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The Benefits of Immediate Treatment Initiation Without Immunovirological Data Compared to Conventional BIC / FTC / TAF Treatment in Naive Patients With Type 1 HIV (Human Immunodeficiency Virus) Infection

Primary Purpose

HIV-1-infection

Status
Completed
Phase
Phase 4
Locations
Spain
Study Type
Interventional
Intervention
BIC/FTC/TAF: Bictegravir/emtricitabina/tenofovir alafenamida fumarato
Sponsored by
Instituto de Investigación Sanitaria de la Fundación Jiménez Díaz
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for HIV-1-infection

Eligibility Criteria

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

Inclusion Criteria: - Men and women > 18 years old Confirmed and documented diagnosis of HIV-1 infection Without prior antiretroviral treatment (excluding 28-day post-exposure prophylaxis) Signed informed consent Negative pregnancy test (women of childbearing age only). Women of childbearing age are considered to be those women who have not undergone permanent infertility procedures or who have been amenorrheic for less than 12 months Exclusion Criteria: Inability to obtain written informed consent to participate in the study Pregnant or breastfeeding women or those who intend to become pregnant during the study period and do not undertake to use proven contraceptive methods Any suspicion or confirmation of resistance to TAF, FTC or BIC Estimated glomerular filtration rate (TFGe) <30 mg / ml / m2 measured by any of the available formulas. The determination of the TFGe of a routine prior analysis of ≤ 12 weeks prior to the signing of the consent is allowed Contraindications to the use of TAF Clinical condition of the patient in rapid deterioration or the investigator considers that there is no reasonable hope that the patient will end the study Simultaneous participation in another clinical trial or research study that requires the need for treatment with other drugs outside the study or interferes with visits to it. Any situation that, in the opinion of the investigator, may interfere with the patient's ability to comply with the treatment schedule and protocol evaluations

Sites / Locations

  • Hospital FUNDACIÓN JIMÉNEZ DÍAZ

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

SDT

Conventional

Arm Description

-75 patients of immediate treatment, will be those patients without immuno-virological data that accept to start the treatment the same day of the first consultation with the hospital specialist (arm 1 or SDT).

- 75 patients of conventional treatment, will be those who in their first consultation with the hospital specialist already have previous immuno-virological data or reject the start of immediate treatment (arm 2 or conventional).

Outcomes

Primary Outcome Measures

Efficacy of immediate treatment.
The time in weeks from the first determination of CD4 and HIV-1 viral load until achieving HIV viral load <50 cop/ml, in number.

Secondary Outcome Measures

Secondary Efficacy Endpoints
CD4 cell count in number Time from HIV diagnosis to achieving undetectable HIV viral load, in weeks. Degree of anxiety of patients (mild, moderate and severe degree according to the HADS scale). Number of sexual contacts with potential for transmission of HIV infection, in number. Quality of patients before and after SDT, según escala EQ-5D 5 (numerical value from 1 to 5).

Full Information

First Posted
September 15, 2022
Last Updated
November 2, 2022
Sponsor
Instituto de Investigación Sanitaria de la Fundación Jiménez Díaz
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1. Study Identification

Unique Protocol Identification Number
NCT05606055
Brief Title
The Benefits of Immediate Treatment Initiation Without Immunovirological Data Compared to Conventional BIC / FTC / TAF Treatment in Naive Patients With Type 1 HIV (Human Immunodeficiency Virus) Infection
Official Title
Phase IV, Single-center, Open Study to Evaluate the Benefits of the Start of Immediate Treatment Without Immunovirological Data ("Same Day Treatment") Compared to Conventional Treatment With BIC / FTC / TAF (Bictegravir/Emtricitabina/Tenofovir) in Naive Patients With Type 1 HIV (Human Immunodeficiency Virus) Infection
Study Type
Interventional

2. Study Status

Record Verification Date
October 2022
Overall Recruitment Status
Completed
Study Start Date
December 1, 2020 (Actual)
Primary Completion Date
February 1, 2021 (Actual)
Study Completion Date
March 3, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Instituto de Investigación Sanitaria de la Fundación Jiménez Díaz

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
Phase IV, single-center, open study to assess the benefits of the start of immediate treatment without immunovirological data ("Same Day Treatment") compared to conventional treatment with BIC / FTC / TAF in naive patients with type 1 HIV (human immunodeficiency virus) infection
Detailed Description
150 patients (75 in each treatment arm) with a confirmed diagnosis of HIV-1 infection and without prior antiretroviral treatment will be included. Expected study period 48 weeks of treatment Main objective of effectiveness Determine the time from the first determination of CD4 and HIV-1 viral load to achieve HIV viral load <50 cop / ml. Secondary objectives of efficacy Evaluate changes in CD4 T cell count. Determine the time from HIV diagnosis to achieve undetectable HIV viral load. Determine the degree of anxiety of patients. Determine the number of sexual contacts with potential for transmission of HIV infection. Determine the quality of patients before and after SDT. Both arms of the study have the same treatment with triple therapy (BIC / FTC / TAF). The treatment guidelines will be as follows: Patients in the immediate treatment arm (SDT) will take 1 tablet (50 mg BIC + 200 mg FTC + 25 mg TAF) orally, once a day, from the moment they are seen in the specialist's office (without immunovirological data information). Patients in the conventional treatment arm will take 1 tablet (50 mg BIC + 200 mg FTC + 25 mg TAF) orally, once a day, from the moment the immunovirological results are obtained (either because it is available them at the first visit with the specialist, or because the patient wishes to wait for such information prior to the start of the treatment). It is a single-center, open and non-randomized study. 150 adult patients with confirmed diagnosis of HIV-1 and without prior antiretroviral treatment may participate in the study. Patients will be divided into two groups, one in immediate treatment (arm 1 or SDT) and another in conventional treatment (arm 2), both strategies being considered part of the usual clinical practice that leads to a low intervention study. 75 patients of immediate treatment, will be those patients without immuno-virological data that accept to start the treatment the same day of the first consultation with the hospital specialist (arm 1 or SDT). 75 patients of conventional treatment, will be those who in their first consultation with the hospital specialist already have previous immuno-virological data or reject the start of immediate treatment (arm 2). Patients will voluntarily grant informed consent before performing any study procedure and will be assigned a patient code for the entire study. The study will include a total of 5 visits and periodic clinical exams will be performed on visits of weeks 0, 4, 12, 24 and 48.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
100 (Actual)

8. Arms, Groups, and Interventions

Arm Title
SDT
Arm Type
Experimental
Arm Description
-75 patients of immediate treatment, will be those patients without immuno-virological data that accept to start the treatment the same day of the first consultation with the hospital specialist (arm 1 or SDT).
Arm Title
Conventional
Arm Type
Active Comparator
Arm Description
- 75 patients of conventional treatment, will be those who in their first consultation with the hospital specialist already have previous immuno-virological data or reject the start of immediate treatment (arm 2 or conventional).
Intervention Type
Drug
Intervention Name(s)
BIC/FTC/TAF: Bictegravir/emtricitabina/tenofovir alafenamida fumarato
Intervention Description
This is a study to assess the impact of immediate ART (FAST ART or SDT) against conventional treatment (CT) on the time to reach an undetectable HIV-1 viral load.
Primary Outcome Measure Information:
Title
Efficacy of immediate treatment.
Description
The time in weeks from the first determination of CD4 and HIV-1 viral load until achieving HIV viral load <50 cop/ml, in number.
Time Frame
48 weeks
Secondary Outcome Measure Information:
Title
Secondary Efficacy Endpoints
Description
CD4 cell count in number Time from HIV diagnosis to achieving undetectable HIV viral load, in weeks. Degree of anxiety of patients (mild, moderate and severe degree according to the HADS scale). Number of sexual contacts with potential for transmission of HIV infection, in number. Quality of patients before and after SDT, según escala EQ-5D 5 (numerical value from 1 to 5).
Time Frame
48 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: - Men and women > 18 years old Confirmed and documented diagnosis of HIV-1 infection Without prior antiretroviral treatment (excluding 28-day post-exposure prophylaxis) Signed informed consent Negative pregnancy test (women of childbearing age only). Women of childbearing age are considered to be those women who have not undergone permanent infertility procedures or who have been amenorrheic for less than 12 months Exclusion Criteria: Inability to obtain written informed consent to participate in the study Pregnant or breastfeeding women or those who intend to become pregnant during the study period and do not undertake to use proven contraceptive methods Any suspicion or confirmation of resistance to TAF, FTC or BIC Estimated glomerular filtration rate (TFGe) <30 mg / ml / m2 measured by any of the available formulas. The determination of the TFGe of a routine prior analysis of ≤ 12 weeks prior to the signing of the consent is allowed Contraindications to the use of TAF Clinical condition of the patient in rapid deterioration or the investigator considers that there is no reasonable hope that the patient will end the study Simultaneous participation in another clinical trial or research study that requires the need for treatment with other drugs outside the study or interferes with visits to it. Any situation that, in the opinion of the investigator, may interfere with the patient's ability to comply with the treatment schedule and protocol evaluations
Facility Information:
Facility Name
Hospital FUNDACIÓN JIMÉNEZ DÍAZ
City
Madrid
Country
Spain

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
16791020
Citation
Marks G, Crepaz N, Janssen RS. Estimating sexual transmission of HIV from persons aware and unaware that they are infected with the virus in the USA. AIDS. 2006 Jun 26;20(10):1447-50. doi: 10.1097/01.aids.0000233579.79714.8d.
Results Reference
result
PubMed Identifier
28867497
Citation
Gallant J, Lazzarin A, Mills A, Orkin C, Podzamczer D, Tebas P, Girard PM, Brar I, Daar ES, Wohl D, Rockstroh J, Wei X, Custodio J, White K, Martin H, Cheng A, Quirk E. Bictegravir, emtricitabine, and tenofovir alafenamide versus dolutegravir, abacavir, and lamivudine for initial treatment of HIV-1 infection (GS-US-380-1489): a double-blind, multicentre, phase 3, randomised controlled non-inferiority trial. Lancet. 2017 Nov 4;390(10107):2063-2072. doi: 10.1016/S0140-6736(17)32299-7. Epub 2017 Aug 31.
Results Reference
result
Links:
URL
https://www.unaids.org/en
Description
UNAIDS is leading the global effort to end AIDS as a public health threat by 2030 as part of the Sustainable Development Goals.
URL
https://apps.who.int/iris/bitstream/handle/10665/255884/9789241550062-eng.pdf;jsessionid=BB91240E0947C3461F781F6FBC9E3B49?sequence=1
Description
GUIDELINES FOR MANAGING ADVANCED HIV DISEASE AND RAPID INITIATION OF ANTIRETROVIRAL THERAPY

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The Benefits of Immediate Treatment Initiation Without Immunovirological Data Compared to Conventional BIC / FTC / TAF Treatment in Naive Patients With Type 1 HIV (Human Immunodeficiency Virus) Infection

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