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Effects of Anti-HIV Therapy on Nervous System Function

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ClinicalTrials.gov Identifier: NCT00432003
Recruitment Status : Completed
First Posted : February 6, 2007
Last Update Posted : April 17, 2014
Information provided by (Responsible Party):
National Institute of Allergy and Infectious Diseases (NIAID)

February 5, 2007
February 6, 2007
April 17, 2014
March 2005
July 2007   (Final data collection date for primary outcome measure)
  • Change in QNPZ-5 scores
  • time to development of symptomatic peripheral neuropathy
  • change in peripheral neuropathy symptoms
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Complete list of historical versions of study NCT00432003 on ClinicalTrials.gov Archive Site
  • Time to neurocognitive impairment
  • time to development of ADC, stage 2 or greater
  • chage in peripheral neuropathy symptoms
  • time to development of asymptomatic or symptomatic peripheral neuropathy
  • time to resolution of symptomatic peripheral neuropathy
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Effects of Anti-HIV Therapy on Nervous System Function
Neurology: A Substudy of a Large, Simple Trial Comparing Two Strategies for Management of Anti-Retroviral Therapy (SMART) to Determine the Impact of the Strategies Upon Central and Peripheral Nervous System Function
The purpose of this study is to observe the way two different anti-HIV treatment strategies affect nerve and brain function in adults with HIV.

AIDS dementia complex (ADC) is a condition characterized by cognitive impairment, psychomotor slowing, and behavioral change. A milder form of ADC, called HIV minor cognitive/motor disorder (MCMD), is characterized by similar symptoms but has less of an impact on daily functioning. The neurocognitive impairment that results from ADC and MCMD carries an increased risk of poor drug adherence, morbidity, and mortality. It is unclear if highly active antiretroviral therapy (HAART) is effective in preserving neurocognitive function or in preventing or treating neurocognitive impairment. Distal symmetric sensory polyneuropathy (DSPN) and nucleoside-related neuropathy are two other serious conditions that HIV patients are at high risk for. DSPN is thought to be caused by active HIV infection; nucleoside-related neuropathy is thought to be caused by mitochondrial toxicity related to the use of certain antiretrovirals. These 2 conditions may lead to severe pain and discomfort in the feet. It is unknown what connection, if any, there is between DSPN and nucleoside-related neuropathy and the use of HAART. More data are needed on the natural history of these conditions.

This trial is a substudy of a study of management of antiretroviral therapy (SMART). In the SMART study, patients will participate in one of two strategies: a drug conservation (DC) strategy and a viral suppression (VS) strategy. Participants in the DC group will stop or defer HAART, then receive episodic HAART treatment for the minimum time needed to maintain a CD4 cell count of at least 250 cells/mm3. Participants in the VS group will receive HAART to maintain a viral load as low as possible, regardless of CD4 count. The purpose of this study is to compare changes in neurocognitive functioning and peripheral neuropathy symptoms between the 2 strategies of the SMART study.

Patients will participate in this substudy and the main SMART study at the same time. Within 45 days prior to randomization into the main SMART study, participants will have baseline data collected for this substudy. This data will include peripheral neuropathy assessments, treatments for symptoms of peripheral neuropathy. At selected study sites, additional measures will assess neurocognitive function, depression, alcohol and drug use, and education. At 6 months, 12 months, and every 12 months thereafter, peripheral neuropathy symptoms and treatment for the symptoms will be assessed; a pain questionnaire will also be completed. Participants will be followed until the SMART study ends.

Time Perspective: Prospective
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HIV Infections
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*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
July 2007
July 2007   (Final data collection date for primary outcome measure)

Inclusion Criteria:

  • Coenrollment in the SMART study

Exclusion Criteria:

  • Unable to comply with all study requirements
Sexes Eligible for Study: All
18 Years and older   (Adult, Senior)
Contact information is only displayed when the study is recruiting subjects
Australia,   Brazil,   Canada,   Thailand,   United States
10115 ( Registry Identifier: DAIDS-ES )
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National Institute of Allergy and Infectious Diseases (NIAID)
National Institute of Allergy and Infectious Diseases (NIAID)
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Study Chair: Edwina Wright, MBBS, FRACP Infectious Disease Unit, the Alfred Hospital
National Institute of Allergy and Infectious Diseases (NIAID)
April 2014