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National Multicenter Trial Evaluating Two Treatments in Patients With Primary Human Immunodeficiency Virus (HIV-1) Infection (OPTIPRIM-2)

Primary Purpose

HIV-1 Infection

Status
Completed
Phase
Phase 3
Locations
France
Study Type
Interventional
Intervention
Dolutegravir
Darunavir-cobicistat
Emtricitabine-Tenofovir
Sponsored by
ANRS, Emerging Infectious Diseases
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for HIV-1 Infection focused on measuring primary infection

Eligibility Criteria

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

Inclusion Criteria:

  • Age ≥ 18 years at screening visit.
  • Patients with primary HIV-1 infection: Any results achieved in the previous 10 days of inclusion visit will be taken into account. If the Enzyme Linked ImmunoSorbent Assay (ELISA) test result does not dissociate the signals antibodies and p24 antigen or in case of rapid test result :

    • Negative ELISA / rapid test and positive HIV-1 RNA confirmed by a second positive HIV-1 RNA.
    • Positive ELISA / rapid test and WB-HIV1 [0-5] band (s) or IB-HIV-1 [0-3] band(s) confirmed by a positive HIV-1 RNA.

If the ELISA test result dissociated p24 antigen and antibodies signals:

  • ELISA Ac - / p24 - and positive HIV-1 RNA confirmed by a second positive HIV-1 RNA.
  • ELISA Ac - / p24 + confirmed by a positive HIV-1 RNA.
  • ELISA Ac + / p24 + or - and WB-HIV1 [0-5] band (s) or IB-HIV-1 [0-3] band(s) confirmed by a positive HIV-1 RNA.

    • Written informed consent signed by the person and the investigator no later than the day of the screening visit and before any exam performed in the trial (article L1122-1-1 Public Health Code).
    • Affiliate or beneficiary of a social security system (Article L1121-11 of the Public Health Code) (the State Medical Aid or AME is not a social security system).
    • Patients followed in selected centers, accepting additional constraints and having signed a consent, will participate to virological, immunological and pharmacological sub-studies.
    • Patient agreeing to participate in the trial for 1 year according to the defined terms.

Exclusion Criteria:

  • Any antiretroviral treatment (for Pre-Exposure Prohylaxis or Post-exposure prophylaxis) during the 4 weeks preceding inclusion.
  • Associated pathology with urgent care needed.
  • Prothrombin Ratio < 50%.
  • Creatinine clearance < 70 mL / min (Cockroft).
  • aspartate transaminase (AST), alanine transaminase (ALT), or bilirubin (total and conjugated) ≥ 10 times the upper limit of normal.
  • Patient with isolated HIV-2 viral strain.
  • Women of childbearing potential without effective contraception method (see appendix A6).
  • Pregnant or breastfeeding women.
  • Person under legal guardianship or deprived of liberty by a judicial or administrative decision.
  • Patient participating in another research evaluating other treatments with an exclusion period ongoing at the screening visit.
  • Planned absence which could prevent optimal trial participation (vacation abroad, moving, imminent job change ...).
  • Co-administration of prohibited treatments (see § 9.5).
  • History or presence of allergy to the study drugs or their components;
  • Unstable liver disease (as defined by the presence of ascites, encephalopathy, coagulopathy, hypoalbuminemia, esophageal or gastric varices, or persistent jaundice), known biliary abnormalities (with the exception of Gilbert's syndrome or asymptomatic gallstones).
  • Subjects with severe hepatic impairment (Class C) as determined by Child-Pugh classification.
  • Any symptoms or laboratory values suggesting a systemic disorder (renal, hepatic, cardiovascular, pulmonary) or other medical conditions that could interfere with the interpretation of trial results or compromise the health of patients.

Sites / Locations

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Dolutegravir + Emtricitabine/Tenofovir

Darunavir/Cobicistat + Emtricitabine/Ténofovir

Arm Description

Patients will take Dolutegravir 50 mg (= Tivicay, 1 tablet per day) with Emtricitabine 200 mg / Ténofovir 245 mg (=Truvada, 1 tablet per day) for 48 weeks

Patients will take Darunavir 800 mg / Cobicistat 150 mg (=Rezolsta, 1 tablet per day) + Emtricitabine 200 mg / Ténofovir 245 mg (=Truvada, 1 tablet per day) for 48 weeks

Outcomes

Primary Outcome Measures

HIV-DNA levels in the peripheral blood mononuclear cell (PBMC) at week 48

Secondary Outcome Measures

Cumulative cellular viremia up to week 48
Cumulative plasmatic viremia (HIV-1 RNA) at week 48
Cumulative plasmatic viremia using the values obtained by ultrasensitive quantification for all HIV-1-RNA values < 50 copies / mL.
Levels of HIV-1 RNA in plasma at week 2, week 4, week 8, week 12, week 24, week 36, week 48 and changes between week 0 and week 48
Percentage of patients with HIV-1 RNA <50 copies / mL at week 2, week 4, week 8, week 12, week 24, week 36, week 48
Proportion of patients with HIV-1-RNA plasma below the ultrasensitive technique quantification threshold at week 2, week 4, week 8, week 12, week 24, week 36 and week 48
Total DNA-HIV levels measured in PBMC at week 2, week 4, week 8, week 12, week 24, week 36 and week 48
Total DNA-HIV levels measured in PBMC: changes between week 0 and week 48.
CD4 and CD8 counts and percentage at week 2, week 4, week 8, week 12, week 24, week 36, week 48.
CD4 and CD8 counts and percentage changes between week 0 and week 48.
CD4/CD8 ratio at week 2, week 4, week 8, week 12, week 24, week 36, week 48.
CD4/CD8 ratio changes between week 0 and week 48.
Pharmacokinetic: mean concentrations between week 0 and week 48 will be linked to plasma RNA-VIH and DNA-VIH decrease.
Pharmacokinetic: cumulative AUC between week 0 and week 48 will be linked to plasma RNA-VIH and DNA-VIH decrease.
Trial treatments tolerance using self-administered questionnaires of symptoms experienced.
Reported quality of life using self-administered questionnaire (PROQOL-HIV questionnaire).
Number, nature and time of occurrence of stage 3 or 4 clinical and biological adverse events (using ANRS scale to grade severity of adverse events in adults).
HIV infection progression defined by occurrence of B or C stage clinical events or death between week 0 and week 48
Evolution of Metabolic disorders assessed by measurement of cholesterol, triglycerides, blood glucose and lipase
Evolution of Renal function assessed by urea and serum creatinine.
Adherence to treatments using self-administered questionnaires
Adherence to treatments using pills' counts by local pharmacist
Adherence to treatments using MEMS (Medical Event Monitoring System) data collected during the first 3 months

Full Information

First Posted
November 30, 2016
Last Updated
January 3, 2022
Sponsor
ANRS, Emerging Infectious Diseases
Collaborators
Institut National de la Santé Et de la Recherche Médicale, France
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1. Study Identification

Unique Protocol Identification Number
NCT02987530
Brief Title
National Multicenter Trial Evaluating Two Treatments in Patients With Primary Human Immunodeficiency Virus (HIV-1) Infection
Acronym
OPTIPRIM-2
Official Title
Phase III Multicenter Randomized Trial Evaluating in Patients at the Time of the Primary HIV-1 Infection, the Impact on the Viral Reservoir of a Combination Including Tenofovir/Emtricitabine and Dolutegravir or Tenofovir/Emtricitabine and Darunavir/Cobicistat
Study Type
Interventional

2. Study Status

Record Verification Date
August 2019
Overall Recruitment Status
Completed
Study Start Date
April 11, 2017 (Actual)
Primary Completion Date
July 30, 2019 (Actual)
Study Completion Date
January 31, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
ANRS, Emerging Infectious Diseases
Collaborators
Institut National de la Santé Et de la Recherche Médicale, France

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to compare the impact of two combination of two tablets once daily: dolutegravir associated with emtricitabine / tenofovir versus darunavir / cobicistat associated with emtricitabine / tenofovir on DNA HIV measured in PBMC at 48 weeks in patients with primary HIV-1 infection.
Detailed Description
Phase III, randomized (1: 1), comparative, superiority, open-label, parallel assignment, national multicenter trial evaluating two treatments in patients with primary HIV-1 infection. Comparison of the two combinations regarding: Viral reservoir at W48 Early inhibition of viral replication, Plasmatic and cellular cumulative viremia at W48, Immune reconstitution with CD4, CD8 levels and CD4 / CD8 ratio, Activation parameters decrease, Adherence to treatments, Treatments tolerance, Adverse events, Quality of life (by self-administered questionnaires). Study of the pharmacokinetics / dynamics relationship of the decay of plasma, cellular and spermatic compartments' viral loads. 50 participants per group will be enrolled in 40 sites in France. Co- inclusion in ANRS CO 06 PRIMO cohort will be offered

