Immuno-Virological Efficacy of Combination With Trizivir +Tenofovir in Multiresistant HIV Patients
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Purpose
To evaluate whether the combined therapy of two nucleosides plus one nucleotide (Trizivir + TDF) manages to keep CD4 lymphocytes stable in patients with HIV infection on antiretroviral treatment that present virological failure and multiple resistance to antiretrovirals.
| Condition | Intervention | Phase |
|---|---|---|
|
HIV Infections |
Drug: Trizivir (AZT+3HT+Abacavir) twice daily Drug: Viread (300 mg Tenofovir disoproxil fumarate) once daily |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Open-Label, Single-Centre, Randomised Pilot Study to Evaluate Immunovirological and Clinical Evolution of a Combination With Nucleoside Analogues/Nucleotides (Trizivir +Tenofovir) in Multiresistant Patients With Virological Failure |
- Variations in the immune status of patients in each group throughout follow-up. [ Time Frame: 48 weeks ] [ Designated as safety issue: No ]
- Percentage of patients that increase viral load by > 0.5 log [ Time Frame: weeks 12, 24, 36 and 48 ] [ Designated as safety issue: No ]
- Percentage of patients that increase viral load by > 100,000 copies/mL [ Time Frame: weeks 12, 24, 36 and 48 ] [ Designated as safety issue: No ]
- Percentage of patients that present some clinical event, B or C classification according to the CDC. [ Time Frame: during the 48 weeks of follow-up ] [ Designated as safety issue: Yes ]
- Percentage of patients that present clinical or analytical adverse effects degree > 2 according to the WHO classification. [ Time Frame: weeks 12, 24, 36 and 48 ] [ Designated as safety issue: Yes ]
- Percentage of patients that drop out of treatment. [ Time Frame: weeks 12, 24, 36 and 48 ] [ Designated as safety issue: Yes ]
- Percentage of patients that drop out of the study due to intolerance or adverse effects. [ Time Frame: weeks 12, 24, 36 and 48 ] [ Designated as safety issue: Yes ]
- Percentage of change in lipid determinations. [ Time Frame: weeks 12, 24, 36 and 48 with regard to baseline ] [ Designated as safety issue: Yes ]
- Percentage of patients that report changes, improvement or worsening in redistribution of body fat. [ Time Frame: weeks 12, 24, 36 and 48 ] [ Designated as safety issue: No ]
- Percentage of patients that present adherence to the antiretroviral treatment > 95%. [ Time Frame: weeks 12, 24, 36 and 48 ] [ Designated as safety issue: No ]
- Percentage of patients that present improvement in the quality of life (MOS-HIV) and satisfaction questionnaires. [ Time Frame: weeks 12, 24, 36 and 48 ] [ Designated as safety issue: No ]
- Percentage of patients that present an increase in the number of active drugs. [ Time Frame: at the end of the study ] [ Designated as safety issue: No ]
| Enrollment: | 24 |
| Study Start Date: | September 2005 |
| Study Completion Date: | June 2007 |
| Primary Completion Date: | June 2007 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: A
Trizivir+ Tenofovir 2/day
|
Drug: Trizivir (AZT+3HT+Abacavir) twice daily
Trizivir (AZT+3HT+Abacavir) twice daily
Drug: Viread (300 mg Tenofovir disoproxil fumarate) once daily
Viread (300 mg Tenofovir disoproxil fumarate) once daily
|
|
No Intervention: B
antiretroviral treatment optimizated by genotyp
|
Detailed Description:
This study has been designed to determine whether the use of a regimen based exclusively on NTRI, containing tenofovir, zidovudine and lamivudine, is able to preserve immunological status in patients with detectable viral load for whom an efficacious salvage regimen cannot be designed, slowing the progression of the viral load and reducing antiretroviral treatment-associated toxicity. In order to complete the salvage regimen without increasing the number of tablets too much, Trizivir plus tenofovir as investigational treatment will be used.
Eligibility| Ages Eligible for Study: | 18 Years to 65 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Age>= 18 years.
- HIV-1 infected patients.
- Patients on antiretroviral treatment including NTRI + PI +/- NNRTI +/- fusion inhibitors at inclusion in the study.
- Virological failure, defined as 2 determinations with viral load >1,000 copies/mL in the last 6 months, during stable HAART therapy over the previous 6 months.
Genotype or phenotype resistance to three families of antiretrovirals (PI, NTRI and NNRTI) demonstrated in genotype study carried out in the last 48 weeks and defined as:
- 3 or more TAMS of the following: M41L, E44D, D67N, V118I, L210W, T215Y/F, K219Q/E.
- Existence of the M184V mutation or probable presence in the cellular archives.
- 5 or more mutations that confer resistance to PI of the following: I10F/I/R/V, V32I, M46I/L, I54V/M/L, V82A/F/T/S/V, I84V/A/C, L90M.
- Existence of 1 or more mutations that confer resistance to NNRTI, or probable presence in the cellular archives of: K103N, Y181C/I/Y, G190S/A/G.
- CD4 lymphocytes >- 300 cells/mm3 in the last two determinations.
- Subject able to follow the treatment period.
- Acceptance of the study and signature of the informed consent form.
- Women may not be of fertile age (defined as at least one year from menopause or undergoing any surgical sterilisation technique), or must undertake to use a barrier contraceptive method during the study.
Exclusion Criteria:
- Suspicion of previous incorrect adherence.
- Pregnancy or breastfeeding
- Suspicion of intolerance to any investigational drug.
- Record of any disease which, according to clinical criteria, may reoccur with the proposed change of therapy (sarcoma, lymphoma, etc).
- CD4 Nadir below 200 cel/mm3.
- Acute intercurrent disease or fever in the 15 days before inclusion.
Contacts and Locations| Spain | |
| H.U. Germans Trias i Pujol | |
| Badalona, Barcelona, Spain, 08916 | |
| Principal Investigator: | Bonaventura Clotet, MD,PhD | LLuita contra la Sida Foundation-HIV Unit |
More Information
No publications provided
| Responsible Party: | Lluita Sida Foundation |
| ClinicalTrials.gov Identifier: | NCT00356616 History of Changes |
| Other Study ID Numbers: | TETRIZ, 2005-002203-17 |
| Study First Received: | July 24, 2006 |
| Last Updated: | January 25, 2008 |
| Health Authority: | Spain: Ministry of Health |
Keywords provided by Germans Trias i Pujol Hospital:
|
Antiretroviral treatment virological failure HIV |
Additional relevant MeSH terms:
|
HIV Infections Acquired Immunodeficiency Syndrome Lentivirus Infections Retroviridae Infections RNA Virus Infections Virus Diseases Sexually Transmitted Diseases, Viral Sexually Transmitted Diseases Immunologic Deficiency Syndromes Immune System Diseases Slow Virus Diseases Tenofovir |
Tenofovir disoproxil Abacavir Reverse Transcriptase Inhibitors Nucleic Acid Synthesis Inhibitors Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action Pharmacologic Actions Anti-Retroviral Agents Antiviral Agents Anti-Infective Agents Therapeutic Uses Anti-HIV Agents |
ClinicalTrials.gov processed this record on May 16, 2013