A Randomized Study of Daily and Intermittent Prophylactic Regimens for the Prevention of Disseminated Mycobacterium Avium Complex (MAC) and Fungal Infections in HIV-Infected Patients

This study has been completed.
Sponsor:
Information provided by:
NIH AIDS Clinical Trials Information Service
ClinicalTrials.gov Identifier:
NCT00002122
First received: November 2, 1999
Last updated: June 23, 2005
Last verified: April 1996
  Purpose

PRIMARY: To determine the efficacy of azithromycin and rifabutin alone and in combination for the prevention of disseminated Mycobacterium avium Complex (MAC) infection in HIV-infected patients. To determine the efficacy of daily versus weekly fluconazole for the prevention of deep fungal infections in this patient population.

SECONDARY: To determine the incidence of bacterial (including mycobacterial) infections, cryptosporidiosis, and toxoplasmosis in azithromycin versus non-azithromycin containing regimens. To determine the incidence of oropharyngeal and vaginal candidiasis in patients treated with daily versus weekly fluconazole. To compare survival and outcomes of primary endpoints in the treatment arms.


Condition Intervention Phase
Mycoses
Mycobacterium Avium-Intracellulare Infection
HIV Infections
Drug: Azithromycin
Drug: Rifabutin
Drug: Fluconazole
Phase 3

Study Type: Interventional
Study Design: Endpoint Classification: Efficacy Study
Masking: Double-Blind
Primary Purpose: Treatment
Official Title: A Randomized Study of Daily and Intermittent Prophylactic Regimens for the Prevention of Disseminated Mycobacterium Avium Complex (MAC) and Fungal Infections in HIV-Infected Patients

Resource links provided by NLM:


Further study details as provided by NIH AIDS Clinical Trials Information Service:

Estimated Enrollment: 720
Detailed Description:

Patients are randomized to receive azithromycin alone, rifabutin alone, or the two drugs in combination for MAC prophylaxis. Patients in each treatment group further receive one of two doses of concomitant fluconazole for deep fungal prophylaxis, unless specifically excluded for fluconazole randomization. Patients are followed for 1 to 2 years.

  Eligibility

Ages Eligible for Study:   12 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria

Concurrent Medication:

Allowed:

  • Preventive therapy with isoniazid for M. tuberculosis.
  • Maintenance therapy for CMV retinitis.

Patients must have:

  • HIV infection or history of an AIDS-defining condition by CDC criteria.
  • One documented CD4 count < 100 cells/mm3 within 12 months prior to study entry.
  • NO active MAC disease, MAC bacteremia, or active mycobacterial infection (tuberculous or nontuberculous).
  • NO acute opportunistic infection.
  • Life expectancy of more than 6 months.
  • Consent of parent or guardian if less than legal age of consent.

Exclusion Criteria

Co-existing Condition:

Patients with the following symptoms or conditions are excluded:

ALL PATIENTS -

  • Unexplained fevers, elevation in alkaline phosphatase, pancytopenia, abnormal liver function tests, or odynophagia for which the diagnoses of MAC and fungal infections have not been excluded.
  • Serious hypersensitivity reactions to macrolides or rifampin.
  • Unable to tolerate oral medications. FOR FLUCONAZOLE RANDOMIZATION -
  • Serious hypersensitivity reaction to fluconazole.
  • Active fungal infection (cryptococcosis, histoplasmosis, blastomycosis, aspergillosis, Candida esophagitis, thrush, vaginal candidiasis).
  • Positive baseline urine cryptococcal culture.

Concurrent Medication:

Excluded for fluconazole randomization:

  • Maintenance therapy for deep fungal infections.
  • Chronic therapy with ketoconazole or fluconazole.
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00002122

Locations
United States, California
Los Angeles County - USC Med Ctr
Los Angeles, California, United States, 90033
UCI Med Ctr
Orange, California, United States, 92668
UCSD Treatment Ctr / Dept of Medicine and Pediatrics
San Diego, California, United States, 92103
Santa Clara Valley Med Ctr
San Jose, California, United States, 951282699
Harbor - UCLA Med Ctr
Torrance, California, United States, 90509
United States, District of Columbia
Georgetown Univ Med Ctr
Washington, District of Columbia, United States, 20007
George Washington Univ Med Ctr
Washington, District of Columbia, United States, 20037
United States, Massachusetts
Univ of Massachusetts Med Ctr
Worcester, Massachusetts, United States, 01655
United States, Pennsylvania
Univ of Pennsylvania
Philadelphia, Pennsylvania, United States, 19104
United States, Texas
Univ of Texas Southwestern Med Ctr
Dallas, Texas, United States, 75235
Baylor College of Medicine
Houston, Texas, United States, 77005
Houston Veterans Administration Med Ctr
Houston, Texas, United States, 77030
Sponsors and Collaborators
Pfizer
  More Information

Publications:
Havlir DV, Mccutchan JA, Bozzette SA, Dunne M. A double-blind, randomized study of weekly azithromycin, daily rifabutin, and combination azithromycin and rifabutin for the prevention of Mycobactetum avium complex (MAC) in AIDS patients. Conf Retroviruses Opportunistic Infect. 1996 Jan 28-Feb 1;3rd:90

ClinicalTrials.gov Identifier: NCT00002122     History of Changes
Other Study ID Numbers: 226A, 066-174
Study First Received: November 2, 1999
Last Updated: June 23, 2005
Health Authority: United States: Food and Drug Administration

Keywords provided by NIH AIDS Clinical Trials Information Service:
Rifabutin
Mycobacterium avium-intracellulare Infection
Mycoses
Drug Therapy, Combination
Fluconazole
Acquired Immunodeficiency Syndrome
Azithromycin

Additional relevant MeSH terms:
HIV Infections
Acquired Immunodeficiency Syndrome
Mycobacterium Infections
Mycobacterium avium-intracellulare Infection
Mycoses
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
Actinomycetales Infections
Gram-Positive Bacterial Infections
Bacterial Infections
Mycobacterium Infections, Nontuberculous
Fluconazole
Azithromycin
Rifabutin
Antifungal Agents
Anti-Infective Agents
Therapeutic Uses
Pharmacologic Actions
14-alpha Demethylase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
Anti-Bacterial Agents
Antibiotics, Antitubercular

ClinicalTrials.gov processed this record on August 26, 2014