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HIV-1 Infection
Keywords
primary infection

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
101 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Dolutegravir + Emtricitabine/Tenofovir
Arm Type
Experimental
Arm Description
Patients will take Dolutegravir 50 mg (= Tivicay, 1 tablet per day) with Emtricitabine 200 mg / Ténofovir 245 mg (=Truvada, 1 tablet per day) for 48 weeks
Arm Title
Darunavir/Cobicistat + Emtricitabine/Ténofovir
Arm Type
Active Comparator
Arm Description
Patients will take Darunavir 800 mg / Cobicistat 150 mg (=Rezolsta, 1 tablet per day) + Emtricitabine 200 mg / Ténofovir 245 mg (=Truvada, 1 tablet per day) for 48 weeks
Intervention Type
Drug
Intervention Name(s)
Dolutegravir
Other Intervention Name(s)
Tivicay
Intervention Description
Oral use, 50mg/day
Intervention Type
Drug
Intervention Name(s)
Darunavir-cobicistat
Other Intervention Name(s)
Rezolsta
Intervention Description
Oral use, 800-150mg/day
Intervention Type
Drug
Intervention Name(s)
Emtricitabine-Tenofovir
Other Intervention Name(s)
Truvada
Intervention Description
Oral use, Emtricititabine : 200mg/day Ténofovir : 245mg
Primary Outcome Measure Information:
Title
HIV-DNA levels in the peripheral blood mononuclear cell (PBMC) at week 48
Time Frame
week 48
Secondary Outcome Measure Information:
Title
Cumulative cellular viremia up to week 48
Time Frame
week 48
Title
Cumulative plasmatic viremia (HIV-1 RNA) at week 48
Time Frame
week 48
Title
Cumulative plasmatic viremia using the values obtained by ultrasensitive quantification for all HIV-1-RNA values < 50 copies / mL.
Time Frame
week 48
Title
Levels of HIV-1 RNA in plasma at week 2, week 4, week 8, week 12, week 24, week 36, week 48 and changes between week 0 and week 48
Time Frame
week 2, week 4, week 8, week 12, week 24, week 36, week 48
Title
Percentage of patients with HIV-1 RNA <50 copies / mL at week 2, week 4, week 8, week 12, week 24, week 36, week 48
Time Frame
week 2, week 4, week 8, week 12, week 24, week 36, week 48
Title
Proportion of patients with HIV-1-RNA plasma below the ultrasensitive technique quantification threshold at week 2, week 4, week 8, week 12, week 24, week 36 and week 48
Time Frame
week 2, week 4, week 8, week 12, week 24, week 36 and week 48
Title
Total DNA-HIV levels measured in PBMC at week 2, week 4, week 8, week 12, week 24, week 36 and week 48
Time Frame
week 2, week 4, week 8, week 12, week 24, week 36 and week 48
Title
Total DNA-HIV levels measured in PBMC: changes between week 0 and week 48.
Time Frame
between week 0 and week 48
Title
CD4 and CD8 counts and percentage at week 2, week 4, week 8, week 12, week 24, week 36, week 48.
Time Frame
week 2, week 4, week 8, week 12, week 24, week 36, week 48
Title
CD4 and CD8 counts and percentage changes between week 0 and week 48.
Time Frame
between week 0 and week 48.
Title
CD4/CD8 ratio at week 2, week 4, week 8, week 12, week 24, week 36, week 48.
Time Frame
week 2, week 4, week 8, week 12, week 24, week 36, week 48
Title
CD4/CD8 ratio changes between week 0 and week 48.
Time Frame
between week 0 and week 48.
Title
Pharmacokinetic: mean concentrations between week 0 and week 48 will be linked to plasma RNA-VIH and DNA-VIH decrease.
Time Frame
between week 0 and week 48
Title
Pharmacokinetic: cumulative AUC between week 0 and week 48 will be linked to plasma RNA-VIH and DNA-VIH decrease.
Time Frame
between week 0 and week 48
Title
Trial treatments tolerance using self-administered questionnaires of symptoms experienced.
Time Frame
week 0, week 4, week 8, week 12, week 24, week 36 and week 48
Title
Reported quality of life using self-administered questionnaire (PROQOL-HIV questionnaire).
Time Frame
between week 0 and week 48
Title
Number, nature and time of occurrence of stage 3 or 4 clinical and biological adverse events (using ANRS scale to grade severity of adverse events in adults).
Time Frame
between week 0 and week 48
Title
HIV infection progression defined by occurrence of B or C stage clinical events or death between week 0 and week 48
Time Frame
between week 0 and week 48
Title
Evolution of Metabolic disorders assessed by measurement of cholesterol, triglycerides, blood glucose and lipase
Time Frame
between week 0 and week 48
Title
Evolution of Renal function assessed by urea and serum creatinine.
Time Frame
between week 0 and week 48
Title
Adherence to treatments using self-administered questionnaires
Time Frame
week 4, week 8, week 12, week 24, week 36 and week 48
Title
Adherence to treatments using pills' counts by local pharmacist
Time Frame
week 4, week 8, week 12, week 24 and week 36
Title
Adherence to treatments using MEMS (Medical Event Monitoring System) data collected during the first 3 months
Time Frame
between week 0 and week 12

