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Minocycline for the Treatment of Decreased Mental Function in HIV-Infected Adults

Primary Purpose

HIV Infections

Status
Terminated
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Minocycline
Placebo (Tetracycline)
Sponsored by
AIDS Clinical Trials Group
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for HIV Infections focused on measuring Treatment Experienced

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: HIV infected Currently on a stable ART regimen for at least 16 consecutive weeks prior to study entry. Participants whose regimens have changed with respect to dose or formulation are eligible, but patients who have changed to different drugs in the same class are not eligible. Participants taking atazanavir must also be taking ritonavir or a ritonavir-boosted drug to be eligible for this study. More information on this criterion can be found in the protocol. Plan to stay on current ART regimen between study screening and Week 24 AIDS Dementia Scale (ADC) Stage greater than 0 Cognitive impairment, as evidenced by neuropsychological tests administered at screening Progressive neurocognitive decline. More information on this criterion can be found in the protocol. Estimated premorbid IQ of 70 or higher indicated by an age-corrected scaled score of 5 or higher on the vocabulary section of the Wechsler Adult Intelligence Scale Revised (WAIS-R) administered at study screening Karnofsky performance score of 60 or higher Ability to sit and stand for at least 2 hours and swallow medications with an 8-ounce glass of water Willing to use acceptable methods of contraception Willing to adhere to study schedule Exclusion Criteria: Current cancers. Patients with basal cell carcinoma, in situ carcinoma of the cervix, or Kaposi's sarcoma without evidence of visceral involvement or cancer not requiring systemic chemotherapy are not excluded. Severe premorbid psychiatric illness, including schizophrenia and major depression, which, in the opinion of the investigator, may interfere with the study Active symptomatic AIDS-defining opportunistic infection within 45 days prior to study entry Previous or current confounding neurological disorders. More information on this criterion can be found in the protocol. Central nervous system infections or cancers. More information on this criterion can be found in the protocol. Systemic lupus Thyroid disease diagnosed within 24 weeks of study entry Active drug or alcohol abuse that, in the opinion of the investigator, may interfere with the study Serious illness requiring systemic treatment or hospitalization. Patients who complete therapy or are clinically stable on therapy are not excluded. Investigational agents within 45 days prior to study entry. Patients taking expanded access drugs or drugs used in an ACTG protocol for HIV treatment or for HIV-associated complications that are not prohibited by this protocol are not excluded. History of allergy/sensitivity to minocycline or other tetracyclines and their formulations Any esophageal or other condition that would interfere with a patient's ability to swallow study medication Participation in a previous clinical drug research trial of HIV-associated cognitive impairment. Patients who have had an objective decline in performance as defined by the protocol are not excluded. Any other clinically significant condition or laboratory abnormality that, in the opinion of the investigator, would interfere with the study Certain medications Certain abnormal laboratory values. Patients who test positive on nonreactive rapid plasma reagin tests (RPR)are not excluded. Inability to undergo lumbar punctures Breastfeeding

Sites / Locations

  • UCLA-David Geffen School of Medicine
  • University of California
  • University of Colorado Health Science Center
  • The Ponce de Leon Ctr. CRS
  • Northwestern University CRS
  • Johns Hopkins School of Medicine
  • Massachusetts General Hospital, Division of Infectious Diseases
  • Henry Ford Hosp. CRS
  • Washington University
  • NYU Med Ctr, Dept of Medicine
  • 1101 University of Rochester Medical Center, Division of Infectious Diseases
  • University of North Carolina, AIDS Clinical Trials Unit
  • The Research and Education Group - Portland CRS
  • University of Pennsylvania, ACTU
  • Virginia Commonwealth Univ. Medical Ctr. CRS
  • Univ of Washington, Harborview Medical Ctr

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Arm 1: Minocycline

Arm 2: Matching placebo

Arm Description

100 mg orally every 12 hours

orally every 12 hours

Outcomes

Primary Outcome Measures

Change in Cognitive Performance Compared to Baseline
Th cognitive performance is measured by NPZ-8. NPZ-8 is defined as the average of age and education adjusted z-scores of eight neuropsychological tests subcomponents in the neuropsychological test battery. These eight tests are: Grooved Pegboard Dominant Hand (GPD) Grooved Pegboard Non-dominant hand (GPN) Choice Reaction Time (CRT) Sequential Reaction Time (QRT) Timed Gait (TIG) Trail Making Part A (TMA) Trail Making Part B (TMB) Symbol Digit (SYD) The primary outcome is NPZ-8 score at week24 - NPZ-8 score at baseline.

Secondary Outcome Measures

Change in Global Deficit Z-Score (GDS)
GDS on the test battery is the simple average of all 14 individual deficit scores in the test battery, including Time Gait, Grooved Pegboard Test for the dominant and non-dominant hands, Trail Making Test parts A and B, Symbol Digit Test, simple and sequential reaction time - CalCAP, Hopkins Verbal Learning Test (Revised)- Learning, Delayed Recall and Recognition trials, and Stroop Color Interference Test-color, word, and interference tasks. The outcome is the 24 week change of GDS Z-score (24 week-baseline).
Change in Investigator's Clinical Global Impression Score (ICGIS)
Clinicians were asked to rate their overall impression about the clinical improvement or worsening of his/her study participants. They can choose from the following 7 levels: (0) No Change, (1) Mild Improvement, (2) Moderate Improvement, (3) Marked Improvement, (4) Mild Worsening, (5) Moderate Worsening, and (6) Marked Worsening. For the analysis, we simplified the outcome into the following 3 levels: (0) worsened, (1) No Change, and (2) Improved.
Change in Cognitive Gross Motor Function Domain Z-Score
The cognitive gross motor function is a age and education adjusted z score of Timed Gait (TIG). The outcome is the 24 week change of cognitive gross motor function domain z-scores (week 24-baseline).
Change in Fine Motor Function Domain Z-Score
The fine motor function domain score is an average of age, sex, education, and African-American ethnicity adjusted z scores of Grooved Pegboard Dominant Hand (GPD) and Grooved Pegboard Non-dominant hand (GPN). The outcome is a 24 week change of the fine motor function domain z-score (week 24-baseline).
Change in Psychomotor Function Domain Z-Score
The psychomotor function domain score us the average of age, sex, education, and African-American ethnicity adjusted z scores of Trail Making Part A (TMA) and Trail Making Part B (TMB). The outcome is the 24 week change of psychomotor function domain z-scores (week24-baseline).
Change in Fine Motor/Nonverbal Function Domain Z-Score
The fine motor/nonverbal function domain score is a age and education adjusted z score of Symbol Digit Test (SYD) The outcome is the 24 change of fine motor/nonverbal function domain z-score (week 24-baseline).
Change in Information Processing Function Domain Z-Score
The information processing function domain score is the average of age and education adjusted z scores of simple and sequential reaction time - CalCAP. The outcome is the 24 week change of information processing function domain z-scores (week 24-baseline).
Change in Verbal Memory Domain Z-Score
The verbal memory domain score is the average of age and education adjusted z scores of Hopkins Verbal Learning Test- Revised, Learning and Delayed Recall. The outcome is the 24 week change of verbal memory domain z-scores (week 24-baseline).
Change in Frontal Systems Function Domain Z-Score
The frontal systems function domain score is the average of age and education adjusted z scores of Stroop Color Interference Test (CTP) and interference task (STP). The outcome is the 24 week change of frontal systems function domain z-score (week 24-baseline).
Change in Karnofsky Performance Score
The original Karnofsky performance score is 11 level score which ranges between 0 to 100. The score 100 means normal and 0 means death; therefore, higher score means higher ability to perform daily tasks. For the analysis, a new dichotomous variable (no change/worse vs. better at 24 weeks compared to baseline) was created.
Changes in Cluster of Differentiation 4 (CD4) Cell Counts (24 Weeks)
The outcome was the 24 week change in CD4 cell count (week 24-baseline).
Changes in Cluster of Differentiation 8 (CD8) Cell Counts (24 Weeks)
The outcome was the 24 week change of CD8 cell counts (week 24-baseline).
Number of Participants With Grade 2 or Higher Toxicity and/or Signs and Symptoms
Grade or higher means that adverse events were moderate, severe, or life-threatening, or death. Grade 2 or higher adverse events are lised in the Adverse Event section.
Change of HIV Plasma RiboNucleic Acid (RNA) Viral Load
The original scale of HIV RNA viral load is between 30 copies/mL to infinitive. The minimum score of 30 is the lowest detectable value. The summary table categorized this continuous value to a dichotomous variable (<30 copies/mL and >= 30 copies/mL).
Changes in Instrumental Activities of Daily Living Questionnaire
The Instrumental Activities of Daily Living (IADL) questionnaire is designed to learn more about how subjects are able to perform common tasks. There are 16 common tasks. For each task, if the score at the time of evaluation is worse than the best in the past, an indicator of 1 is given. Otherwise, the indicator is 0. The overall IADL score is a sum of 16 indicators divided by 16; therefore, the range is between 0 and 1 and the lower score is better. The 24-week change of IADL score was changed into a categorical variable (no change/worse vs. better) at week 24 compare to baseline.
Changes in Medication Management Test (Modified)
The medication management test (modified) is designed to assess participants' medication management ability and their own medications and management. It's the number of how many times participants correctly answered 16 questions. The score ranges between 0 and 16, and higher score indicates better medication management.
Changes in Protein Markers of Oxidative Stress (Unit = Counts Per Second Only)
Protein marker of oxidative stress (Ceramides, Monohexosylceramides, Dihydro Glycosyl Galceramides, and Dihexosylceramides). For all markers, the outcome is the 24 week change (week 24-baseline).
Changes in Markers of Oxidative Stress and Immune Activation (Unit=pg/mL Only)
Protein markers of oxidative stress (Protein carbonyls) and markers of immune activation (TNF-a, IL-6,CXCL8, Hepatocyte growth factor, Osteopontin, sFAS, sFAS ligand, and CXCL12). For all markers, the outcome is the 24 week change (week 24-baseline).
Changes in Markers of Oxidative Stress (Unit = Pixels/mm2 Only)
Protein marker of oxidative stress (Neurofilament heavy polypeptide). The outcome is the 24 week change (week 24-baseline).
Changes in Neurotransmitter Levels (Unit = uM Only)
Neurotransmitter levels (Glutamate, Tryptophan, Anthranilic Acid, Quinolinic Acid, Kynurenin, and 3-Hydroxykynurenine). The outcome is the 24 week change (week 24-baseline).
Changes in Alternate Psychomotor Function Z-Score
The alternate psychomotor function is defined as the mean of age, sex, education, and African-American ethnicity adjusted z scores of Trail Making Part A (TMA), and age and education adjusted z score of Symbol Digit (SYD). The outcome is the 24 week change in alternate psychomotor function z-score (week 24-baseline).
Changes in Alternate Verbal Memory Z-Score
The alternate verbal memory was defined as a mean of age and education adjusted z score of trials 1 to 3 and delayed recall tests. The outcome is the 24 week change in alternate verbal memory z-score (week 24-baseline).
Changes in Alternate Frontal Systems Z-Score
The alternate frontal systems was defined as a mean of age and education adjusted z score of Interference task, and age, sex, education, and African-American ethnicity adjusted z score of Trail Making Part B. The outcome was the 24 week change in alternate frontal systems z-score (week 24-baseline).

Full Information

First Posted
August 4, 2006
Last Updated
January 7, 2016
Sponsor
AIDS Clinical Trials Group
Collaborators
National Institute of Allergy and Infectious Diseases (NIAID), Neurologic AIDS Research Consortium (NARC)
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1. Study Identification

Unique Protocol Identification Number
NCT00361257
Brief Title
Minocycline for the Treatment of Decreased Mental Function in HIV-Infected Adults
Official Title
Phase II, Randomized, Placebo-Controlled, Double-Blind Study of Minocycline in the Treatment of HIV-Associated Cognitive Impairment
Study Type
Interventional

2. Study Status

Record Verification Date
January 2016
Overall Recruitment Status
Terminated
Why Stopped
This study was terminated early due to futility.
Study Start Date
March 2007 (undefined)
Primary Completion Date
January 2010 (Actual)
Study Completion Date
January 2010 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
AIDS Clinical Trials Group
Collaborators
National Institute of Allergy and Infectious Diseases (NIAID), Neurologic AIDS Research Consortium (NARC)

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to determine the effectiveness of minocycline, an antibiotic, in lessening the decreased mental function sometimes caused by anti-HIV drugs.
Detailed Description
Cognitive impairment, including disabling cognitive, behavioral, and social dysfunction, continues to be a major problem faced by HIV-infected people taking antiretroviral therapy (ART). Research is needed to develop treatment that can be given alongside ART to prevent or lessen cognitive impairment caused by ART. Minocycline, an antibiotic commonly used for the treatment of acne and rheumatoid arthritis, has demonstrated anti-inflammatory and neuroprotective properties in previous studies. This study will evaluate the effectiveness of 24-week therapy with minocycline in lessening the cognitive impairment of HIV infected adults taking ART. This study will last at least 24 weeks and has two steps. Patients will be stratified by HIV viral load and their neurocognitive state at study screening. In Step I, patients will be randomly assigned to one of two groups. Group 1 participants will receive twice-daily minocycline for 24 weeks; Group 2 participants will receive placebo. At the end of Phase I, study participants will be offered to enter Step II; all participants in Step II will receive twice-daily minocycline for an additional 24 weeks. There will be a total of 8 study visits: 5 visits for Step I (including the entry visit) and 3 visits for Step II. Medical history will occur at all visits. Blood collection will occur at all visits. Participants who have positive nonreactive rapid plasma regain (RPR) values at screening will have mandatory lumbar punctures; for those with negative serum RPR results lumbar punctures are optional. Participants who test positive for syphilis will also have a lumbar puncture at their discretion to determine if syphilis has affected the brain. A neurological exam, other neuropsychological, dementia, and depression scale assessments, and urine collection will occur at most visits. Patients will be asked to complete a questionnaire on daily living at study entry and Weeks 12 and 24. Patients who have a lumbar puncture at Week 24 will receive a phone call 2 to 5 days after the procedure to report any adverse effects. Some participants may also have an electrocardiogram (ECG) during the study. For participants not on atazanavir some procedures and sample collections are optional.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HIV Infections
Keywords
Treatment Experienced

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare Provider
Allocation
Randomized
Enrollment
107 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Arm 1: Minocycline
Arm Type
Experimental
Arm Description
100 mg orally every 12 hours
Arm Title
Arm 2: Matching placebo
Arm Type
Placebo Comparator
Arm Description
orally every 12 hours
Intervention Type
Drug
Intervention Name(s)
Minocycline
Intervention Description
Tetracycline antibiotic, 100 mg taken orally every 12 hours
Intervention Type
Drug
Intervention Name(s)
Placebo (Tetracycline)
Intervention Description
Tetracycline antibiotic placebo, orally every 12 hours
Primary Outcome Measure Information:
Title
Change in Cognitive Performance Compared to Baseline
Description
Th cognitive performance is measured by NPZ-8. NPZ-8 is defined as the average of age and education adjusted z-scores of eight neuropsychological tests subcomponents in the neuropsychological test battery. These eight tests are: Grooved Pegboard Dominant Hand (GPD) Grooved Pegboard Non-dominant hand (GPN) Choice Reaction Time (CRT) Sequential Reaction Time (QRT) Timed Gait (TIG) Trail Making Part A (TMA) Trail Making Part B (TMB) Symbol Digit (SYD) The primary outcome is NPZ-8 score at week24 - NPZ-8 score at baseline.
Time Frame
At baseline and week 24
Secondary Outcome Measure Information:
Title
Change in Global Deficit Z-Score (GDS)
Description
GDS on the test battery is the simple average of all 14 individual deficit scores in the test battery, including Time Gait, Grooved Pegboard Test for the dominant and non-dominant hands, Trail Making Test parts A and B, Symbol Digit Test, simple and sequential reaction time - CalCAP, Hopkins Verbal Learning Test (Revised)- Learning, Delayed Recall and Recognition trials, and Stroop Color Interference Test-color, word, and interference tasks. The outcome is the 24 week change of GDS Z-score (24 week-baseline).
Time Frame
At baseline and week 24
Title
Change in Investigator's Clinical Global Impression Score (ICGIS)
Description
Clinicians were asked to rate their overall impression about the clinical improvement or worsening of his/her study participants. They can choose from the following 7 levels: (0) No Change, (1) Mild Improvement, (2) Moderate Improvement, (3) Marked Improvement, (4) Mild Worsening, (5) Moderate Worsening, and (6) Marked Worsening. For the analysis, we simplified the outcome into the following 3 levels: (0) worsened, (1) No Change, and (2) Improved.
Time Frame
At week 24
Title
Change in Cognitive Gross Motor Function Domain Z-Score
Description
The cognitive gross motor function is a age and education adjusted z score of Timed Gait (TIG). The outcome is the 24 week change of cognitive gross motor function domain z-scores (week 24-baseline).
Time Frame
At baseline and week 24
Title
Change in Fine Motor Function Domain Z-Score
Description
The fine motor function domain score is an average of age, sex, education, and African-American ethnicity adjusted z scores of Grooved Pegboard Dominant Hand (GPD) and Grooved Pegboard Non-dominant hand (GPN). The outcome is a 24 week change of the fine motor function domain z-score (week 24-baseline).
Time Frame
At baseline and week 24
Title
Change in Psychomotor Function Domain Z-Score
Description
The psychomotor function domain score us the average of age, sex, education, and African-American ethnicity adjusted z scores of Trail Making Part A (TMA) and Trail Making Part B (TMB). The outcome is the 24 week change of psychomotor function domain z-scores (week24-baseline).
Time Frame
At baseline and week 24
Title
Change in Fine Motor/Nonverbal Function Domain Z-Score
Description
The fine motor/nonverbal function domain score is a age and education adjusted z score of Symbol Digit Test (SYD) The outcome is the 24 change of fine motor/nonverbal function domain z-score (week 24-baseline).
Time Frame
At baseline and week 24
Title
Change in Information Processing Function Domain Z-Score
Description
The information processing function domain score is the average of age and education adjusted z scores of simple and sequential reaction time - CalCAP. The outcome is the 24 week change of information processing function domain z-scores (week 24-baseline).
Time Frame
At baseline and week 24
Title
Change in Verbal Memory Domain Z-Score
Description
The verbal memory domain score is the average of age and education adjusted z scores of Hopkins Verbal Learning Test- Revised, Learning and Delayed Recall. The outcome is the 24 week change of verbal memory domain z-scores (week 24-baseline).
Time Frame
At baseline and week 24
Title
Change in Frontal Systems Function Domain Z-Score
Description
The frontal systems function domain score is the average of age and education adjusted z scores of Stroop Color Interference Test (CTP) and interference task (STP). The outcome is the 24 week change of frontal systems function domain z-score (week 24-baseline).
Time Frame
At baseline and week 24
Title
Change in Karnofsky Performance Score
Description
The original Karnofsky performance score is 11 level score which ranges between 0 to 100. The score 100 means normal and 0 means death; therefore, higher score means higher ability to perform daily tasks. For the analysis, a new dichotomous variable (no change/worse vs. better at 24 weeks compared to baseline) was created.
Time Frame
At baseline and week 24
Title
Changes in Cluster of Differentiation 4 (CD4) Cell Counts (24 Weeks)
Description
The outcome was the 24 week change in CD4 cell count (week 24-baseline).
Time Frame
At baseline and weeks 24
Title
Changes in Cluster of Differentiation 8 (CD8) Cell Counts (24 Weeks)
Description
The outcome was the 24 week change of CD8 cell counts (week 24-baseline).
Time Frame
At baseline and week 24
Title
Number of Participants With Grade 2 or Higher Toxicity and/or Signs and Symptoms
Description
Grade or higher means that adverse events were moderate, severe, or life-threatening, or death. Grade 2 or higher adverse events are lised in the Adverse Event section.
Time Frame
Throughout study up to week 48
Title
Change of HIV Plasma RiboNucleic Acid (RNA) Viral Load
Description
The original scale of HIV RNA viral load is between 30 copies/mL to infinitive. The minimum score of 30 is the lowest detectable value. The summary table categorized this continuous value to a dichotomous variable (<30 copies/mL and >= 30 copies/mL).
Time Frame
At baseline and week 24
Title
Changes in Instrumental Activities of Daily Living Questionnaire
Description
The Instrumental Activities of Daily Living (IADL) questionnaire is designed to learn more about how subjects are able to perform common tasks. There are 16 common tasks. For each task, if the score at the time of evaluation is worse than the best in the past, an indicator of 1 is given. Otherwise, the indicator is 0. The overall IADL score is a sum of 16 indicators divided by 16; therefore, the range is between 0 and 1 and the lower score is better. The 24-week change of IADL score was changed into a categorical variable (no change/worse vs. better) at week 24 compare to baseline.
Time Frame
At baseline and week 24
Title
Changes in Medication Management Test (Modified)
Description
The medication management test (modified) is designed to assess participants' medication management ability and their own medications and management. It's the number of how many times participants correctly answered 16 questions. The score ranges between 0 and 16, and higher score indicates better medication management.
Time Frame
At baseline and weeks 24
Title
Changes in Protein Markers of Oxidative Stress (Unit = Counts Per Second Only)
Description
Protein marker of oxidative stress (Ceramides, Monohexosylceramides, Dihydro Glycosyl Galceramides, and Dihexosylceramides). For all markers, the outcome is the 24 week change (week 24-baseline).
Time Frame
At pre-entry and Week 24
Title
Changes in Markers of Oxidative Stress and Immune Activation (Unit=pg/mL Only)
Description
Protein markers of oxidative stress (Protein carbonyls) and markers of immune activation (TNF-a, IL-6,CXCL8, Hepatocyte growth factor, Osteopontin, sFAS, sFAS ligand, and CXCL12). For all markers, the outcome is the 24 week change (week 24-baseline).
Time Frame
At pre-entry and Week 24
Title
Changes in Markers of Oxidative Stress (Unit = Pixels/mm2 Only)
Description
Protein marker of oxidative stress (Neurofilament heavy polypeptide). The outcome is the 24 week change (week 24-baseline).
Time Frame
At pre-entry and Week 24
Title
Changes in Neurotransmitter Levels (Unit = uM Only)
Description
Neurotransmitter levels (Glutamate, Tryptophan, Anthranilic Acid, Quinolinic Acid, Kynurenin, and 3-Hydroxykynurenine). The outcome is the 24 week change (week 24-baseline).
Time Frame
At pre-entry and Week 24
Title
Changes in Alternate Psychomotor Function Z-Score
Description
The alternate psychomotor function is defined as the mean of age, sex, education, and African-American ethnicity adjusted z scores of Trail Making Part A (TMA), and age and education adjusted z score of Symbol Digit (SYD). The outcome is the 24 week change in alternate psychomotor function z-score (week 24-baseline).
Time Frame
At baseline and week 24
Title
Changes in Alternate Verbal Memory Z-Score
Description
The alternate verbal memory was defined as a mean of age and education adjusted z score of trials 1 to 3 and delayed recall tests. The outcome is the 24 week change in alternate verbal memory z-score (week 24-baseline).
Time Frame
At baseline and week 24
Title
Changes in Alternate Frontal Systems Z-Score
Description
The alternate frontal systems was defined as a mean of age and education adjusted z score of Interference task, and age, sex, education, and African-American ethnicity adjusted z score of Trail Making Part B. The outcome was the 24 week change in alternate frontal systems z-score (week 24-baseline).
Time Frame
At baseline and week 24

