Adherence to HIV Therapy in Heroin Addicts
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Purpose
This study will obtain pilot data on the impact oral naltrexone 50 mg/day vs. a sustained-release naltrexone implant on response to antiretroviral therapy (ART) in opioid addicted patients beginning ART in St. Petersburg, Russia.
| Condition | Intervention | Phase |
|---|---|---|
|
HIV Substance Abuse HIV Infections |
Drug: Oral Naltrexone (ON) Drug: Implantable Naltrexone (IN) |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Adherence to HIV Therapy in Heroin Addicts: Oral vs. Extended Release Naltrexone |
- Adherence Oral (ON) vs Implant (IN) naltrexone [ Time Frame: 48 weeks ] [ Designated as safety issue: No ]The primary aim is to compare the ability IN vs ON to achieve a viral load of <400 copies at weeks 24 and 48
- Compare efficacy of the two treatments on: [ Time Frame: 48 weeks ] [ Designated as safety issue: No ]
- Adherence to ART;
- Time to relapse;
- Number of days relapsed;
- Decline in CD4 counts;
- HIV risk behavior;
- Opioid positive urine tests;
- Number of days kept scheduled appointments;
- Psychiatric symptoms, other drug use, overall adjustment
| Estimated Enrollment: | 200 |
| Study Start Date: | July 2010 |
| Estimated Study Completion Date: | June 2013 |
| Estimated Primary Completion Date: | June 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: Oral Naltrexone (ON)
Oral naltrexone for 48 weeks versus implantable naltrexone for 48 weeks
|
Drug: Oral Naltrexone (ON)
48 weeks of oral naltrexone as compared to 48 weeks of implantable naltrexone
|
|
Active Comparator: Implantable Naltrexone (IN)
48 Weeks of implantable naltrexone as compared with 48 weeks of oral naltrexone
|
Drug: Implantable Naltrexone (IN)
48 weeks of implantable naltrexone as compared with 48 weeks of oral naltrexone
|
Detailed Description:
The study will randomize, in a 1:1 ratio, 260 recently detoxified opioid addicts beginning ART to a 48-week course of biweekly drug counseling with either oral naltrexone 50 mg/day + placebo naltrexone implant, or placebo tablet + naltrexone implant. Approximate balanced randomization will be achieved by using an urn randomization design within each set of sites based in two baseline characteristics: (1) viral load >100,000 copies/<100,000 copies, and (2) CDF count >50/>50 copies. The primary outcome will be the response to ART as measured by reduction in viral load at 24 and 48 weeks.
Eligibility| Ages Eligible for Study: | 18 Years to 64 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- HIV+ men or women with no prior ART
- Age 18 and above
- CD4+ lymphocyte counts <350 cells/mm3
- Viral load of 1,000 copies or more
- Meet DSM-IV criteria for Opioid Dependence in Early Remission
- Negative opiate urine toxicology and alcohol breath test
- No evidence of physiologic dependence on physical examination and After naloxone challenge
- Stable address in St. Petersburg or the Leningrad Region
- Telephone number where subjects can be reached (most patients in prior Studies have mobile phones and all live with friends or relatives)
- Negative pregnancy test & use adequate contraception if childbearing age
- Ability to give informed consent as judged by ability to read the consent and correctly answer 9 of 10 questions about the study on a quiz that will be administered after discussing the study and reading the consent (patients will be given three opportunities to retake and pass the quiz if they fail the first time)
Exclusion Criteria:
- Currently psychotic as determined by psychiatric examination (schizophrenia, Paranoid disorder, mania)
- Suicidal or homicidal ideation requiring immediate attention as determined at Baseline assessment
- Uncontrolled seizure disorder;
- Cognitive impairment with inability to read and understand the consent
- Significant laboratory abnormality such as >2 grade anemia, hepatic transaminase Levels >3 times upper limit of normal, serum creatinine >1.5 times UNL
- Legal charges with impending incarceration
- Concurrent participation in another treatment study
- Currently taking naltrexone.
Contacts and Locations| Contact: Evgeny Krupitsky, MD | 78122969905 | kru@ek3506.edu |
| Contact: Edwin Zvartau, MD | 7184997023 | zvartau@spmu.rssi.ru |
| Russian Federation | |
| Leningrad Region Addiction Treatment | Not yet recruiting |
| Leningrad Region, Russian Federation, 188661 | |
| Principal Investigator: Evgeny Krupitsky, MD | |
| Leningrad Region AIDS Center | Not yet recruiting |
| St. Petersburg, Russian Federation, 197376 | |
| Principal Investigator: Evgeny Krupitsky, MD | |
More Information
No publications provided
| Responsible Party: | Pam Caudill, Associate Vice Provost of Research Services, Trustees of the University of Pennsylvania |
| ClinicalTrials.gov Identifier: | NCT01101815 History of Changes |
| Other Study ID Numbers: | DA026336, R01DA026336 |
| Study First Received: | April 8, 2010 |
| Last Updated: | January 10, 2012 |
| Health Authority: | United States: Federal Government |
Keywords provided by University of Pennsylvania:
|
Viral Loads Naltrexone HIV Risk Substance Abuse |
Additional relevant MeSH terms:
|
HIV Infections Acquired Immunodeficiency Syndrome Substance-Related Disorders 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 Mental Disorders Naltrexone Narcotic Antagonists Physiological Effects of Drugs Pharmacologic Actions Sensory System Agents Peripheral Nervous System Agents Central Nervous System Agents Therapeutic Uses |
ClinicalTrials.gov processed this record on May 23, 2013