Evaluation of Patients Who Have Not Had Success With Zidovudine

This study has been completed.
Sponsor:
Collaborators:
Bristol-Myers Squibb
Glaxo Wellcome
Information provided by (Responsible Party):
National Institute of Allergy and Infectious Diseases (NIAID)
ClinicalTrials.gov Identifier:
NCT00001025
First received: November 2, 1999
Last updated: March 28, 2012
Last verified: March 2012

November 2, 1999
March 28, 2012
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Complete list of historical versions of study NCT00001025 on ClinicalTrials.gov Archive Site
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Evaluation of Patients Who Have Not Had Success With Zidovudine
A Study to Evaluate the Short-Term Clinical and Virologic Significance of Zidovudine Resistance

To determine the relationship of viral susceptibility to zidovudine (AZT) and baseline viral load (as determined by plasma viremia and quantitative endpoint dilution). To determine the relationship between viral load and susceptibility during different antiretroviral therapy strategies. To correlate measures of viral load and short term clinical and laboratory markers (such as weight, CD4 count, p24 antigenemia, and beta2 microglobulin) on the different therapy arms.

High-grade resistance to AZT has been detected in HIV isolates from approximately 25 percent of individuals with AIDS who received AZT for at least 1 year. To elucidate the clinical significance of in vitro AZT resistance, it is necessary to distinguish between clinical failure caused by AZT resistance and clinical decompensation caused by other factors.

High-grade resistance to AZT has been detected in HIV isolates from approximately 25 percent of individuals with AIDS who received AZT for at least 1 year. To elucidate the clinical significance of in vitro AZT resistance, it is necessary to distinguish between clinical failure caused by AZT resistance and clinical decompensation caused by other factors.

One hundred-twenty patients who have been receiving AZT for at least 1 year are randomized to 1) continue with AZT, 2) switch to treatment with didanosine at 1 of 2 doses, or 3) receive both AZT and ddI. Treatment is given for 16 weeks, with a possible extension to 32 weeks. Patients are followed at weeks 2, 4, 8, 12, and 16. For analysis purposes only, patients are stratified according to degree of susceptibility of HIV isolates to AZT.

Interventional
Phase 2
Primary Purpose: Treatment
HIV Infections
  • Drug: Zidovudine
  • Drug: Didanosine
Not Provided
  • Cavert W, Coombs RW, Kuritzkes D, Grimes J, Stein D, Rojo W, Beatty C, Winters M, Corey L. Baseline zidovudine (ZDV) susceptibility, codon 215 mutation, viral load and syncytium-inducting characteristics(SI) of HIV isolates from ACTG protocol 194. Natl Conf Hum Retroviruses Relat Infect (1st). 1993 Dec 12-16:137
  • Reichelderfer PS, Coombs RW. Multifactorial analysis of the inverse relationship between viral load and CD4+ cell count. Int Conf AIDS. 1996 Jul 7-12;11(2):277 (abstract no ThB4148)

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Completed
120
May 1995
Not Provided

Inclusion Criteria

Concurrent Medication:

Allowed:

  • Chemoprophylaxis against Pneumocystis carinii pneumonia (PCP), Mycobacterium tuberculosis, or Herpes simplex virus, or against other opportunistic infections as indicated.
  • Corticosteroids for no longer than 21 days (only as part of PCP therapy).
  • Erythropoietin and G-CSF.

Patients must have:

  • Documented HIV-seropositivity.
  • CD4 count 100 - 300 cells/mm3.
  • Prior continuous AZT dose = or > 300 mg/day for 1 year or longer.

Prior Medication: Required:

  • AZT for at least 1 year prior to study entry.

Exclusion Criteria

Co-existing Condition:

Patients with the following symptoms and conditions are excluded:

  • Medical contraindication or is considered noncompliant in the opinion of the investigator.
  • Peripheral neuropathy = or > grade 2.

Concurrent Medication:

Excluded:

  • Anti-HIV agents other than study drugs.
  • Biologic response modifiers (other than erythropoietin or G-CSF).
  • Systemic cytotoxic chemotherapy.
  • Regularly prescribed medications (such as antipyretics, analgesics, allergy medications) that are associated with an increased risk of pancreatitis, peripheral neuropathy, or bone marrow suppression.

Concurrent Treatment:

Excluded:

  • Radiation therapy.

Patients with the following prior conditions are excluded:

  • History of acute or chronic pancreatitis, gout, or uric acid nephropathy.

Prior Medication:

Excluded:

  • Other antiretrovirals besides AZT.
  • ddI or ddC for more than 30 days within the past year or any time within 3 months prior to study entry.
  • Acute therapy for an infection or other medical illness within 14 days prior to study entry.
Both
12 Years and older
No
Contact information is only displayed when the study is recruiting subjects
United States
 
NCT00001025
ACTG 194, 11170
Not Provided
National Institute of Allergy and Infectious Diseases (NIAID)
National Institute of Allergy and Infectious Diseases (NIAID)
  • Bristol-Myers Squibb
  • Glaxo Wellcome
Study Chair: Corey L
Study Chair: Cavert W
Study Chair: Coombs R
National Institute of Allergy and Infectious Diseases (NIAID)
March 2012

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP