search
Back to results

Treatment of Acute HIV With Emtricitabine, Tenofovir and Efavirenz (CID 0805)

Primary Purpose

Acute HIV Infection, HIV Infections

Status
Completed
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
efavirenz, emtricitabine, and tenofovir
Sponsored by
University of North Carolina, Chapel Hill
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Acute HIV Infection focused on measuring Acute HIV, HIV, Acute Infections, Acute Infection

Eligibility Criteria

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

Inclusion Criteria:

  1. Diagnosis of acute HIV infection as defined by protocol.
  2. The following laboratory parameters verified within 30 days of study entry:

    • Bilirubin </= 3.0mg/dL
    • ALT/AST </= 10 X upper limit of normal
    • Absolute neutrophil count (ANC) >/= 500cells/mm3
    • Platelet count >/= 25,000 cells/mm3
    • Hemoglobin >/= 8.5g/dL for men and >/= 8.0 g/dL for women
    • Calculated creatinine clearance (Cockcroft-Gault formula) >/= 50mL/min:

    CrCl = (140-age) x body weight (kg) (x 0.85 if female)/ Serum creatinine [mg/dL] x (72)

  3. All women of child-bearing potential (WOCBP) must have a negative serum or urine pregnancy test (minimum sensitivity 25 IU/L or equivalent units of bHCG) within 72 hours prior to start of study medication. WOCBP is defined as any female who has experienced menarche and who has not undergone successful surgical sterilization (hysterectomy, bilateral tubal ligation, or bilateral oophorectomy), who is not postmenopausal (defined as amenorrhea >/=12 consecutive months), or is on hormone replacement therapy (HRT) with documented plasma follicle-stimulating hormone level >/=35mLU/mL. Women who are using oral, implanted, or injectable contraceptive hormones or mechanical products such as an intrauterine device or barrier methods (diaphragm, condoms, spermicides) to prevent pregnancy or practicing abstinence or where partner is sterile (e.g., vasectomy), should be considered to be of child bearing potential;
  4. Be willing to use two effective forms of contraception throughout study. Barrier contraception should always be used in combination with other methods of contraception (oral or other hormonal contraceptives);
  5. Weigh >/= 40 kg;

Exclusion Criteria:

  1. A life expectancy less than twelve months.
  2. Women who are pregnant or breastfeeding.
  3. Women with a positive pregnancy test on enrollment or prior to study drug administration.
  4. WOCBP who are unwilling or unable to use two acceptable methods to avoid pregnancy for the entire study period
  5. WOCBP using a prohibited contraceptive method
  6. Hypersensitivity to any component of the formulation of study drugs.
  7. A clinically important illness not explicitly excluded by the protocol, a physical or psychiatric disability, or a laboratory abnormality that might place the patient at increased risk by being exposed to the medications in this study or which might confound the interpretation of this investigation.
  8. Proven or suspected acute hepatitis within 30 days prior to study entry (this excludes liver inflammation related to acute HIV infection).
  9. Intractable diarrhea (>/=6 loose stools/day for at least 7 consecutive days) within 30 days prior to study entry or vomiting lasting more than 4 days within one month prior to dosing (this excludes symptoms attributed to acute HIV infection).
  10. An active AIDS-defining opportunistic infection or disease (for the purpose of this study, a CD4 count </=200 cells/mm3 in the absence of any other AIDS-defining indicator condition is not considered an AIDS-defining event. AIDS-defining events occurring during the acute HIV infection syndrome period such as Candida esophagitis will be considered on a case-by-case basis and will not be automatically considered exclusionary).
  11. Inability to communicate effectively with study personnel.
  12. Current alcohol or recreational drug use which in the investigator's opinion interferes with the subject's ability to comply with dosing schedule and protocol evaluations or increases the risk of developing pancreatitis.
  13. Incarceration; prisoner recruitment and participation are not permitted.
  14. Difficulty swallowing capsules/tablets.
  15. Prior treatment with any other experimental drug for any indication (within 30 days of initiating study treatment).
  16. Treatment with immune-modulating agents (within 30 days of initiating study treatment) such as cyclosporine and systemic corticosteroids. Routine vaccinations are allowed.
  17. Therapy with agents with significant systemic neurotoxic pancreotropic or cytotoxic potential within 3 months of study start, or the need for such therapy is expected at the time of enrollment.
  18. Therapy with nephrotoxic agents (aminoglycosides, IV amphotericin, cidofovir, IV pentamidine, cisplatin other agents with nephrotoxic potential), adefovir or probenecid. These agents must be discontinued at least 30 days prior to starting study medications. Brief course of aminoglycosides within 30 days of enrollment may be allowed after discussion with Study Chairs.
  19. Concomitant Medications:

    • The following medications are expressly prohibited during the course of the trial: Astemizole, cisapride, ergot derivatives, hydroxyurea, midazolam, thalidomide, triazolam, vincristine, zalcitabine, ribavirin, doxorubicin, Voriconazole, St. John's wort or any medications that are contraindicated for concomitant use as described in the current product information packet insert for the ARV therapies used.

Sites / Locations

  • The University of North Carolina - Chapel Hill
  • Duke University

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Acute HIV Treatment Group

Arm Description

Single arm, open label study in which all participants received the same study treatment with efavirenz, emtricitabine, and tenofovir DF

Outcomes

Primary Outcome Measures

Number of Participants Without Virologic Failure at Week 24
Number of participants with a HIV RNA level <200 copies/mL at week 24

Secondary Outcome Measures

Number of Participants Without Virologic Failure at Week 48
HIV RNA level <50 copies/mL at week 48
Number of Participants With HIV RNA Suppression at Week 96
Number of participants wtih HIV RNA level <50 copies/mL at week 96
Number of Participants With Baseline Genotypic Resistance to Antiretroviral Medications
Prevalence of any of the surveillance drug resistance mutations associated with resistance to antiretroviral medications listed by the World Health Organization
Number of Participants With Baseline Genotypic Resistance to One or More Antiretroviral Drugs in the Study Treatment
Baseline genotypic resistance defined as presence of any surveillance drug resistance mutation to any drug in the study treatment listed by the World Health Organization
Time to HIV RNA Suppression <50 Copies/mL
Number of days from ART initiation to HIV RNA suppression <50 copies/mL

Full Information

First Posted
June 17, 2009
Last Updated
April 6, 2017
Sponsor
University of North Carolina, Chapel Hill
Collaborators
Bristol-Myers Squibb, Gilead Sciences
search

1. Study Identification

Unique Protocol Identification Number
NCT00924898
Brief Title
Treatment of Acute HIV With Emtricitabine, Tenofovir and Efavirenz (CID 0805)
Official Title
CID 0805 - Treatment of Acute HIV Infection With a Once Daily Regimen of Emtricitabine, Tenofovir and Efavirenz - A Pilot Study of Response to Therapy and HIV Pathogenesis
Study Type
Interventional

2. Study Status

Record Verification Date
April 2017
Overall Recruitment Status
Completed
Study Start Date
January 2005 (undefined)
Primary Completion Date
November 2013 (Actual)
Study Completion Date
December 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of North Carolina, Chapel Hill
Collaborators
Bristol-Myers Squibb, Gilead Sciences

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This is a pilot study of treatment of acute HIV infection with a once daily regimen of Emtricitabine, Tenofovir and Efavirenz. The primary objectives of this study are: To determine the safety and tolerability, and the virologic and immunologic efficacy of FTC, TDF, and efavirenz given once daily to patients with acute HIV infection. To assess the impact of once daily therapy combined with a standardized adherence program on treatment adherence, virologic suppression, and rate of viral load decline in blood and infectious fluids (semen, cervico-vaginal secretions). To define the prevalence of genotypic and phenotypic resistance to antiretroviral agents among persons diagnosed with acute HIV infection in the Southeastern United States.
Detailed Description
Hypothesis: Once daily ART with fixed dose combination FTC/TDF/EFV will reduce viral replication to <200 copies RNA/ml plasma in blood and other body compartments in patients with acute HIV infection, reducing infectivity. The treatment regimen will be well tolerated during treatment follow-up. A coordinated program of counseling and support will facilitate adherence and promote successful therapy. Prevalence of transmitted drug resistant HIV-1 will be assessed. Study Design: Dual-center, prospective, single-arm pilot study of FTC/TDF/EFV in patients with acute HIV infection. Study sites will be members of the Duke-UNC Acute HIV Infection Study Consortium. Patients will be followed intensively for 96 weeks.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acute HIV Infection, HIV Infections
Keywords
Acute HIV, HIV, Acute Infections, Acute Infection

