BASTA Study on STI in HIV Infected Patients
This is a single center, independent study. The primary objective is to compare efficacy and safety of continuing a conventional HAART in chronically infected HIV patients with a therapeutic strategy based on long term, immunologically driven treatment interruptions. Evaluation will be based on clinical, immunological and virological response.
Patients will be randomized in a ratio 1:2 to one of the two treatment arms:
Control group continuing the ongoing therapy STI group performing long term CD4 guided structured treatment interruptions In the STI arm patients will stay off therapy until their CD4 count will drop < 400 cells/mcL. At that time point patients will resume the HAART regimen they were assuming before STI and will continue HAART until they CD4 count will raise > 800 cells/mcL and their HIV-RNA will drop below the detection limit of 50 copies/ml. When both the CD4 count and the viral load will be within these pre-set values they will stop therapy again. There is no limit to the number of interruptions and re-start cycles during the study period The study is powered to evaluate equivalence between the two strategies under the assumption of a failure proportion in the control arm at each time point not greater than 5% and a maximum allowed difference of 15%.
Procedure: STI (structured Treatment Interruption)
|Study Design:||Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
|Official Title:||Strategic Long Term, Immunologically Driven Treatment Interruptions in Patients on Effective HAART: a Controlled, Randomized Study|
- Proportion of subjects maintaining at each time-point a CD4 + cell count above 400 cells/mcL.
- Occurrence of clinical end-points (AIDS defining event and death)
- Virologic failure with the selection of resistance conferring mutations.
- Mean variation of blood cholesterol and triglycerides from baseline values. For these parameters the proportion of subjects with a value above grade 2 (AHA) will be also used as evaluation criteria.
- Development of lipodystrophy or modification of a pre-existing lipodystrophy
- Time off therapy
- Economic evaluation
- Genotypic tests to be performed in the case of HIV-RNA > 1000 copies/ml while on therapy for at least 4 months or one month after each treatment interruption.
|Study Start Date:||November 2000|
|Estimated Study Completion Date:||November 2005|
|Antiviral Therapy Unit, Ospedali Riuniti|
|Bergamo, Italy, 24128|
|Principal Investigator:||Franco Maggiolo, MD||Ospedali Riuniti, Bergamo|