= 300 CD4+ cells/mm3. All patients in the RNA arm as well as a subset (n = 183) of those in the CCP arm will have a plasma HIV RNA quantitation drawn every 4 months. The results of these quantitations will be blinded until the end of the study. CD4 counts will be obtained at least every 4 months if the previous count was > 20 cells/mm3. The remaining patients in the CCP arm will have CD4 counts obtained according to their clinicians' current clinical practices. Medications, clinical status, and changes in antiretroviral therapy will be recorded for all patients in the study. Patients are stratified by CD4+ cell count (<100 cells/mm3 [200 patients] vs. 100-300 cells/mm3 [900 patients]).
Studietyp
Inskrivning
Kontakter och platser
Studieorter
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California
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San Francisco, California, Förenta staterna, 94110
- Community Consortium of San Francisco
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Colorado
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Denver, Colorado, Förenta staterna, 802044507
- Denver CPCRA / Denver Public Hlth
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District of Columbia
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Washington, District of Columbia, Förenta staterna, 20422
- Veterans Administration Med Ctr / Regional AIDS Program
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Georgia
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Atlanta, Georgia, Förenta staterna, 30308
- AIDS Research Consortium of Atlanta
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Illinois
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Chicago, Illinois, Förenta staterna, 60657
- AIDS Research Alliance - Chicago
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Louisiana
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New Orleans, Louisiana, Förenta staterna, 70112
- Louisiana Comm AIDS Rsch Prog / Tulane Univ Med
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Maryland
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Baltimore, Maryland, Förenta staterna, 21201
- Baltimore Trials
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Michigan
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Detroit, Michigan, Förenta staterna, 48202
- Henry Ford Hosp
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Detroit, Michigan, Förenta staterna, 48201
- Comprehensive AIDS Alliance of Detroit
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New Jersey
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Camden, New Jersey, Förenta staterna, 08103
- Southern New Jersey AIDS Cln Trials / Dept of Med
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Newark, New Jersey, Förenta staterna, 071032842
- North Jersey Community Research Initiative
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New Mexico
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Albuquerque, New Mexico, Förenta staterna, 871315271
- Partners Research
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New York
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New York, New York, Förenta staterna, 10037
- Harlem AIDS Treatment Group / Harlem Hosp Ctr
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Oregon
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Portland, Oregon, Förenta staterna, 97210
- The Research and Education Group
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Portland, Oregon, Förenta staterna, 972109951
- Portland Veterans Adm Med Ctr / Rsch & Education Grp
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Pennsylvania
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Philadelphia, Pennsylvania, Förenta staterna, 19107
- Philadelphia FIGHT
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Virginia
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Richmond, Virginia, Förenta staterna, 23298
- Richmond AIDS Consortium
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Deltagandekriterier
Urvalskriterier
Åldrar som är berättigade till studier
Tar emot friska volontärer
Kön som är behöriga för studier
Beskrivning
Inclusion Criteria
Patients must have:
- HIV infection.
- CD4 count <= 300 cells/mm3.
- NO stage 2 or worse AIDS dementia complex.
- Life expectancy of at least 6 months.
- Reasonably good health.
- age >= 13yrs.
- signed informed consent.
Exclusion Criteria
Co-existing Condition:
Patients with the following symptoms or conditions are excluded:
- Disorders or conditions that may prevent adequate compliance with study requirements.
Patients with the following prior conditions are excluded:
- Stage 2 >= AIDS dementia complex.
Studieplan
Hur är studien utformad?
Designdetaljer
Samarbetspartners och utredare
Utredare
- Studiestol: Perez G
- Studiestol: Thompson M
Publikationer och användbara länkar
Allmänna publikationer
- Doepel LK. Volunteers needed for study of HIV viral load test. NIAID AIDS Agenda. 1995 Dec:3.
- James JS. Viral load: new "strategy" trial in 15 U.S. cities. AIDS Treat News. 1995 Oct 20;(no 233):1-3.
- Raghavan S, Grant LB, Barisch G, Thompson M, Williams B, Matoe N, el-Sadr WM. Change in log10 HIV RNA and protease inhibitor use associated with weight change in HIV+ men in a national clinical trial. Int Conf AIDS. 1998;12:556 (abstract no 32180)
Studieavstämningsdatum
Studieregistreringsdatum
Först inskickad
Först inskickad som uppfyllde QC-kriterierna
Första postat (Uppskatta)
Uppdateringar av studier
Senaste uppdatering publicerad (Uppskatta)
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
Senast verifierad
Mer information
Termer relaterade till denna studie
Nyckelord
Ytterligare relevanta MeSH-villkor
Andra studie-ID-nummer
- CPCRA 036
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