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: HIV infected Currently on a stable ART regimen for at least 16 consecutive weeks prior to study entry. Participants whose regimens have changed with respect to dose or formulation are eligible, but patients who have changed to different drugs in the same class are not eligible. Participants taking atazanavir must also be taking ritonavir or a ritonavir-boosted drug to be eligible for this study. More information on this criterion can be found in the protocol. Plan to stay on current ART regimen between study screening and Week 24 AIDS Dementia Scale (ADC) Stage greater than 0 Cognitive impairment, as evidenced by neuropsychological tests administered at screening Progressive neurocognitive decline. More information on this criterion can be found in the protocol. Estimated premorbid IQ of 70 or higher indicated by an age-corrected scaled score of 5 or higher on the vocabulary section of the Wechsler Adult Intelligence Scale Revised (WAIS-R) administered at study screening Karnofsky performance score of 60 or higher Ability to sit and stand for at least 2 hours and swallow medications with an 8-ounce glass of water Willing to use acceptable methods of contraception Willing to adhere to study schedule Exclusion Criteria: Current cancers. Patients with basal cell carcinoma, in situ carcinoma of the cervix, or Kaposi's sarcoma without evidence of visceral involvement or cancer not requiring systemic chemotherapy are not excluded. Severe premorbid psychiatric illness, including schizophrenia and major depression, which, in the opinion of the investigator, may interfere with the study Active symptomatic AIDS-defining opportunistic infection within 45 days prior to study entry Previous or current confounding neurological disorders. More information on this criterion can be found in the protocol. Central nervous system infections or cancers. More information on this criterion can be found in the protocol. Systemic lupus Thyroid disease diagnosed within 24 weeks of study entry Active drug or alcohol abuse that, in the opinion of the investigator, may interfere with the study Serious illness requiring systemic treatment or hospitalization. Patients who complete therapy or are clinically stable on therapy are not excluded. Investigational agents within 45 days prior to study entry. Patients taking expanded access drugs or drugs used in an ACTG protocol for HIV treatment or for HIV-associated complications that are not prohibited by this protocol are not excluded. History of allergy/sensitivity to minocycline or other tetracyclines and their formulations Any esophageal or other condition that would interfere with a patient's ability to swallow study medication Participation in a previous clinical drug research trial of HIV-associated cognitive impairment. Patients who have had an objective decline in performance as defined by the protocol are not excluded. Any other clinically significant condition or laboratory abnormality that, in the opinion of the investigator, would interfere with the study Certain medications Certain abnormal laboratory values. Patients who test positive on nonreactive rapid plasma reagin tests (RPR)are not excluded. Inability to undergo lumbar punctures Breastfeeding
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ned Sacktor, MD
Organizational Affiliation
Department of Neurology, Johns Hopkins Bayview Medical Center
Official's Role
Study Chair
Facility Information:
Facility Name
UCLA-David Geffen School of Medicine
City
Los Angeles
State/Province
California
ZIP/Postal Code
90035
Country
United States
Facility Name
University of California
City
San Diego
State/Province
California
ZIP/Postal Code
92103
Country
United States
Facility Name
University of Colorado Health Science Center
