search
Back to results

Can Valacyclovir Delay the Need for Initiation of Human Immunodeficiency Virus (HIV) Treatment in HIV-infected Individuals? (VALIDATE)

Primary Purpose

HIV Infection, Herpes Simplex Type II, HIV Infections

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
valacyclovir
Placebo
Sponsored by
University Health Network, Toronto
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for HIV Infection focused on measuring HIV, Herpes simplex virus type II, Genital herpes, Treatment Naive

Eligibility Criteria

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

Inclusion Criteria:

  • adult (aged 18 years or older or as per Local/Provincial Guidelines)
  • documented HIV-1 infection (determined by EIA and Western blot, sites' standard assays are acceptable if approved in advance by the PIs for the study, Dr. Darrell Tan and/or Dr. Sharon Walmsley)
  • no use of chronic anti-HSV therapy for the past 6 months, and not anticipated to require chronic anti-HSV therapy during the study
  • antiretroviral naïve (no more than 14 days of total prior ARV exposure)
  • CD4 count within the 400-900 cells/mm3 range (inclusive) on two consecutive occasions, with at least one measurement within 30 days of initiating trial (baseline visit)
  • does not meet recommendations for initiating ARV therapy according to current guidelines

Exclusion Criteria:

  • pregnancy or actively planning to become pregnant
  • receiving chemotherapy, chronic steroid therapy or other immunomodulatory medications (e.g. interferon, azathioprine, methotrexate, TNF-alpha antagonists, etc.)
  • Estimated creatinine clearance <30 mL/min
  • Other medical condition likely to cause death within 24 months
  • Enrolled in a therapeutic HIV vaccine or immunotherapy trial
  • Enrolled in another trial investigating the impact of another intervention on HIV disease progression
  • HIV elite controller (EC), phenotypically defined here as documented duration of HIV infection of ≥5 years, a persistent CD4 cell count ≥500 cells/mm3, and a persistent plasma HIV viral load of <1000 copies/mL in the absence of antiretroviral therapy

Sites / Locations

  • Fundación Huesped
  • Instituto de Pesquisa Clínica Evandro Chagas
  • Ambulatorio de Infectologia da UNIFESP
  • Centro de Referencia e Treinamento em DST/AIDS
  • University of Alberta
  • B.C. Women's Hospital & Health Centre - Oak Tree Clinic
  • Vancouver Infectious Disease Clinic
  • Cool Aid Community Health Centre
  • CDHA, QEII Health Sciences Centre
  • McMaster University Health Sciences Centre
  • The Ottawa Hospital, General Campus Divsions of Infectious Diseases
  • University of Ottawa Health Services
  • Sunnybrook Health Science Centre
  • St. Clair Medical Associates
  • Maple Leaf Medical Clinic
  • St. Michael's Hospital
  • University Health Network
  • Windsor Regional Hospital
  • Montreal Chest Institute
  • Centre Hospitalier de l'Université de Montréal
  • Centre Hospitalier Universitaire de Quebec-Pavillon CHUL
  • Brighton & Sussex University Hospitals NHS Trust
  • Guy's and St. Thomas' NHS Foundation Trust
  • St. Stephen's AIDS Trust
  • St. Mary's Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Placebo Comparator

Experimental

Arm Label

Placebo

Valacyclovir

Arm Description

Odourless placebo tablet identical to valacyclovir in appearance and taste, to be taken twice daily

oral valacyclovir 500mg twice daily

Outcomes

Primary Outcome Measures

annual rate of change in CD4 count, calculated as the slope of participants' CD4 count change / time.

Secondary Outcome Measures

time from baseline until reaching the composite of either a CD4 cell count ≤350 cells/mm3 measured on two consecutive occasions at least 1 month apart, or initiation of HAART for any reason, whichever occurs first.
Annual rate of change in the CD4 cell count percentage, calculated as the slope of the participants' CD4 count percentage change over time
Log10 plasma HIV viral load at 12, 24 and 36 months of follow-up
Treatment-emergent adverse events and laboratory abnormalities (CBC, serum creatinine)
Frequency of episodes of HSV reactivations at any anatomic site
Proportion of microbiologically confirmed flares of HSV during the trial that are caused by laboratory-confirmed acyclovir-resistant HSV
Overall quality of life as measured by the MOS-HIV questionnaire at each 6-monthly time point

Full Information

First Posted
March 11, 2009
Last Updated
March 2, 2018
Sponsor
University Health Network, Toronto
Collaborators
CIHR Canadian HIV Trials Network
search

1. Study Identification

Unique Protocol Identification Number
NCT00860977
Brief Title
Can Valacyclovir Delay the Need for Initiation of Human Immunodeficiency Virus (HIV) Treatment in HIV-infected Individuals?
Acronym
VALIDATE
Official Title
VALacyclovir In Delaying Antiretroviral Treatment Entry
Study Type
Interventional

2. Study Status

Record Verification Date
March 2018
Overall Recruitment Status
Completed
Study Start Date
March 2010 (Actual)
Primary Completion Date
August 2015 (Actual)
Study Completion Date
August 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University Health Network, Toronto
Collaborators
CIHR Canadian HIV Trials Network

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This study is a multicentre, randomized, placebo-controlled, fully blinded, clinical trial of twice daily oral valacyclovir 500mg versus placebo with the goal of delaying the need for initiating HAART among HIV infected individuals who neither use nor require HAART, and who have not used chronic suppressive anti-HSV therapy for at least the 6 months prior to study initiation.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HIV Infection, Herpes Simplex Type II, HIV Infections
Keywords
HIV, Herpes simplex virus type II, Genital herpes, Treatment Naive

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
202 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Odourless placebo tablet identical to valacyclovir in appearance and taste, to be taken twice daily
Arm Title
Valacyclovir
Arm Type
Experimental
Arm Description
oral valacyclovir 500mg twice daily
Intervention Type
Drug
Intervention Name(s)
valacyclovir
Other Intervention Name(s)
Valtrex
Intervention Description
oral valacyclovir 500mg twice daily
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Odourless placebo tablet identical to valacyclovir in appearance and taste, to be taken twice daily
Primary Outcome Measure Information:
Title
annual rate of change in CD4 count, calculated as the slope of participants' CD4 count change / time.
Time Frame
up to 5 years
Secondary Outcome Measure Information:
Title
time from baseline until reaching the composite of either a CD4 cell count ≤350 cells/mm3 measured on two consecutive occasions at least 1 month apart, or initiation of HAART for any reason, whichever occurs first.
Time Frame
up to 5 years
Title
Annual rate of change in the CD4 cell count percentage, calculated as the slope of the participants' CD4 count percentage change over time
Time Frame
up to 5 years
Title
Log10 plasma HIV viral load at 12, 24 and 36 months of follow-up
Time Frame
up to 5 years
Title
Treatment-emergent adverse events and laboratory abnormalities (CBC, serum creatinine)
Time Frame
up to 5 years
Title
Frequency of episodes of HSV reactivations at any anatomic site
Time Frame
up to 5 years
Title
Proportion of microbiologically confirmed flares of HSV during the trial that are caused by laboratory-confirmed acyclovir-resistant HSV
Time Frame
up to 5 years
Title
Overall quality of life as measured by the MOS-HIV questionnaire at each 6-monthly time point
Time Frame
up to 5 years
Other Pre-specified Outcome Measures:
Title
analysis of inflammatory markers in HIV disease progression, HIV Resistance Mutations and other herpesvirus serologies
Time Frame
up to 6 years
Title
genetic testing of HLA-B*5701 and HLA-B*5703 status, and future genetic markers related to HIV disease progression and the impact of herpes and valacyclovir
Time Frame
up to 5 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: adult (aged 18 years or older or as per Local/Provincial Guidelines) documented HIV-1 infection (determined by EIA and Western blot, sites' standard assays are acceptable if approved in advance by the PIs for the study, Dr. Darrell Tan and/or Dr. Sharon Walmsley) no use of chronic anti-HSV therapy for the past 6 months, and not anticipated to require chronic anti-HSV therapy during the study antiretroviral naïve (no more than 14 days of total prior ARV exposure) CD4 count within the 400-900 cells/mm3 range (inclusive) on two consecutive occasions, with at least one measurement within 30 days of initiating trial (baseline visit) does not meet recommendations for initiating ARV therapy according to current guidelines Exclusion Criteria: pregnancy or actively planning to become pregnant receiving chemotherapy, chronic steroid therapy or other immunomodulatory medications (e.g. interferon, azathioprine, methotrexate, TNF-alpha antagonists, etc.) Estimated creatinine clearance <30 mL/min Other medical condition likely to cause death within 24 months Enrolled in a therapeutic HIV vaccine or immunotherapy trial Enrolled in another trial investigating the impact of another intervention on HIV disease progression HIV elite controller (EC), phenotypically defined here as documented duration of HIV infection of ≥5 years, a persistent CD4 cell count ≥500 cells/mm3, and a persistent plasma HIV viral load of <1000 copies/mL in the absence of antiretroviral therapy
