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CCRC: A Project of the Treatment of HIV Enteropathy With ImmunoLin® Supplements

Primary Purpose

HIV

Status
Completed
Phase
Early Phase 1
Locations
United States
Study Type
Interventional
Intervention
Immunolin®
Sponsored by
University of California, Davis
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for HIV focused on measuring HIV, diarrhea

Eligibility Criteria

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

Inclusion Criteria:

  • GI complaints consisting of at least 2 loose or watery stools per day or marked abdominal bloating that adversely effects activities of daily living (ADLs) or common social functioning for greater than 6 months, even though the symptomatology may wax and wane over that time period.
  • Subjects should have had routine testing to exclude enteric pathogens.
  • Subjects should have made an effort to identify food intolerance, especially lactose intolerance.
  • Symptoms should be believed to be independent of ART or other medications known to have the potential to cause similar GI complaints; either because the symptoms predate initiation of the medications or shifts between different options for ART has had no appreciable effect on symptoms.
  • Over the previous 6 months, alcohol use should be characterized as occasional with less than 1.5 ounces per day being the maximum estimated use (<2 beers or glasses of wine or 1 drink of hard liquor).
  • Subjects will be greater than 18 years of age.
  • Plasma HIV load should be suppressed to less than 400 cp/mL for at least four months, but there is no restriction on peripheral CD4+ T-cell count. Blips of <1000 cp/mL are allowed, provided that these are not associated with medication interruptions and that the pVL is undetectable before and after the observed blip.
  • Subjects are willing to maintain a food and GI-symptom diary while receiving the ImmunoLin® supplement.
  • Subjects should be willing to attempt to maintain a stable regimen of ART for the duration of the study unless indicated for patient safety.
  • Subjects should be free of antibiotic use for at least 3-weeks prior to study entry except for chronic antibiotics used for prophylaxis according to SOC in HIV management. Usage of antibiotics during the course of the study will be assessed on a case by case basis by the study team.
  • Subjects must be free of conditions which require chronic therapy that are known to alter the gut flora. Steroid use must be limited to intermittent topical preparations only which includes inhaled or dermatologic routes of application.

Exclusion Criteria:

  • known unrelated causes for GI abnormalities.
  • abnormal coagulation parameters (PT>1.2 ULN)
  • thrombocytopenia (platelet count <50,000 within 6 weeks)
  • contra-indications to upper endoscopy or conscious sedation
  • anemia (> grade 1 [appendix D])
  • aspirin, ibuprofen, warfarin or other agents that interfere with the coagulation cascade are prohibited within 1 week of endoscopy.
  • positive pregnancy test

Sites / Locations

  • UCD CTSC Clinical Research Center (CCRC)

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

ImmunoLin®

Arm Description

8-week treatment course

Outcomes

Primary Outcome Measures

Number of Bowel Movements Per Day
self-reported bowel movement in diary

Secondary Outcome Measures

Frequency of Pro-inflammatory Bacterial Orders
16S rDNA sequencing for Bacteroidetes/Firmicutes ratio
Measures of Gut Permeability
five-hour disaccharide absorption test
Systemic Immune Activation
CD8+ T-cells with an activated phenotype (HLA-DR/CD38+ coexpression)
Duodenal Immune Reconstitution
changes in duodenal lamina propria CD3+/CD4+ density by immunohistochemistry

Full Information

First Posted
March 10, 2011
Last Updated
May 24, 2017
Sponsor
University of California, Davis
Collaborators
Proliant Health & Biologicals
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1. Study Identification

Unique Protocol Identification Number
NCT01313910
Brief Title
CCRC: A Project of the Treatment of HIV Enteropathy With ImmunoLin® Supplements
Official Title
CCRC: A Pilot Project of the Treatment of HIV Enteropathy With ImmunoLin® Supplements
Study Type
Interventional

2. Study Status

Record Verification Date
May 2017
Overall Recruitment Status
Completed
Study Start Date
March 2011 (undefined)
Primary Completion Date
August 2012 (Actual)
Study Completion Date
August 2012 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of California, Davis
Collaborators
Proliant Health & Biologicals

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of the study is to see if ImmunoLin® will reduce the frequency of bowel movements and gastrointestinal (GI) symptoms in HIV volunteers with persistent GI symptoms. The study will also examine the effect of ImmunoLin® on the bacteria in the gut and the immune system in gut tissue as well as in the blood.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HIV
Keywords
HIV, diarrhea

