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The Safety and Effectiveness of Valacyclovir HCl in the Treatment of Herpes Simplex or Varicella/Zoster Infections in HIV-1 Infected Children

Primary Purpose

Herpes Simplex, HIV Infections, Chickenpox

Status
Withdrawn
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
Valacyclovir hydrochloride
Sponsored by
National Institute of Allergy and Infectious Diseases (NIAID)
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Herpes Simplex focused on measuring Herpes Zoster, AIDS-Related Opportunistic Infections, Herpes Simplex, Acquired Immunodeficiency Syndrome, AIDS-Related Complex, valacyclovir, Chickenpox

Eligibility Criteria

4 Years - 12 Years (Child)All SexesDoes not accept healthy volunteers

Inclusion Criteria Concurrent Medication: Allowed: Antiretrovirals. PCP prophylaxis. IVIG, G-CSF, and erythropoietin. Concurrent Treatment: Allowed: Transfusions. Patients must have: Localized mucocutaneous herpes simplex OR undisseminated varicella or zoster. HIV positive. NOTE: Varicella patients must NOT have AIDS. CD4 count >= 100 cells/mm3 (herpes simplex or zoster patients) OR >= 250 cells/mm3 (varicella patients). BSA > 0.6 m2. Ability to swallow solid dosage formulations. Prior Medication: Allowed: Prior VZV immune globulin and/or IVIG. Antiretrovirals if at a stable dose for at least 14 days. Exclusion Criteria Co-existing Condition: Patients with the following symptoms or conditions are excluded: Clinical evidence of pneumonitis. Severe abdominal pain or back pain. Encephalopathy. Hemorrhagic varicella. Zoster involving ophthalmic branch of trigeminal nerve. Severe gastrointestinal disorder. Concurrent Medication: Excluded: Agents with potential activity against HSV or VZV, such as acyclovir, famciclovir, ganciclovir, foscarnet, and sorivudine. Probenecid. Aspartamine within 48 hours prior to pharmacokinetic samplings. Patients with the following prior conditions are excluded: Grade 2 creatinine value within the past 30 days. Grade 3 hematologic or hepatic values within the past 30 days. Prior hypersensitivity and/or allergic reaction to acyclovir. Grade 3 or 4 mental status changes within the past 30 days. Prior Medication: Excluded: Acyclovir within 1 week prior to study entry. Steroids within 4 weeks prior to onset of varicella lesions.

Sites / Locations

    Outcomes

    Primary Outcome Measures

    Secondary Outcome Measures

    Full Information

    First Posted
    November 2, 1999
    Last Updated
    October 28, 2021
    Sponsor
    National Institute of Allergy and Infectious Diseases (NIAID)
    Collaborators
    Glaxo Wellcome
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    1. Study Identification

    Unique Protocol Identification Number
    NCT00001054
    Brief Title
    The Safety and Effectiveness of Valacyclovir HCl in the Treatment of Herpes Simplex or Varicella/Zoster Infections in HIV-1 Infected Children
    Official Title
    A Phase I Trial to Evaluate the Pharmacokinetics, Safety, and Tolerance of Valacyclovir HCl in HIV-1 Infected Children With Herpes Simplex Infections or Varicella/Zoster Infections
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    October 2021
    Overall Recruitment Status
    Withdrawn
    Study Start Date
    undefined (undefined)
    Primary Completion Date
    undefined (undefined)
    Study Completion Date
    January 2001 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    National Institute of Allergy and Infectious Diseases (NIAID)
    Collaborators
    Glaxo Wellcome

