A Study to Evaluate the Use of a Protease Inhibitor and of Interleukin-2 (IL-2) in the Treatment of Early HIV Infection
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| ClinicalTrials.gov Identifier: NCT00006154 |
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Recruitment Status
:
Completed
First Posted
: August 31, 2001
Last Update Posted
: September 6, 2013
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The purpose of this study is to look at the effectiveness of combination anti-HIV drug therapy (with protease inhibitors [PIs] or without) in patients with early HIV infections. This study also looks at whether a drug called interleukin-2 (IL-2) can boost the immune system of these patients.
Doctors are not sure which anti-HIV drug combination is best to use in patients who have early HIV infection and have never received anti-HIV treatment. PIs are anti-HIV drugs that decrease viral load (level of HIV in the blood). However, PIs can cause serious side effects in some patients. Doctors would like to know if a drug combination that does not contain a PI is just as good as one that contains PIs.
| Condition or disease | Intervention/treatment | Phase |
|---|---|---|
| HIV Infections | Drug: Indinavir sulfate Drug: Ritonavir Drug: Abacavir sulfate Drug: Efavirenz Drug: Stavudine Drug: Didanosine Drug: Aldesleukin | Phase 3 |
Studies have suggested that an antiretroviral drug regimen of the non-nucleoside agent efavirenz (EFV) in combination with two nucleoside analogues is effective at achieving maximal viral suppression. This provides an alternative treatment to that of the more toxic PI-containing regimen. This trial examines whether a nonPI regimen with EFV is more beneficial than a PI-containing regimen when each is used in combination with the same two nucleoside analogues. A second part of the study looks at whether the addition of IL-2 may offer immunologic benefits as a co-administered drug.
Patients are randomized to initiate antiretroviral therapy of a PI-based (stavudine/didanosine/ritonavir [RTV]/indinavir [IDV]) or nonPI-based (stavudine/didanosine/EFV) regimen. Within these treatment arms, they are stratified according to a positive or negative p24 antigen result. At Week 16, patients not achieving maximal viral suppression (lower than 50 copies/ml) have the option to add abacavir (ABC) or other drugs as intensification therapy. Those achieving virologic suppression (less than 50 copies/ml) are randomized either to receive IL-2 or not. At study entry, and after 12 months, tissue samples of CSF, lymph node, and genital secretions are obtained, with permission. Patients have physical exams, women of child-bearing potential have pregnancy tests, and blood samples are drawn at clinic visits 12-16 times a year over 3 years so that virologic and immunologic evaluations may be performed. Compensation for time and transportation is given.
| Study Type : | Interventional (Clinical Trial) |
| Estimated Enrollment : | 165 participants |
| Allocation: | Randomized |
| Intervention Model: | Parallel Assignment |
| Masking: | None (Open Label) |
| Primary Purpose: | Treatment |
| Official Title: | Randomized, Controlled, Open Label, Multi-Center Phase III Trial Comparing the Safety and Antiviral Activity of a Protease-Containing Regimen (d4T/ddI/IDV/RTV) Versus a Protease-Sparing Regimen (d4T/ddI/EFV) and the Ability of Interleukin-2 to Purge HIV From Latent Stores in Patients With Acute/Early HIV Infection |
| Arm | Intervention/treatment |
|---|---|
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Experimental: A
Patients will receive combination antiretroviral therapy with a protease inhibitor
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Drug: Indinavir sulfate
400 mg tablets equaling 1600 mg daily
Other Name: IDV
Drug: Ritonavir
100 mg liquid capsules equaling 400 mg daily
Other Name: RTV
Drug: Abacavir sulfate
300 mg capsules equaling 600 mg daily. Administration based on individual results after 16 weeks.
Other Name: ABC
Drug: Didanosine
250-400 mg E.coated tablets equaling 250 or 400 mg daily
Other Name: ddI
Drug: Aldesleukin
Subcutaneous injection equaling 15 x 10^6 IU daily dose. Administration based on individual results after 16 weeks and randomization.
Other Names:
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Active Comparator: B
Patients will receive combination antiretroviral therapy without a protease inhibitor
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Drug: Abacavir sulfate
300 mg capsules equaling 600 mg daily. Administration based on individual results after 16 weeks.