7. Study Design

Primary Purpose
Treatment
Study Phase
Early Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
8 (Actual)

8. Arms, Groups, and Interventions

Arm Title
ImmunoLin®
Arm Type
Experimental
Arm Description
8-week treatment course
Intervention Type
Dietary Supplement
Intervention Name(s)
Immunolin®
Intervention Description
Immunolin® 500 mg capsules to be taken 5 capsules twice daily for eight weeks
Primary Outcome Measure Information:
Title
Number of Bowel Movements Per Day
Description
self-reported bowel movement in diary
Time Frame
8 weeks (56 days)
Secondary Outcome Measure Information:
Title
Frequency of Pro-inflammatory Bacterial Orders
Description
16S rDNA sequencing for Bacteroidetes/Firmicutes ratio
Time Frame
8 weeks
Title
Measures of Gut Permeability
Description
five-hour disaccharide absorption test
Time Frame
8 weeks
Title
Systemic Immune Activation
Description
CD8+ T-cells with an activated phenotype (HLA-DR/CD38+ coexpression)
Time Frame
8 weeks
Title
Duodenal Immune Reconstitution
Description
changes in duodenal lamina propria CD3+/CD4+ density by immunohistochemistry
Time Frame
8 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: GI complaints consisting of at least 2 loose or watery stools per day or marked abdominal bloating that adversely effects activities of daily living (ADLs) or common social functioning for greater than 6 months, even though the symptomatology may wax and wane over that time period. Subjects should have had routine testing to exclude enteric pathogens. Subjects should have made an effort to identify food intolerance, especially lactose intolerance. Symptoms should be believed to be independent of ART or other medications known to have the potential to cause similar GI complaints; either because the symptoms predate initiation of the medications or shifts between different options for ART has had no appreciable effect on symptoms. Over the previous 6 months, alcohol use should be characterized as occasional with less than 1.5 ounces per day being the maximum estimated use (<2 beers or glasses of wine or 1 drink of hard liquor). Subjects will be greater than 18 years of age. Plasma HIV load should be suppressed to less than 400 cp/mL for at least four months, but there is no restriction on peripheral CD4+ T-cell count. Blips of <1000 cp/mL are allowed, provided that these are not associated with medication interruptions and that the pVL is undetectable before and after the observed blip. Subjects are willing to maintain a food and GI-symptom diary while receiving the ImmunoLin® supplement. Subjects should be willing to attempt to maintain a stable regimen of ART for the duration of the study unless indicated for patient safety. Subjects should be free of antibiotic use for at least 3-weeks prior to study entry except for chronic antibiotics used for prophylaxis according to SOC in HIV management. Usage of antibiotics during the course of the study will be assessed on a case by case basis by the study team. Subjects must be free of conditions which require chronic therapy that are known to alter the gut flora. Steroid use must be limited to intermittent topical preparations only which includes inhaled or dermatologic routes of application. Exclusion Criteria: known unrelated causes for GI abnormalities. abnormal coagulation parameters (PT>1.2 ULN) thrombocytopenia (platelet count <50,000 within 6 weeks) contra-indications to upper endoscopy or conscious sedation anemia (> grade 1 [appendix D]) aspirin, ibuprofen, warfarin or other agents that interfere with the coagulation cascade are prohibited within 1 week of endoscopy. positive pregnancy test
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
David M. Asmuth, MD
Organizational Affiliation
University of California, Davis Int Med: ID
Official's Role
Principal Investigator
Facility Information:
Facility Name
UCD CTSC Clinical Research Center (CCRC)
City
Mather
State/Province
California
ZIP/Postal Code
95655
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
23660579
Citation
Asmuth DM, Ma ZM, Albanese A, Sandler NG, Devaraj S, Knight TH, Flynn NM, Yotter T, Garcia JC, Tsuchida E, Wu TT, Douek DC, Miller CJ. Oral serum-derived bovine immunoglobulin improves duodenal immune reconstitution and absorption function in patients with HIV enteropathy. AIDS. 2013 Sep 10;27(14):2207-17. doi: 10.1097/QAD.0b013e328362e54c.
Results Reference
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CCRC: A Project of the Treatment of HIV Enteropathy With ImmunoLin® Supplements

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