Immune Reconstitution of Lopinavir/Ritonavir-Based vs Efavirenz-based HAART in Advanced HIV Disease
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ClinicalTrials.gov Identifier: NCT00775606 |
Recruitment Status
:
Terminated
(Study stopped 12/2010 due to poor enrollment. Only 15 of 60 needed enrolled.)
First Posted
: October 20, 2008
Results First Posted
: May 29, 2014
Last Update Posted
: June 9, 2014
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Condition or disease | Intervention/treatment | Phase |
---|---|---|
Acquired Immune Deficiency Syndrome | Drug: Lopinavir 400 mg/ritonavir 100 mg Drug: Efavirenz | Phase 4 |
DESIGN: ICE-001 is a phase IV, randomized, two-arm unblinded study, comparing the effect on immune reconstitution of open-label ritonavir (RTV)-enhanced lopinavir (LPV) to efavirenz (EFV), in combination with daily emtricitabine (FTC)/tenofovir (TDF) as initial therapy for HIV-1 infection in HIV-infected treatment naïve subjects with CD4+ T-cells less than 200 cells/ml.
DURATION: Subjects will participate in ICE-001 for approximately 48 weeks after starting study treatment.
SAMPLE SIZE: ICE-001 will enroll 60 subjects (30 per treatment arm).
POPULATION: HIV-1-infected, antiretroviral (ARV) drug-naïve (≤7 days of ARV treatment at anytime prior to study entry) men and women between18 to 60 years of age with plasma HIV-1 RNA levels >1000 copies/mL and CD4+ T-cell counts < 200 cells/ml obtained within 90 days prior to study entry.
STRATIFICATION: Subjects will be stratified at screening based on plasma HIV-1 RNA levels <100,000 and ≥100,000 copies/mL.
REGIMEN: At entry subjects will be randomized to one of the following:
- ARM A: LPV 400 mg/RTV 100 mg BID + FTC 200 mg/TDF 300 mg QD
- ARM B: EFV 600 mg QD/FTC 200 mg/TDF 300 mg fixed dose combination QD
The objective is to determine the differences in the degree of immune reconstitution in HIV-infected patients with a CD4+ T-cell count < 200 cells/ml who initiated treatment with LPV/RTV + FTC/TDF compared to EFV/FTC/TDF.
Study visits will occur at screening, pre-entry, entry and weeks 1, 4, 8, 12, 24 and 48 after study entry. Study medications will be provided at entry after randomization. At most study visits, clinical assessments, including histories, physical exams and determination of drug adherence, will occur. Blood for hematologic and metabolic safety assessments and for the assessment of immune parameters will be obtained. Immune parameters that will be measured include levels of T-cell apoptosis, maturation and activation. Frequencies of various T-cell subsets and other lymphocyte populations will also be done. Response to vaccination with tetanus-diphtheria vaccine and 23-valent pneumococcal polysaccharide vaccine (both given at week 8) will be measured.
Study Type : | Interventional (Clinical Trial) |
Actual Enrollment : | 15 participants |
Allocation: | Randomized |
Intervention Model: | Parallel Assignment |
Masking: | None (Open Label) |
Primary Purpose: | Treatment |
Official Title: | A Phase 4 Study of the Effect on Immune Reconstitution of a Lopinavir/Ritonavir-Based Versus an Efavirenz-based HAART (Highly Active Antiretroviral Therapy) Regimen in Antiretroviral-Naïve Subjects With Advanced HIV Disease |
Study Start Date : | October 2008 |
Actual Primary Completion Date : | December 2010 |
Actual Study Completion Date : | January 2011 |

Arm | Intervention/treatment |
---|---|
Active Comparator: ARM A/Lopinar/ritonavir
Subjects randomized to Arm A initiated Lopinavir 400 mg/ritonavir 100 mg BID + emtricitabine 200 mg/tenofovir 300 mg QD
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Drug: Lopinavir 400 mg/ritonavir 100 mg
Lopinavir 400 mg/ritonavir 100 mg fixed dose combination BID + emtricitabine 200 mg/tenofovir 300 mg fixed dose combination QD
Other Names:
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Active Comparator: ARM B/Efavirenz
Subjects randomized to Arm B initiated Efavirenz 600 mg/emtricitabine 200 mg/tenofovir 300 mg QD
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Drug: Efavirenz
Efavirenz 600 mg/emtricitabine 200 mg/tenofovir 300 mg fixed dose combination QD
Other Name: Atripla
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- CD4+ (Cluster of Differentiation 4) T-cell Apoptosis [ Time Frame: 24 weeks from treatment initiation (baseline and week 24) ]Change in the percentage of naive CD4 T-cells undergoing apoptosis as measured by propidium iodide staining. This is a lab test that measures the percentage of naive CD4 T-cells that are undergoing cell death. The change in this measure is obtained by determining the difference between the percentage of naive CD4 T-cells undergoing apoptosis at week 24 of treatment and the percentage undergoing apoptosis at baseline.
- CD4+ T-cell Change [ Time Frame: 24 weeks after treatment initiation (baseline and week 24) ]This measures the change in CD4+ T-cells from baseline to week 24 of treatment.
- Naive, Central Memory and Effector Memory CD4+ and CD8+ (Cluster of Differentiation 8) T-cell Frequency [ Time Frame: 4, 12 and 24 weeks after treatment initiation ]
- Activated and Regulatory CD4+ and CD8+ T-cell Frequencies [ Time Frame: 4, 12 and 24 weeks after treatment initiation ]
- Response to Immunization With Pneumococcus Polysaccharide and Tetanus-diphtheria Vaccines [ Time Frame: 4 weeks after treatment initiation ]Response to immunization with pneumococcus polysaccharide and tetanus-diphtheria vaccines was not done due to small sample size

