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Immuno-Virological Efficacy of Combination With Trizivir +Tenofovir in Multiresistant HIV Patients

Primary Purpose

HIV Infections

Status
Terminated
Phase
Phase 4
Locations
Spain
Study Type
Interventional
Intervention
Trizivir (AZT+3HT+Abacavir) twice daily
Viread (300 mg Tenofovir disoproxil fumarate) once daily
Sponsored by
Germans Trias i Pujol Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for HIV Infections focused on measuring Antiretroviral treatment, virological failure, HIV

Eligibility Criteria

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

Inclusion Criteria: Age>= 18 years. HIV-1 infected patients. Patients on antiretroviral treatment including NTRI + PI +/- NNRTI +/- fusion inhibitors at inclusion in the study. Virological failure, defined as 2 determinations with viral load >1,000 copies/mL in the last 6 months, during stable HAART therapy over the previous 6 months. Genotype or phenotype resistance to three families of antiretrovirals (PI, NTRI and NNRTI) demonstrated in genotype study carried out in the last 48 weeks and defined as: 3 or more TAMS of the following: M41L, E44D, D67N, V118I, L210W, T215Y/F, K219Q/E. Existence of the M184V mutation or probable presence in the cellular archives. 5 or more mutations that confer resistance to PI of the following: I10F/I/R/V, V32I, M46I/L, I54V/M/L, V82A/F/T/S/V, I84V/A/C, L90M. Existence of 1 or more mutations that confer resistance to NNRTI, or probable presence in the cellular archives of: K103N, Y181C/I/Y, G190S/A/G. CD4 lymphocytes >- 300 cells/mm3 in the last two determinations. Subject able to follow the treatment period. Acceptance of the study and signature of the informed consent form. Women may not be of fertile age (defined as at least one year from menopause or undergoing any surgical sterilisation technique), or must undertake to use a barrier contraceptive method during the study. Exclusion Criteria: Suspicion of previous incorrect adherence. Pregnancy or breastfeeding Suspicion of intolerance to any investigational drug. Record of any disease which, according to clinical criteria, may reoccur with the proposed change of therapy (sarcoma, lymphoma, etc). CD4 Nadir below 200 cel/mm3. Acute intercurrent disease or fever in the 15 days before inclusion.

Sites / Locations

  • H.U. Germans Trias i Pujol

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

No Intervention

Arm Label

A

B

Arm Description

Trizivir+ Tenofovir 2/day

antiretroviral treatment optimizated by genotyp

Outcomes

Primary Outcome Measures

Variations in the immune status of patients in each group throughout follow-up.

Secondary Outcome Measures

Percentage of patients that increase viral load by > 0.5 log
Percentage of patients that increase viral load by > 100,000 copies/mL
Percentage of patients that present some clinical event, B or C classification according to the CDC.
Percentage of patients that present clinical or analytical adverse effects degree > 2 according to the WHO classification.
Percentage of patients that drop out of treatment.
Percentage of patients that drop out of the study due to intolerance or adverse effects.
Percentage of change in lipid determinations.
Percentage of patients that report changes, improvement or worsening in redistribution of body fat.
Percentage of patients that present adherence to the antiretroviral treatment > 95%.
Percentage of patients that present improvement in the quality of life (MOS-HIV) and satisfaction questionnaires.
Percentage of patients that present an increase in the number of active drugs.

Full Information

First Posted
July 24, 2006
Last Updated
January 25, 2008
Sponsor
Germans Trias i Pujol Hospital
Collaborators
Fundación FLS de Lucha Contra el Sida, las Enfermedades Infecciosas y la Promoción de la Salud y la Ciencia
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1. Study Identification

Unique Protocol Identification Number
NCT00356616
Brief Title
Immuno-Virological Efficacy of Combination With Trizivir +Tenofovir in Multiresistant HIV Patients
Official Title
Open-Label, Single-Centre, Randomised Pilot Study to Evaluate Immunovirological and Clinical Evolution of a Combination With Nucleoside Analogues/Nucleotides (Trizivir +Tenofovir) in Multiresistant Patients With Virological Failure
Study Type
Interventional

2. Study Status

Record Verification Date
November 2007
Overall Recruitment Status
Terminated
Why Stopped
terminated
Study Start Date
September 2005 (undefined)
Primary Completion Date
June 2007 (Actual)
Study Completion Date
June 2007 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
Germans Trias i Pujol Hospital
Collaborators
Fundación FLS de Lucha Contra el Sida, las Enfermedades Infecciosas y la Promoción de la Salud y la Ciencia