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Sharon L Walmsley, MD FRCPC MSc
Organizational Affiliation
University Health Network, Toronto
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Darrell HS Tan, MD FRCPC
Organizational Affiliation
University Health Network, Toronto
Official's Role
Principal Investigator
Facility Information:
Facility Name
Fundación Huesped
City
Buenos Aires
ZIP/Postal Code
C1202ABB
Country
Argentina
Facility Name
Instituto de Pesquisa Clínica Evandro Chagas
City
Rio de Janeiro
Country
Brazil
Facility Name
Ambulatorio de Infectologia da UNIFESP
City
Sao Paulo
ZIP/Postal Code
04040-002
Country
Brazil
Facility Name
Centro de Referencia e Treinamento em DST/AIDS
City
Sao Paulo
ZIP/Postal Code
04121-000
Country
Brazil
Facility Name
University of Alberta
City
Edmonton
State/Province
Alberta
ZIP/Postal Code
T6G 2C8
Country
Canada
Facility Name
B.C. Women's Hospital & Health Centre - Oak Tree Clinic
City
Vancouver
State/Province
British Columbia
ZIP/Postal Code
V6H 1N1
Country
Canada
Facility Name
Vancouver Infectious Disease Clinic
City
Vancouver
State/Province
British Columbia
ZIP/Postal Code
V6Z 2C7
Country
Canada
Facility Name
Cool Aid Community Health Centre
City
VIctoria
State/Province
British Columbia
ZIP/Postal Code
V8W 1M8
Country
Canada
Facility Name
CDHA, QEII Health Sciences Centre
City
Halifax
State/Province
Nova Scotia
ZIP/Postal Code
B3H 2Y9
Country
Canada
Facility Name
McMaster University Health Sciences Centre
City
Hamilton
State/Province
Ontario
ZIP/Postal Code
L8N 3Z5
Country
Canada
Facility Name
The Ottawa Hospital, General Campus Divsions of Infectious Diseases
City
Ottawa
State/Province
Ontario
ZIP/Postal Code
K1H 8L6
Country
Canada
Facility Name
University of Ottawa Health Services
City
Ottawa
State/Province
Ontario
ZIP/Postal Code
K1N 6N5
Country
Canada
Facility Name
Sunnybrook Health Science Centre
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M2N 3M5
Country
Canada
Facility Name
St. Clair Medical Associates
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M4K 1N1
Country
Canada
Facility Name
Maple Leaf Medical Clinic
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5B 1L6
Country
Canada
Facility Name
St. Michael's Hospital
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5B 1W8
Country
Canada
Facility Name
University Health Network
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5G 2N2
Country
Canada
Facility Name
Windsor Regional Hospital
City
Windsor
State/Province
Ontario
ZIP/Postal Code
N8W 1E3
Country
Canada
Facility Name
Montreal Chest Institute
City
Montreal
State/Province
Quebec
ZIP/Postal Code
H2X 2P4
Country
Canada
Facility Name
Centre Hospitalier de l'Université de Montréal
City
Montréal
State/Province
Quebec
ZIP/Postal Code
H2L 4M1
Country
Canada
Facility Name
Centre Hospitalier Universitaire de Quebec-Pavillon CHUL
City
Quebec
ZIP/Postal Code
G1V 4G2
Country
Canada
Facility Name
Brighton & Sussex University Hospitals NHS Trust
City
Brighton
ZIP/Postal Code
BN2 1ES
Country
United Kingdom
Facility Name
Guy's and St. Thomas' NHS Foundation Trust
City
London
ZIP/Postal Code
SE1 7EH
Country
United Kingdom
Facility Name
St. Stephen's AIDS Trust
City
London
ZIP/Postal Code
SW10 9NH
Country
United Kingdom
Facility Name
St. Mary's Hospital
City
London
ZIP/Postal Code
W2 1NY
Country
United Kingdom

12. IPD Sharing Statement

Citations:
PubMed Identifier
21106086
Citation
Tan DH, Raboud JM, Kaul R, Grinsztejn B, Cahn P, Walmsley SL. Can herpes simplex virus type 2 suppression slow HIV disease progression: a study protocol for the VALacyclovir In Delaying Antiretroviral Treatment Entry (VALIDATE) trial. Trials. 2010 Nov 24;11:113. doi: 10.1186/1745-6215-11-113.
Results Reference
background
Links:
URL
http://www.hivnet.ubc.ca/clinical-trials/ctn240/
Description
CIHR Canadian HIV Trials Network - CTN 240

Learn more about this trial

Can Valacyclovir Delay the Need for Initiation of Human Immunodeficiency Virus (HIV) Treatment in HIV-infected Individuals?

We'll reach out to this number within 24 hrs