    4. Oversight

    5. Study Description

    Brief Summary
    To obtain tolerance, safety, and pharmacokinetic data for oral valacyclovir hydrochloride ( 256U87 ) in HIV-1 infected children with herpes simplex virus infections ( cold sores ) and/or varicella / zoster virus infections ( chicken pox / shingles ). Varicella and zoster are common problems in HIV-infected children. It is believed that chronic oral therapy with acyclovir may result in subtherapeutic concentrations of acyclovir, resulting in resistance to that drug. Valacyclovir hydrochloride, which converts to acyclovir in the body, increases acyclovir bioavailability by 3-5 fold.
    Detailed Description
    Varicella and zoster are common problems in HIV-infected children. It is believed that chronic oral therapy with acyclovir may result in subtherapeutic concentrations of acyclovir, resulting in resistance to that drug. Valacyclovir hydrochloride, which converts to acyclovir in the body, increases acyclovir bioavailability by 3-5 fold. In the first cohort, patients with stable herpes simplex virus receive valacyclovir hydrochloride at 1 of 2 doses, depending on body surface area (BSA), for 10 days. If acceptable safety is seen at this dose level, a second cohort of patients with stable herpes simplex virus receive a higher dose, depending on BSA, for 10 days. A third cohort of patients with varicella or zoster receive a selected dose based on results from the previous cohorts.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Herpes Simplex, HIV Infections, Chickenpox
    Keywords
    Herpes Zoster, AIDS-Related Opportunistic Infections, Herpes Simplex, Acquired Immunodeficiency Syndrome, AIDS-Related Complex, valacyclovir, Chickenpox

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 1
    Masking
    None (Open Label)
    Enrollment
    0 (Actual)

    8. Arms, Groups, and Interventions

    Intervention Type
    Drug
    Intervention Name(s)
    Valacyclovir hydrochloride

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    4 Years
    Maximum Age & Unit of Time
    12 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria Concurrent Medication: Allowed: Antiretrovirals. PCP prophylaxis. IVIG, G-CSF, and erythropoietin. Concurrent Treatment: Allowed: Transfusions. Patients must have: Localized mucocutaneous herpes simplex OR undisseminated varicella or zoster. HIV positive. NOTE: Varicella patients must NOT have AIDS. CD4 count >= 100 cells/mm3 (herpes simplex or zoster patients) OR >= 250 cells/mm3 (varicella patients). BSA > 0.6 m2. Ability to swallow solid dosage formulations. Prior Medication: Allowed: Prior VZV immune globulin and/or IVIG. Antiretrovirals if at a stable dose for at least 14 days. Exclusion Criteria Co-existing Condition: Patients with the following symptoms or conditions are excluded: Clinical evidence of pneumonitis. Severe abdominal pain or back pain. Encephalopathy. Hemorrhagic varicella. Zoster involving ophthalmic branch of trigeminal nerve. Severe gastrointestinal disorder. Concurrent Medication: Excluded: Agents with potential activity against HSV or VZV, such as acyclovir, famciclovir, ganciclovir, foscarnet, and sorivudine. Probenecid. Aspartamine within 48 hours prior to pharmacokinetic samplings. Patients with the following prior conditions are excluded: Grade 2 creatinine value within the past 30 days. Grade 3 hematologic or hepatic values within the past 30 days. Prior hypersensitivity and/or allergic reaction to acyclovir. Grade 3 or 4 mental status changes within the past 30 days. Prior Medication: Excluded: Acyclovir within 1 week prior to study entry. Steroids within 4 weeks prior to onset of varicella lesions.
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Keller MA
    Official's Role
    Study Chair
    First Name & Middle Initial & Last Name & Degree
    Bryson Y
    Official's Role
    Study Chair
    First Name & Middle Initial & Last Name & Degree
    Gershon A
    Official's Role
    Study Chair

    12. IPD Sharing Statement

    Citations:
    PubMed Identifier
    8551421
    Citation
    von Seidlein L, Gillette SG, Bryson Y, Frederick T, Mascola L, Church J, Brunell P, Kovacs A, Deveikis A, Keller M. Frequent recurrence and persistence of varicella-zoster virus infections in children infected with human immunodeficiency virus type 1. J Pediatr. 1996 Jan;128(1):52-7. doi: 10.1016/s0022-3476(96)70427-4.
    Results Reference
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    PubMed Identifier
    10375341
    Citation
    Cohen JI, Brunell PA, Straus SE, Krause PR. Recent advances in varicella-zoster virus infection. Ann Intern Med. 1999 Jun 1;130(11):922-32. doi: 10.7326/0003-4819-130-11-199906010-00017.
    Results Reference
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    The Safety and Effectiveness of Valacyclovir HCl in the Treatment of Herpes Simplex or Varicella/Zoster Infections in HIV-1 Infected Children

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