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Early and Intermittent Antiretroviral Therapy in Naive HIV Infected Adults

Phase 2
Completed
Conditions
HIV Infections
Interventions
Drug: Structured treatment interruption
Registration Number
NCT00820118
Lead Sponsor
ANRS, Emerging Infectious Diseases
Brief Summary

The primary objective of the trial is to assess the ability of an early and intermittent antiretroviral therapy in maintaining an immunological stability in antiretroviral naive HIV infected adults, to offer a potential alternative strategy to differed and continuous antiretroviral treatment.This is a 2-year phase II, open-label, multicentric "proof of concept" trial. The patients included are treated following a pulse-therapy scheme, i.e. 6-month periods with once daily boosted-PI based therapy in alternance with 6-month periods without antiretroviral therapy. The preferentially recommended treatment of the study is atazanavir boosted with ritonavir, associated with a fixed combination of abacavir and lamivudine or emtricitabine + tenofovir.The patients are closely followed to assess the efficacy and the tolerance of the strategy, with clinical, biochemical, immunological, virological and pharmacokinetic evaluations.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
45
Inclusion Criteria
  • adult confirmed HIV-1 infection
  • no previous treatment with antiretroviral drugs or interleukin-2
  • CD4 count ≥ 500/mm3
  • no active opportunistic infection
  • written informed consent
Exclusion Criteria
  • non barrier contraception in women of child bearing potential, pregnant or breastfeeding woman, pregnancy project within the next 2 years
  • HIV-2 infection (with or without HIV-1), recent HIV primary infection, resistance to trial drugs at study entry, Ag HBs+, HCV requiring specific therapy
  • previous history of cerebrovascular accident or coronary heart disease, splenectomy
  • previous CD4 count < 400/mm3
  • CD4 percentage < 15%
  • hemoglobin < 8 g/dl, neutrophils < 750/mm3, platelets < 100.000/mm3, creatinine clearance < 50 ml/mn, AST or ALT or total bilirubin > 3 ULN

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Intermittent treatmentStructured treatment interruption6 months on antiretroviral treatment and 6 months off treatment
Primary Outcome Measures
NameTimeMethod
proportion of patients with mean CD4 count at M21 and M24 above or equal to the mean CD4 count at screening and inclusion, without experiencing a decrease below 400/mm3 throughout the study.M21 and M24
Secondary Outcome Measures
NameTimeMethod
proportion of patients having followed the strategy of the trialfrom week 0 to M24
existence and nature of HIV genotypic mutations associated with antiretroviral resistanceM9 and M24 and at any time visit in case of failure
proportion of patients following the strategy of the trial and with AIDS related and non AIDS-related (cardiovascular, renal, hepatic, infectious, cancerous) serious clinical eventM12 and M24
number, type and time to AIDS and non AIDS-related serious clinical eventsfrom week 0 to M24
number, type and time to clinical and biological events (whatever the grade of severity)from week 0 to M24
evolution of HIV RNA and HIV DNA throughout the studyfrom week 0 to M24 for RNA and each 6 months for DNA
Quality of life and observance (questionnaires)QL each 6 months, observance at M1, M6, M13 and M18

Trial Locations

Locations (1)

Services maladies infectieuses et tropicales CHU

🇫🇷

Dijon, France

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