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
92 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Acute HIV Treatment Group
Arm Type
Experimental
Arm Description
Single arm, open label study in which all participants received the same study treatment with efavirenz, emtricitabine, and tenofovir DF
Intervention Type
Drug
Intervention Name(s)
efavirenz, emtricitabine, and tenofovir
Other Intervention Name(s)
Tenofovir disoproxil fumarate, Emtricitabine, FDC Emtricitabine 200 mg/ tenofovir 300 mg, Efavirenz, FDC Emtricitabine 200mg/Tenofovir 300mg DF/Efavirenz 600mg
Intervention Description
Once daily ART with emtricitabine, tenofovir DF and efavirenz
Primary Outcome Measure Information:
Title
Number of Participants Without Virologic Failure at Week 24
Description
Number of participants with a HIV RNA level <200 copies/mL at week 24
Time Frame
HIV RNA level prior to or at week 24 following enrollment
Secondary Outcome Measure Information:
Title
Number of Participants Without Virologic Failure at Week 48
Description
HIV RNA level <50 copies/mL at week 48
Time Frame
HIV RNA level at week 48 following enrollment
Title
Number of Participants With HIV RNA Suppression at Week 96
Description
Number of participants wtih HIV RNA level <50 copies/mL at week 96
Time Frame
HIV RNA level at 96 weeks following enrollment
Title
Number of Participants With Baseline Genotypic Resistance to Antiretroviral Medications
Description
Prevalence of any of the surveillance drug resistance mutations associated with resistance to antiretroviral medications listed by the World Health Organization
Time Frame
At enrollment
Title
Number of Participants With Baseline Genotypic Resistance to One or More Antiretroviral Drugs in the Study Treatment
Description
Baseline genotypic resistance defined as presence of any surveillance drug resistance mutation to any drug in the study treatment listed by the World Health Organization
Time Frame
At enrollment
Title
Time to HIV RNA Suppression <50 Copies/mL
Description
Number of days from ART initiation to HIV RNA suppression <50 copies/mL
Time Frame
Number of days from start of study treatment until HIV RNA suppression, assessed through week 96

