Pilot Study of the Impact of Adding Raltegravir (MK-0518) to Antiretroviral Therapy in Patients With Undetectable Plasma Virus

The recruitment status of this study is unknown because the information has not been verified recently.
Verified October 2008 by University of Pittsburgh.
Recruitment status was  Recruiting
National Cancer Institute (NCI)
Information provided by:
University of Pittsburgh
ClinicalTrials.gov Identifier:
First received: September 29, 2007
Last updated: October 13, 2008
Last verified: October 2008
The medicines used to treat HIV can suppress but cannot kill all the virus in the body. A small amount of virus remains at low levels in the part of the blood called the plasma. It is of crucial importance to identify the source of the residual virus in patients receiving antiretroviral therapy. The purpose of this study is to investigate whether the source of low level plasma virus is from latent (old) infection or ongoing (new) infection. MK-0518 is a investigational drug, which means that is not yet FDA approved, that works in a different way to other anti-HIV medicines to help kill the virus. We hypothesize that addition of MK-0518 to a stable anti-HIV regimen will reduce the viral load further in patients with undetectable plasma virus.

Condition Intervention
HIV Infections
Drug: Raltegravir (MK-0518)

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Official Title: Investigating the Source of HIV-1 Viremia in Patients on Antiretroviral Therapy Through Intensification With MK-0518

Resource links provided by NLM:

Further study details as provided by University of Pittsburgh:

Primary Outcome Measures:
  • HIV-1 RNA response: ≥ 1 log decrease in viral load [ Time Frame: 4 weeks ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Proviral DNA response, HIV-1 sequence variation [ Time Frame: 4 weeks ] [ Designated as safety issue: No ]

Estimated Enrollment: 18
Study Start Date: October 2007
Estimated Study Completion Date: March 2009
Estimated Primary Completion Date: March 2009 (Final data collection date for primary outcome measure)
Intervention Details:
    Drug: Raltegravir (MK-0518)
    Raltegravir 400mg PO every 12 hours for 28 days in addition to the prescribed antiretroviral therapy
    Other Name: MK-0518
Detailed Description:
This is a non-randomized, non-comparative, single center trial of antiretroviral therapy intensification using the investigational integrase inhibitor MK-0518 and an investigational viral load assay to measure response to additional antiviral therapy. Eighteen patients will receive open-label MK-0518 400 mg P.O. every 12 hours for 28 days in addition to their prescribed antiretroviral therapy. Patients will take their doses of MK-0518 without regard to food. The study will enroll patients on antiretroviral therapy regimens with CD4 counts greater than 200 cells/ul, HIV-1 RNA levels <50 copies RNA/ml plasma using a commercial assay(conventional Amplicor) and with detectable plasma virus (viral loads ≥ 1 copies RNA/ml plasma, SCA assay). Acceptable antiretroviral regimens will include those on NRTIs + PI, NRTIs + NNRTI + PI, or NRTIs + NNRTI-containing regimens. Patients cannot have prior evidence of resistance to antiretroviral drugs. Patients will be screened for intensification by history, physical exam, and laboratory evaluations (see below). Patients who are eligible and who agree to participate will intensify their antiretroviral therapy for 28 days with MK-0518 400 mg by mouth twice a day. During the 28- day drug addition, patients will have samples drawn for SCA assay at entry and on days 7, 14, 21, and 28 (+/- 1 d), with the last day of intensification as day 28. Patients will have additional phlebotomy after intensification on days 29, 30, 35, 42, 49 and 58 (+/- 1 day). The intensification period is followed by a post- intensification period to determine whether removal of the drug resulted in viral RNA changes.

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

Inclusion Criteria:

  • HIV-1 infection documented by positive HIV-1 ELISA and positive
  • Male or female at least 18 years of age, and able to provide written, informed consent
  • Current antiretroviral therapy with DHHS-recommended regimen: NRTIs + PI, NRTIs + NNRTI + PI, or NRTIs + NNRTI
  • Screening CD4 > 200 cells/ µl and CD4%> 14%; does not require prophylaxis for opportunistic infections
  • Receiving a stable antiretroviral regimen for 4 months prior to screening
  • HIV-1 RNA level below the limit of detection by commercial HIV-1 RNA determination assays for at least 12 months prior to screening.
  • HIV RNA ≥ 0.6 copy RNA/ml plasma by SCA(single copy assay)
  • Hgb ≥ 9.0 mg/dl, absolute neutrophil count > 1000/mm3, platelet count > 100,000/mm3
  • Alkaline phosphatase, AST and ALT < 2.0 x upper limit of normal
  • Willing to take MK-0518 for 28 days in addition to ongoing antiretroviral therapy
  • Be considered clinically stable, in the opinion of the investigator, at the time of entry into the study; i.e., clinical status and all chronic medications should be unchanged for at least two weeks prior to entry.

Exclusion Criteria:

  • Prior participation in an MK-0518 or other integrase inhibitor trial
  • Requires prohibited medications noted in the protocol
  • Requires cytotoxic agents including hydroxyurea or vaccinations during the study period
  • Received immunosuppressive therapy including steroids within one month prior to treatment in this study
  • Used any investigational agents within a month prior to treatment in this study
  • Documented resistance to any drug in each of the 4 classes of licensed antiretroviral agents by genotype or phenotype
  • Any febrile illness (T>38oC) in the 3 weeks prior to enrollment
  • Any vaccination in the 6 weeks prior to enrollment
  • Diagnosis of acute hepatitis due to any cause
  • Positive Hepatitis B surface antigen
  • Severe renal insufficiency defined as a calculated creatinine clearance at time of screening as < 30 ml/min, based on the Cockcroft-Gault equation.
  • Condition (including but not limited to alcohol or other substance use) which in the opinion of the investigator would interfere with patient compliance or safety
  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: NCT00618371

Contact: Deborah McMahon, MD 412-647-6710 mcmahon@dom.pitt.edu

United States, Pennsylvania
University of Pittsburgh Recruiting
Pittsburgh, Pennsylvania, United States, 15213
Principal Investigator: Deborah McMahon, MD         
Sub-Investigator: Joseph Jones, MD         
Sub-Investigator: Sharon Riddler, MD         
Sub-Investigator: Emmanuel Vergis, MD         
Sponsors and Collaborators
University of Pittsburgh
National Cancer Institute (NCI)
Principal Investigator: Deborah McMahon, MD University of Pittsburgh
  More Information


Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: Deborah McMahon, MD, University of Pittsburgh
ClinicalTrials.gov Identifier: NCT00618371     History of Changes
Other Study ID Numbers: 27XS050 
Study First Received: September 29, 2007
Last Updated: October 13, 2008
Health Authority: United States: Food and Drug Administration

Keywords provided by University of Pittsburgh:
HIV viremia
Human Immunodeficiency Virus

Additional relevant MeSH terms:
Raltegravir Potassium
Anti-HIV Agents
Anti-Infective Agents
Anti-Retroviral Agents
Antiviral Agents
Enzyme Inhibitors
HIV Integrase Inhibitors
Integrase Inhibitors
Molecular Mechanisms of Pharmacological Action

ClinicalTrials.gov processed this record on May 24, 2016