Using the Drug Thalidomide to Stimulate T Cells in HIV-Infected People
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Purpose
Despite treatment with anti-HIV drugs, people infected with HIV continue to have problems with their immune systems. This study will evaluate whether the drug thalidomide, which stimulates the immune system's T cells, can improve immune system function in people with HIV.
| Condition | Intervention | Phase |
|---|---|---|
|
HIV Infections |
Drug: Thalidomide Drug: Thalidomide placebo |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver) Primary Purpose: Treatment |
| Official Title: | Pharmacologic T Cell Costimulation In HIV Disease |
- Doubling in HIV Pol-specific CD8 cells, measured by ELISPOT [ Time Frame: Through Day 28 ] [ Designated as safety issue: No ]
- Increase in CMV pp65 CD8 cells, measured by ELISPOT in the thalidomide treatment group [ Time Frame: Throughout study ] [ Designated as safety issue: No ]
- Increase in HIV p24-specific IFN-gamma-secreting CD4 cells in the thalidomide treatment group, measured by fluorescence-activated cell sorting (FACS) [ Time Frame: Throughout study ] [ Designated as safety issue: No ]
- Increase in cytomegalovirus (CMV)-specific interferon (IFN)-gamma-secreting CD4 T cells in the thalidomide treatment group, measured by FACS [ Time Frame: Throughout study ] [ Designated as safety issue: No ]
- Increase in the frequency of keyhole limpet hemocyanin (KLH)-specific lymphocyte proliferative responses in the thalidomide treatment group [ Time Frame: Throughout study ] [ Designated as safety issue: No ]
- Increase in adverse events in the thalidomide treatment group [ Time Frame: Throughout study ] [ Designated as safety issue: Yes ]
| Enrollment: | 40 |
| Study Start Date: | April 2001 |
| Study Completion Date: | February 2006 |
| Primary Completion Date: | August 2005 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: 1
Participants will receive low dose thalidomide for 28 days
|
Drug: Thalidomide
Tablet taken orally daily
|
|
Placebo Comparator: 2
Participants will receive low dose thalidomide placebo for 28 days
|
Drug: Thalidomide placebo
Placebo tablet taken orally daily
|
Detailed Description:
In patients with chronic HIV infection, HIV replication and abnormalities in immune function persist following treatment with highly active antiretroviral therapy (HAART). Specifically, costimulatory T cell interactions are impaired. The immune modulatory drug thalidomide was recently found to costimulate T cells. Pharmacologic T cell costimulation may compensate for the T cell deficiencies in people with HIV disease and improve immune function. This study will test whether thalidomide treatment enhances HIV and cytomegalovirus (CMV)-specific immunity in patients with HIV and CMV, and will evaluate the effect of thalidomide on HIV replication.
In this study, 40 HIV and CMV infected patients on HAART and 40 HIV uninfected CMV seropositive controls will be randomly assigned to low dose thalidomide or placebo treatment for 28 days. T cell responses and HIV replication and genetic diversification will be assessed.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | Yes |
Inclusion Criteria
- HIV-infected for at least 5 years prior to study entry
- CD4 count of 300/mm3 or above
- Pre-HAART nadir CD4 count of 300/mm3 or less
- CMV infection
- HAART for 12 months prior to study entry
- Same effective HAART regimen for 3 months prior to study entry
- HIV viral load less than 200 copies/ml
- Clinically stable
Exclusion Criteria
- Active opportunistic infection
- Females of childbearing potential
Contacts and Locations| United States, Florida | |
| University of Miami School of Medicine | |
| Miami, Florida, United States, 33125 | |
| Principal Investigator: | Patrick Haslett, MD | Department of Microbiology and Immunology, University of Miami School of Medicine |
More Information
Publications:
| Responsible Party: | Rona Siskind, DAIDS |
| ClinicalTrials.gov Identifier: | NCT00053430 History of Changes |
| Other Study ID Numbers: | 1R01AI47742-01A1, 7R01AI047742-02 |
| Study First Received: | January 29, 2003 |
| Last Updated: | August 6, 2009 |
| Health Authority: | United States: Food and Drug Administration |
Keywords provided by National Institute of Allergy and Infectious Diseases (NIAID):
|
Immune Modulation Thalidomide Immune reconstitution Treatment Experienced |
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 Thalidomide Immunosuppressive Agents |
Immunologic Factors Physiological Effects of Drugs Pharmacologic Actions Leprostatic Agents Anti-Bacterial Agents Anti-Infective Agents Therapeutic Uses Angiogenesis Inhibitors Angiogenesis Modulating Agents Growth Substances Growth Inhibitors Antineoplastic Agents |
ClinicalTrials.gov processed this record on May 16, 2013