City
Denver
State/Province
Colorado
ZIP/Postal Code
80262-3706
Country
United States
Facility Name
The Ponce de Leon Ctr. CRS
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30308
Country
United States
Facility Name
Northwestern University CRS
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
Facility Name
Johns Hopkins School of Medicine
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21287-8106
Country
United States
Facility Name
Massachusetts General Hospital, Division of Infectious Diseases
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02114
Country
United States
Facility Name
Henry Ford Hosp. CRS
City
Detroit
State/Province
Michigan
ZIP/Postal Code
48202
Country
United States
Facility Name
Washington University
City
St. Louis
State/Province
Missouri
ZIP/Postal Code
63108-2138
Country
United States
Facility Name
NYU Med Ctr, Dept of Medicine
City
New York
State/Province
New York
ZIP/Postal Code
10016
Country
United States
Facility Name
1101 University of Rochester Medical Center, Division of Infectious Diseases
City
Rochester
State/Province
New York
ZIP/Postal Code
14642
Country
United States
Facility Name
University of North Carolina, AIDS Clinical Trials Unit
City
Chapel Hill
State/Province
North Carolina
ZIP/Postal Code
27514
Country
United States
Facility Name
The Research and Education Group - Portland CRS
City
Portland
State/Province
Oregon
ZIP/Postal Code
97209
Country
United States
Facility Name
University of Pennsylvania, ACTU
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
Facility Name
Virginia Commonwealth Univ. Medical Ctr. CRS
City
Richmond
State/Province
Virginia
ZIP/Postal Code
23219
Country
United States
Facility Name
Univ of Washington, Harborview Medical Ctr
City
Seattle
State/Province
Washington
ZIP/Postal Code
98104
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
15569045
Citation
Bell JE. An update on the neuropathology of HIV in the HAART era. Histopathology. 2004 Dec;45(6):549-59. doi: 10.1111/j.1365-2559.2004.02004.x.
Results Reference
background
PubMed Identifier
16471077
Citation
Ferrari S, Vento S, Monaco S, Cavallaro T, Cainelli F, Rizzuto N, Temesgen Z. Human immunodeficiency virus-associated peripheral neuropathies. Mayo Clin Proc. 2006 Feb;81(2):213-9. doi: 10.4065/81.2.213.
Results Reference
background
PubMed Identifier
15855434
Citation
Zink MC, Uhrlaub J, DeWitt J, Voelker T, Bullock B, Mankowski J, Tarwater P, Clements J, Barber S. Neuroprotective and anti-human immunodeficiency virus activity of minocycline. JAMA. 2005 Apr 27;293(16):2003-11. doi: 10.1001/jama.293.16.2003.
Results Reference
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PubMed Identifier
21900636
Citation
Sacktor N, Miyahara S, Deng L, Evans S, Schifitto G, Cohen BA, Paul R, Robertson K, Jarocki B, Scarsi K, Coombs RW, Zink MC, Nath A, Smith E, Ellis RJ, Singer E, Weihe J, McCarthy S, Hosey L, Clifford DB; ACTG A5235 team. Minocycline treatment for HIV-associated cognitive impairment: results from a randomized trial. Neurology. 2011 Sep 20;77(12):1135-42. doi: 10.1212/WNL.0b013e31822f0412. Epub 2011 Sep 7.
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PubMed Identifier
25377444
Citation
Sacktor N, Miyahara S, Evans S, Schifitto G, Cohen B, Haughey N, Drewes JL, Graham D, Zink MC, Anderson C, Nath A, Pardo CA, McCarthy S, Hosey L, Clifford D; ACTG A5235 team. Impact of minocycline on cerebrospinal fluid markers of oxidative stress, neuronal injury, and inflammation in HIV-seropositive individuals with cognitive impairment. J Neurovirol. 2014 Dec;20(6):620-6. doi: 10.1007/s13365-014-0292-0. Epub 2014 Nov 7.
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Minocycline for the Treatment of Decreased Mental Function in HIV-Infected Adults

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