Other Name: ABC
Drug: Efavirenz
200 mg capsules equaling 600 mg daily
Other Name: DMP
Drug: Stavudine
30-40 mg capsules equaling 60 or 80 mg daily
Other Name: d4T
Drug: Didanosine
250-400 mg E.coated tablets equaling 250 or 400 mg daily
Other Name: ddI
Drug: Aldesleukin
Subcutaneous injection equaling 15 x 10^6 IU daily dose. Administration based on individual results after 16 weeks and randomization.
Other Names:
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- Virologic: A. Plasma viral load B. Tissue viral load (CNS, lymphoid tissues, genital tract) C. HIV DNA (proviral) levels in circulating mononuclear cells D. Phenotypic and genotypic antiretroviral drug resistance [ Time Frame: Throughout study ]
- Immunologic: A. Evaluation of CD4, CD8, CD45RA, CD45RO phenotypes and defined activation markers B. Evaluation of the diversity and persistence of the T cell repertoire (CD4+, CD8+) in the circulation and lymphoid tissues [ Time Frame: Throughout study ]
- Immunologic: C. Functional CD4+ cellular assays (class II MHC tetramers) D. Thymic regeneration as studied by the exclusion circle assay E. Evolution of Western blot banding patterns F. Evolution of anti-HIV neutralizing antibody levels [ Time Frame: Throughout study ]
- Clinical: A. Minor opportunistic infections or AIDS-defining conditions B. Death C. Clinical or laboratory adverse events D. Evaluation of adherence to therapy E. Evaluation of lipodystrophy [ Time Frame: Throughout study ]
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, Learn About Clinical Studies.
| Ages Eligible for Study: | 18 Years and older (Adult, Senior) |
| Sexes Eligible for Study: | All |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria
Patients may be eligible for this study if they:
- Have been infected recently with HIV. This will be determined by certain lab tests.
- Are 18 years of age or older.
- Are able to swallow a large number of pills.
- Are willing to use barrier methods of birth control (such as condoms) during the study.
Exclusion Criteria
Patients will not be eligible for this study if they:
- Abuse drugs or alcohol.
- Have any condition that, in the opinion of the investigator, could impair their ability to participate in the study.
- Are breast-feeding or pregnant.
- Have received any prior anti-HIV drugs. (However, use of anti-HIV drugs to try to prevent infection more than 6 months prior to study entry is allowed.)
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00006154
| Canada, British Columbia | |
| Viridae Clinical Sciences / University of British Columbia | |
| Vancouver, British Columbia, Canada | |
| Canada, Quebec | |
| Centre de traitment d'immunodeficience | |
| Montreal, Quebec, Canada | |
| Centre Hospitalier de la Universite de Montreal (CHUM) | |
| Montreal, Quebec, Canada | |
| Institut Thoracique de Montreal | |
| Montreal, Quebec, Canada | |
| Principal Investigator: | Rafick-Pierre Sekaly | ||
| Principal Investigator: | Brian Conway |
| Responsible Party: | National Institute of Allergy and Infectious Diseases (NIAID) |
| ClinicalTrials.gov Identifier: | NCT00006154 History of Changes |
| Other Study ID Numbers: |
AI-07-001 CTN #124 11530 ( Registry Identifier: DAIDS-ES ) |
| First Posted: | August 31, 2001 Key Record Dates |
| Last Update Posted: | September 6, 2013 |
| Last Verified: | September 2013 |
Keywords provided by National Institute of Allergy and Infectious Diseases (NIAID):
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Interleukin-2 Didanosine Drug Therapy, Combination Stavudine HIV Protease Inhibitors Ritonavir Indinavir |
Virus Latency Reverse Transcriptase Inhibitors Anti-HIV Agents abacavir efavirenz Acute Infection |
Additional relevant MeSH terms:
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Infection Communicable Diseases 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 Ritonavir HIV Protease Inhibitors |
Indinavir Aldesleukin Abacavir Stavudine Didanosine Efavirenz Protease Inhibitors Interleukin-2 Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action Anti-HIV Agents Anti-Retroviral Agents Antiviral Agents Anti-Infective Agents Cytochrome P-450 CYP3A Inhibitors |