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Diagnosis of acute HIV infection as defined by protocol. The following laboratory parameters verified within 30 days of study entry: Bilirubin </= 3.0mg/dL ALT/AST </= 10 X upper limit of normal Absolute neutrophil count (ANC) >/= 500cells/mm3 Platelet count >/= 25,000 cells/mm3 Hemoglobin >/= 8.5g/dL for men and >/= 8.0 g/dL for women Calculated creatinine clearance (Cockcroft-Gault formula) >/= 50mL/min: CrCl = (140-age) x body weight (kg) (x 0.85 if female)/ Serum creatinine [mg/dL] x (72) All women of child-bearing potential (WOCBP) must have a negative serum or urine pregnancy test (minimum sensitivity 25 IU/L or equivalent units of bHCG) within 72 hours prior to start of study medication. WOCBP is defined as any female who has experienced menarche and who has not undergone successful surgical sterilization (hysterectomy, bilateral tubal ligation, or bilateral oophorectomy), who is not postmenopausal (defined as amenorrhea >/=12 consecutive months), or is on hormone replacement therapy (HRT) with documented plasma follicle-stimulating hormone level >/=35mLU/mL. Women who are using oral, implanted, or injectable contraceptive hormones or mechanical products such as an intrauterine device or barrier methods (diaphragm, condoms, spermicides) to prevent pregnancy or practicing abstinence or where partner is sterile (e.g., vasectomy), should be considered to be of child bearing potential; Be willing to use two effective forms of contraception throughout study. Barrier contraception should always be used in combination with other methods of contraception (oral or other hormonal contraceptives); Weigh >/= 40 kg; Exclusion Criteria: A life expectancy less than twelve months. Women who are pregnant or breastfeeding. Women with a positive pregnancy test on enrollment or prior to study drug administration. WOCBP who are unwilling or unable to use two acceptable methods to avoid pregnancy for the entire study period WOCBP using a prohibited contraceptive method Hypersensitivity to any component of the formulation of study drugs. A clinically important illness not explicitly excluded by the protocol, a physical or psychiatric disability, or a laboratory abnormality that might place the patient at increased risk by being exposed to the medications in this study or which might confound the interpretation of this investigation. Proven or suspected acute hepatitis within 30 days prior to study entry (this excludes liver inflammation related to acute HIV infection). Intractable diarrhea (>/=6 loose stools/day for at least 7 consecutive days) within 30 days prior to study entry or vomiting lasting more than 4 days within one month prior to dosing (this excludes symptoms attributed to acute HIV infection). An active AIDS-defining opportunistic infection or disease (for the purpose of this study, a CD4 count </=200 cells/mm3 in the absence of any other AIDS-defining indicator condition is not considered an AIDS-defining event. AIDS-defining events occurring during the acute HIV infection syndrome period such as Candida esophagitis will be considered on a case-by-case basis and will not be automatically considered exclusionary). Inability to communicate effectively with study personnel. Current alcohol or recreational drug use which in the investigator's opinion interferes with the subject's ability to comply with dosing schedule and protocol evaluations or increases the risk of developing pancreatitis. Incarceration; prisoner recruitment and participation are not permitted. Difficulty swallowing capsules/tablets. Prior treatment with any other experimental drug for any indication (within 30 days of initiating study treatment). Treatment with immune-modulating agents (within 30 days of initiating study treatment) such as cyclosporine and systemic corticosteroids. Routine vaccinations are allowed. Therapy with agents with significant systemic neurotoxic pancreotropic or cytotoxic potential within 3 months of study start, or the need for such therapy is expected at the time of enrollment. Therapy with nephrotoxic agents (aminoglycosides, IV amphotericin, cidofovir, IV pentamidine, cisplatin other agents with nephrotoxic potential), adefovir or probenecid. These agents must be discontinued at least 30 days prior to starting study medications. Brief course of aminoglycosides within 30 days of enrollment may be allowed after discussion with Study Chairs. Concomitant Medications: The following medications are expressly prohibited during the course of the trial: Astemizole, cisapride, ergot derivatives, hydroxyurea, midazolam, thalidomide, triazolam, vincristine, zalcitabine, ribavirin, doxorubicin, Voriconazole, St. John's wort or any medications that are contraindicated for concomitant use as described in the current product information packet insert for the ARV therapies used.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Cynthia Gay, MD, MPH
Organizational Affiliation
University of North Carolina, Chapel Hill
Official's Role
Principal Investigator
Facility Information:
Facility Name
The University of North Carolina - Chapel Hill
City
Chapel Hill
State/Province
North Carolina
ZIP/Postal Code
27599
Country
United States
Facility Name
Duke University
City
Durham
State/Province
North Carolina
ZIP/Postal Code
27707
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
27662549
Citation
Gay CL, Willis SJ, Cope AB, Kuruc JD, McGee KS, Sebastian J, Crooks AM, McKellar MS, Margolis DM, Fiscus SA, Hicks CB, Ferrari G, Eron JJ; Duke-UNC Acute HIV Infection Consortium. Fixed-dose combination emtricitabine/tenofovir/efavirenz initiated during acute HIV infection; 96-week efficacy and durability. AIDS. 2016 Nov 28;30(18):2815-2822. doi: 10.1097/QAD.0000000000001255.
Results Reference
background
PubMed Identifier
21487250
Citation
Gay CL, Mayo AJ, Mfalila CK, Chu H, Barry AC, Kuruc JD, McGee KS, Kerkau M, Sebastian J, Fiscus SA, Margolis DM, Hicks CB, Ferrari G, Eron JJ; Duke-UNC Acute HIV Infection Consortium. Efficacy of NNRTI-based antiretroviral therapy initiated during acute HIV infection. AIDS. 2011 Apr 24;25(7):941-9. doi: 10.1097/QAD.0b013e3283463c07.
Results Reference
result

Learn more about this trial

Treatment of Acute HIV With Emtricitabine, Tenofovir and Efavirenz (CID 0805)

We'll reach out to this number within 24 hrs