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age ≥ 18 years at screening visit. Patients with primary HIV-1 infection: Any results achieved in the previous 10 days of inclusion visit will be taken into account. If the Enzyme Linked ImmunoSorbent Assay (ELISA) test result does not dissociate the signals antibodies and p24 antigen or in case of rapid test result : Negative ELISA / rapid test and positive HIV-1 RNA confirmed by a second positive HIV-1 RNA. Positive ELISA / rapid test and WB-HIV1 [0-5] band (s) or IB-HIV-1 [0-3] band(s) confirmed by a positive HIV-1 RNA. If the ELISA test result dissociated p24 antigen and antibodies signals: ELISA Ac - / p24 - and positive HIV-1 RNA confirmed by a second positive HIV-1 RNA. ELISA Ac - / p24 + confirmed by a positive HIV-1 RNA. ELISA Ac + / p24 + or - and WB-HIV1 [0-5] band (s) or IB-HIV-1 [0-3] band(s) confirmed by a positive HIV-1 RNA. Written informed consent signed by the person and the investigator no later than the day of the screening visit and before any exam performed in the trial (article L1122-1-1 Public Health Code). Affiliate or beneficiary of a social security system (Article L1121-11 of the Public Health Code) (the State Medical Aid or AME is not a social security system). Patients followed in selected centers, accepting additional constraints and having signed a consent, will participate to virological, immunological and pharmacological sub-studies. Patient agreeing to participate in the trial for 1 year according to the defined terms. Exclusion Criteria: Any antiretroviral treatment (for Pre-Exposure Prohylaxis or Post-exposure prophylaxis) during the 4 weeks preceding inclusion. Associated pathology with urgent care needed. Prothrombin Ratio < 50%. Creatinine clearance < 70 mL / min (Cockroft). aspartate transaminase (AST), alanine transaminase (ALT), or bilirubin (total and conjugated) ≥ 10 times the upper limit of normal. Patient with isolated HIV-2 viral strain. Women of childbearing potential without effective contraception method (see appendix A6). Pregnant or breastfeeding women. Person under legal guardianship or deprived of liberty by a judicial or administrative decision. Patient participating in another research evaluating other treatments with an exclusion period ongoing at the screening visit. Planned absence which could prevent optimal trial participation (vacation abroad, moving, imminent job change ...). Co-administration of prohibited treatments (see § 9.5). History or presence of allergy to the study drugs or their components; Unstable liver disease (as defined by the presence of ascites, encephalopathy, coagulopathy, hypoalbuminemia, esophageal or gastric varices, or persistent jaundice), known biliary abnormalities (with the exception of Gilbert's syndrome or asymptomatic gallstones). Subjects with severe hepatic impairment (Class C) as determined by Child-Pugh classification. Any symptoms or laboratory values suggesting a systemic disorder (renal, hepatic, cardiovascular, pulmonary) or other medical conditions that could interfere with the interpretation of trial results or compromise the health of patients.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Antoine Chéret, MD, PhD
Organizational Affiliation
Hôpital Bicêtre
Official's Role
Principal Investigator
Facility Information:
City
All The Regions Of The Country (40 Centers)
Country
France

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

National Multicenter Trial Evaluating Two Treatments in Patients With Primary Human Immunodeficiency Virus (HIV-1) Infection

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