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Controlled Clinical Trial of Antiviral Cytotoxic T Lymphocyte (CTL) Infusion Following Combination Antiretroviral Drug Therapy for Asymptomatic HIV-1 Infection

This study has been terminated.

Sponsored by: National Institute of Allergy and Infectious Diseases (NIAID)
Information provided by: National Institute of Allergy and Infectious Diseases (NIAID)
ClinicalTrials.gov Identifier: NCT00000875
  Purpose

To evaluate the safety of anti-HIV CTL therapy in early stage patients and to verify the safety when combined with antiviral therapy with zidovudine/lamivudine/indinavir and low-dose interleukin-2 (IL-2). To compare the effects on plasma and cell-associated viral load following combination drug therapy with and without antiviral CTL in early-stage patients. To study in detail the immune effects of lowering viral burden with antiviral combination drugs with and without T cell infusion on antiviral CTL activity, viral suppression and proliferation, circulating T cell phenotype, T cell apoptosis, CD4 cell numbers, DTH reaction, and inflammatory cytokine levels.

In an HIV-infected person, there is an ongoing struggle between HIV replication and host immune control. In the past decade most therapeutic strategies have targeted the virus. This approach has been frustrated by viral mutation to evade drug sensitivity. Promising drugs have recently been approved and there are encouraging sustained results from combination antiviral chemotherapy. However, even the most potent drug regimens do not seem to be curative, may eventually lead to drug resistance and may not completely restore lost immune function. The addition of immune-based therapy to antiviral drugs may lead to better viral control.


Condition Intervention
HIV Infections
Drug: Indinavir sulfate
Drug: Diphenhydramine hydrochloride
Drug: Lymphocytes, Activated
Drug: Lamivudine
Drug: Zidovudine
Drug: Acetaminophen
Drug: Aldesleukin

MedlinePlus related topics:   AIDS   

Drug Information available for:   Zidovudine    Lamivudine    Indinavir    Indinavir Sulfate    Aldesleukin    Diphenhydramine    Diphenhydramine citrate    Diphenhydramine hydrochloride    Promethazine    Promethazine hydrochloride    Acetaminophen   

U.S. FDA Resources

Study Type:   Interventional
Study Design:   Treatment, Parallel Assignment, Safety Study
Official Title:   Controlled Clinical Trial of Antiviral Cytotoxic T Lymphocyte (CTL) Infusion Following Combination Antiretroviral Drug Therapy for Asymptomatic HIV-1 Infection

Further study details as provided by National Institute of Allergy and Infectious Diseases (NIAID):

Estimated Enrollment:   16

Detailed Description:

In an HIV-infected person, there is an ongoing struggle between HIV replication and host immune control. In the past decade most therapeutic strategies have targeted the virus. This approach has been frustrated by viral mutation to evade drug sensitivity. Promising drugs have recently been approved and there are encouraging sustained results from combination antiviral chemotherapy. However, even the most potent drug regimens do not seem to be curative, may eventually lead to drug resistance and may not completely restore lost immune function. The addition of immune-based therapy to antiviral drugs may lead to better viral control.

This study has 2 regimens of 8 patients each. Patients are randomized as to CTL infusion only. Patients are stratified by viral load (less than 10,000 copies/ml vs. greater than or equal to 10,000 copies/ml). All patients receive combination drug therapy with AZT/3TC/indinavir for 9 months at which time patients have the option of continuing their study regimen another year or changing therapy. Patients in the T cell treatment regimen (regimen 2) receive 2 infusions of ex vivo expanded autologous anti-HIV CTL at 3 and 6 months after beginning AZT/3TC/indinavir therapy. The second infusion is administered with low-dose sc IL-2 1 day before and 4 days following T cell infusion.

  Eligibility
Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No

Criteria

Inclusion Criteria

Patients must have:

  • Serologically confirmed HIV-1 infection.
  • CD4 count >= 400/mm3.

Exclusion Criteria

Co-existing Condition:

Patients with any of the following conditions or symptoms are excluded:

  • Symptoms of HIV-1 disease, except lymphadenopathy.
  • Symptoms of cardiac disease.
  • Evidence of clinical pulmonary disease.
  • Significant medical disease.

Patients with any of the following prior conditions are excluded:

  • History of symptoms of HIV-1 disease, except lymphadenopathy.
  • Participation in another experimental AIDS treatment clinical trial within 4 weeks into entry.
  • History of significant psychiatric disease.
  • History of pancreatitis, history of neuropathy or neurotoxic drug therapy.
  • History of serious allergies requiring either systemic steroid therapy or prior hospitalization.
  • History of significant arrhythmia, infarction or heart failure. Immunomodulatory therapy such as steroids or cyclosporine, systemic chemotherapy or alpha-interferon.

Prior Medication: Exclusion:

  • Past treatment with any protease inhibitor.
  • History of neurotoxic drug therapy.

Risk Behavior: Excluded

  • Patients with current substance abuse.
  • Excessive alcohol intake.
  Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00000875

Locations
United States, Massachusetts
The Ctr For Blood Research Inc    
      Boston, Massachusetts, United States, 02115

Sponsors and Collaborators
  More Information


Click here for more information about Zidovudine  This link exits the ClinicalTrials.gov site
 
Click here for more information about Aldesleukin  This link exits the ClinicalTrials.gov site
 
Click here for more information about Lamivudine  This link exits the ClinicalTrials.gov site
 
Click here for more information about Indinavir sulfate  This link exits the ClinicalTrials.gov site
 

Study ID Numbers:   SPIRAT 3
First Received:   November 2, 1999
Last Updated:   August 4, 2008
ClinicalTrials.gov Identifier:   NCT00000875
Health Authority:   United States: Federal Government

Keywords provided by National Institute of Allergy and Infectious Diseases (NIAID):
Drug Therapy, Combination  
Immunotherapy, Adoptive  
T-Lymphocytes, Cytotoxic  
Anti-HIV Agents  
Viral Load  

Study placed in the following topic categories:
Sexually Transmitted Diseases, Viral
Indinavir
Acquired Immunodeficiency Syndrome
Zidovudine
Lamivudine
Immunologic Deficiency Syndromes
Histamine
Virus Diseases
Aldesleukin
Promethazine
HIV Infections
Sexually Transmitted Diseases
Histamine phosphate
Retroviridae Infections
Acetaminophen
Diphenhydramine

Additional relevant MeSH terms:
Antimetabolites
Anti-Infective Agents
Communicable Diseases
Neurotransmitter Agents
Slow Virus Diseases
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Physiological Effects of Drugs
Anesthetics
Antiemetics
Infection
Reverse Transcriptase Inhibitors
Anti-Retroviral Agents
Sensory System Agents
Therapeutic Uses
Hypnotics and Sedatives
Antipruritics
Analgesics
Dermatologic Agents
Nucleic Acid Synthesis Inhibitors
HIV Protease Inhibitors
RNA Virus Infections
Anti-HIV Agents
Immune System Diseases
Gastrointestinal Agents
Histamine Agents
Central Nervous System Depressants
Enzyme Inhibitors
Anti-Allergic Agents
Antiviral Agents

ClinicalTrials.gov processed this record on December 03, 2008




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