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
To evaluate whether the combined therapy of two nucleosides plus one nucleotide (Trizivir + TDF) manages to keep CD4 lymphocytes stable in patients with HIV infection on antiretroviral treatment that present virological failure and multiple resistance to antiretrovirals.
Detailed Description
This study has been designed to determine whether the use of a regimen based exclusively on NTRI, containing tenofovir, zidovudine and lamivudine, is able to preserve immunological status in patients with detectable viral load for whom an efficacious salvage regimen cannot be designed, slowing the progression of the viral load and reducing antiretroviral treatment-associated toxicity. In order to complete the salvage regimen without increasing the number of tablets too much, Trizivir plus tenofovir as investigational treatment will be used.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HIV Infections
Keywords
Antiretroviral treatment, virological failure, HIV

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
A
Arm Type
Experimental
Arm Description
Trizivir+ Tenofovir 2/day
Arm Title
B
Arm Type
No Intervention
Arm Description
antiretroviral treatment optimizated by genotyp
Intervention Type
Drug
Intervention Name(s)
Trizivir (AZT+3HT+Abacavir) twice daily
Intervention Description
Trizivir (AZT+3HT+Abacavir) twice daily
Intervention Type
Drug
Intervention Name(s)
Viread (300 mg Tenofovir disoproxil fumarate) once daily
Intervention Description
Viread (300 mg Tenofovir disoproxil fumarate) once daily
Primary Outcome Measure Information:
Title
Variations in the immune status of patients in each group throughout follow-up.
Time Frame
48 weeks
Secondary Outcome Measure Information:
Title
Percentage of patients that increase viral load by > 0.5 log
Time Frame
weeks 12, 24, 36 and 48
Title
Percentage of patients that increase viral load by > 100,000 copies/mL
Time Frame
weeks 12, 24, 36 and 48
Title
Percentage of patients that present some clinical event, B or C classification according to the CDC.
Time Frame
during the 48 weeks of follow-up
Title
Percentage of patients that present clinical or analytical adverse effects degree > 2 according to the WHO classification.
Time Frame
weeks 12, 24, 36 and 48
Title
Percentage of patients that drop out of treatment.
Time Frame
weeks 12, 24, 36 and 48
Title
Percentage of patients that drop out of the study due to intolerance or adverse effects.
Time Frame
weeks 12, 24, 36 and 48
Title
Percentage of change in lipid determinations.
Time Frame
weeks 12, 24, 36 and 48 with regard to baseline
Title
Percentage of patients that report changes, improvement or worsening in redistribution of body fat.
Time Frame
weeks 12, 24, 36 and 48
Title
Percentage of patients that present adherence to the antiretroviral treatment > 95%.
Time Frame
weeks 12, 24, 36 and 48
Title
Percentage of patients that present improvement in the quality of life (MOS-HIV) and satisfaction questionnaires.
Time Frame
weeks 12, 24, 36 and 48
Title
Percentage of patients that present an increase in the number of active drugs.
Time Frame
at the end of the study

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: Age>= 18 years. HIV-1 infected patients. Patients on antiretroviral treatment including NTRI + PI +/- NNRTI +/- fusion inhibitors at inclusion in the study. Virological failure, defined as 2 determinations with viral load >1,000 copies/mL in the last 6 months, during stable HAART therapy over the previous 6 months. Genotype or phenotype resistance to three families of antiretrovirals (PI, NTRI and NNRTI) demonstrated in genotype study carried out in the last 48 weeks and defined as: 3 or more TAMS of the following: M41L, E44D, D67N, V118I, L210W, T215Y/F, K219Q/E. Existence of the M184V mutation or probable presence in the cellular archives. 5 or more mutations that confer resistance to PI of the following: I10F/I/R/V, V32I, M46I/L, I54V/M/L, V82A/F/T/S/V, I84V/A/C, L90M. Existence of 1 or more mutations that confer resistance to NNRTI, or probable presence in the cellular archives of: K103N, Y181C/I/Y, G190S/A/G. CD4 lymphocytes >- 300 cells/mm3 in the last two determinations. Subject able to follow the treatment period. Acceptance of the study and signature of the informed consent form. Women may not be of fertile age (defined as at least one year from menopause or undergoing any surgical sterilisation technique), or must undertake to use a barrier contraceptive method during the study. Exclusion Criteria: Suspicion of previous incorrect adherence. Pregnancy or breastfeeding Suspicion of intolerance to any investigational drug. Record of any disease which, according to clinical criteria, may reoccur with the proposed change of therapy (sarcoma, lymphoma, etc). CD4 Nadir below 200 cel/mm3. Acute intercurrent disease or fever in the 15 days before inclusion.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Bonaventura Clotet, MD,PhD
Organizational Affiliation
LLuita contra la Sida Foundation-HIV Unit
Official's Role
Principal Investigator
Facility Information:
Facility Name
H.U. Germans Trias i Pujol
City
Badalona
State/Province
Barcelona
ZIP/Postal Code
08916
Country
Spain

12. IPD Sharing Statement

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Immuno-Virological Efficacy of Combination With Trizivir +Tenofovir in Multiresistant HIV Patients

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