Analysis of HIV-1 Replication During Antiretroviral Therapy

This study is currently recruiting participants. (see Contacts and Locations)
Verified March 2014 by National Institutes of Health Clinical Center (CC)
Sponsor:
Information provided by:
National Institutes of Health Clinical Center (CC)
ClinicalTrials.gov Identifier:
NCT00767312
First received: October 6, 2008
Last updated: March 14, 2014
Last verified: March 2014

October 6, 2008
March 14, 2014
September 2008
Not Provided
Relationship of HIV-1 RNA levels and genetic variation in patients on antiretroviral therapy.
Not Provided
Complete list of historical versions of study NCT00767312 on ClinicalTrials.gov Archive Site
Determinants of viremai, characteristics of rebound viremai.
Not Provided
Not Provided
Not Provided
 
Analysis of HIV-1 Replication During Antiretroviral Therapy
Analysis of HIV-1 Replication During Antiretroviral Therapy

This study will determine if the level of virus in HIV-infected patients taking antiretroviral medications for prolonged periods decreases or persists at a stable level. It will also examine whether new gene changes (mutations) occur during drug suppression.

HIV-infected patients who are 18 years of age or older, have been enrolled in another NIH protocol, have been suppressed on antiretroviral therapy and have very low levels of virus in their blood may be eligible for this 5-year (or more) study.

Participants come to the NIH Clinical Center about every 6 months for a physical examination, routine and research blood tests and leukapheresis to collect white blood cells for T cell analysis. For leukapheresis, blood is collected through a vein much like donating whole blood, but the blood is directed through a machine that separates and extracts the white cells and returns the rest of the blood components to the patient. Patients may also have an optional third clinic visit each year for another blood draw.

Combination antiretroviral therapy for human immunodeficiency virus serotype 1 (HIV-1) infection has resulted in profound reductions in viremia and is associated with marked improvements in morbidity and mortality. Therapy is not curative, however, and prolonged therapy is complicated by drug toxicity and the emergence of drug resistance. How drug resistance emerges during suppressive antiretroviral therapy remains poorly understood. Investigating the characteristics of HIV-1 replication during suppressive antiretroviral therapy will yield important insights in understanding the emergence resistance, and requires patients who have suppressed viral RNA levels. Prior National Institutes of Health (NIH) protocols have made important observations regarding the kinetics of HIV-1 decline in response to therapy, the levels of HIV-1 viremia during suppressive therapy, and the nature of HIV-1 genetic diversity prior to and following initiation of antiretroviral therapy. In the process, these studies have generated a useful cohort of patients with suppressed viral RNA levels, who have been extensively characterized from a virologic and immunologic standpoint. Similarly, patients from other NIH protocols have been followed for prolonged periods before and after therapy has been initiated, and they also have stored sample sets that would be useful in new studies of HIV replication. The HIV Drug Resistance Program (DRP) has studied samples from protocols 00-I-0110 and 97-I-0082 to develop a number of new, sensitive laboratory techniques to measure and quantitate genetic variation and to investigate immune response parameters. To further advance understanding of HIV-1 replication during suppressive antiretroviral therapy and the emergence of drug resistance, we propose a new protocol to study these 2 patient cohorts (from the above cited protocols) and selected patients in other protocols with a new series of studies. The primary objective of this protocol is to investigate the virologic and immunologic characteristics of HIV-infected individuals undergoing antiretroviral therapy. Upon implementation, this new protocol will provide human subjects protection for samples collected under the two prior protocols, whether patients enroll in the new study or not.

Observational
Time Perspective: Prospective
Not Provided
Not Provided
Not Provided
Not Provided
HIV Infection
Not Provided
Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruiting
70
Not Provided
Not Provided
  • INCLUSION CRITERIA:

Inclusion criteria for this protocol comprise all of the following conditions:

  • Age greater than or equal to 18 years.
  • HIV infection with documented reactive ELISA and positive western blot.
  • Prior enrollment in 00-I-0110, 97-I-0082 OR patients with long term evaluation at NIH for whom additional sampling will be useful for protocol objectives, including:

    • Available stored specimens from pretherapy period.
    • Ongoing suppression of viremia with bDNA less than 50 copies/mL, OR
    • Suppression of viremia to less than 50 copies/mL followed by rebound viremia during therapy.
  • Patients must have a private physician for routine medical care.

EXCLUSION CRITERIA:

Any prospective study subject who has been previously withdrawn from any prior study for inability to comply with study procedures will be considered ineligible for this study.

Both
18 Years and older
No
Contact: Gabbie M Diaz, R.N. (301) 435-8019 diazgm@mail.nih.gov
Contact: Frank Maldarelli, M.D. (301) 435-8019 fmalli@mail.nih.gov
United States
 
NCT00767312
080221, 08-I-0221
Not Provided
Not Provided
National Institute of Allergy and Infectious Diseases (NIAID)
Not Provided
Principal Investigator: Frank Maldarelli, M.D. National Cancer Institute (NCI)
National Institutes of Health Clinical Center (CC)
March 2014

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