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Ages Eligible for Study: | 18 Years to 60 Years (Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- HIV-1 infection
- The absence of exclusionary resistance mutations on a genotypic resistance assay
- Antiretroviral (ARV) drug-naïve
- Screening HIV-1 RNA >1000 copies/mL
- Screening CD4+ T-cell count < 200 cells/ml
-
Laboratory values obtained within 30 days prior to study entry.
- Absolute neutrophil count (ANC) >500/mm3
- Hemoglobin >8.0 g/dL
- Platelet count >40,000/mm3
- AST (SGOT), ALT (SGPT), and alkaline phosphatase <5 x ULN
- Total bilirubin <2.5 x ULN
- Calculated creatinine clearance ≥60 mL/min (by Cockcroft-Gault equation)
- For women of reproductive potential, negative serum or urine pregnancy test within 48 hours prior to initiating study medications.
- Contraception requirements
- Men and women age >18 years and < 60 years.
- Ability and willingness of subject or legal guardian/representative to give written informed consent.
Exclusion Criteria:
- Currently breast-feeding.
- Use of immunomodulators, vaccines, growth hormone, systemic cytotoxic chemotherapy, or investigational therapy within 30 days prior to study entry.
- Known allergy/sensitivity to study drugs, pneumococcal polysaccharide vaccine, tetanus-diphtheria vaccine
- Receipt of pneumococcal polysaccharide vaccine or tetanus-diphtheria vaccine in the past 5 years.
- Active drug or alcohol use or dependence
- Serious illness requiring systemic treatment and/or hospitalization until candidate either completes therapy or is clinically stable on therapy, in the opinion of the site investigator, for at least 14 days prior to study entry.
- Requirement for any current medications that are prohibited with any study treatment.
- Evidence of any major resistance-associated mutation on any genotype or evidence of significant resistance on any phenotype performed at any time prior to study entry
- Current or anticipated imprisonment or involuntary incarceration in a medical facility for psychiatric or physical (e.g., infectious disease) illness
- History of, or current bipolar disorder, major depression, schizophrenia or other psychotic disorders

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): NCT00775606
United States, Illinois | |
Rush University Medical Center | |
Chicago, Illinois, United States, 60612 | |
University of Illinois Medical Center | |
Chicago, Illinois, United States, 60612 | |
Howard Brown Health Center | |
Chicago, Illinois, United States, 60613 | |
University of Chicago Hospital | |
Chicago, Illinois, United States, 60637 |
Study Chair: | Allan R. Tenorio, M.D. | Rush University Medical Center |
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: | Allan Tenorio, MD, MD, Rush University Medical Center |
ClinicalTrials.gov Identifier: | NCT00775606 History of Changes |
Other Study ID Numbers: |
ICE-001 |
First Posted: | October 20, 2008 Key Record Dates |
Results First Posted: | May 29, 2014 |
Last Update Posted: | June 9, 2014 |
Last Verified: | May 2014 |
Keywords provided by Allan Tenorio, MD, Rush University Medical Center:
AIDS, HIV |
Additional relevant MeSH terms:
Immunologic Deficiency Syndromes Acquired Immunodeficiency Syndrome HIV Infections Immune System Diseases Lentivirus Infections Retroviridae Infections RNA Virus Infections Virus Diseases Sexually Transmitted Diseases, Viral Sexually Transmitted Diseases Slow Virus Diseases Ritonavir Lopinavir Tenofovir Emtricitabine |
Efavirenz HIV Protease Inhibitors Protease Inhibitors Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action Anti-HIV Agents Anti-Retroviral Agents Antiviral Agents Anti-Infective Agents Cytochrome P-450 CYP3A Inhibitors Cytochrome P-450 Enzyme Inhibitors Reverse Transcriptase Inhibitors Nucleic Acid Synthesis Inhibitors Cytochrome P-450 CYP2C9 Inhibitors Cytochrome P-450 CYP2C19 Inhibitors |