Safety, Tolerability, and Adherence to a Raltegravir-based Antiretroviral Regimen for HIV Non-occupational Postexposure Prophylaxis
试验速览
- 阶段
- 4 期
- 状态
- 已完成
- 发起方
- 入组人数
- 120
- 试验地点
- 2
- 主要终点
- To describe the safety of 28 days of nonoccupational post-exposure prophylaxis containing raltegravir
研究概览
简要总结
The use of anti-HIV drugs following a potential sexual or injecting drug use exposure to HIV in order to try and prevent an exposure from becoming an infection is common. This is called nonoccupational postexposure prophylaxis (NPEP). The likelihood of NPEP succeeding is related to intrinsic qualities of the drugs used which includes at which point in the life cycle of the HIV virus the drugs work, how strong the drugs are against HIV, and how well tolerated the drugs are i.e. what side effects they produce. Many people skip doses during their treatment or abandon their treatment because of side effects. The anti-HIV drug raltegravir works early in the life cycle of the virus i.e. before it integrates with human DNA, is potent against HIV and causes few side effects. These qualities make it an obvious choice for use as a NPEP treatment. In this study 100 HIV negative men will receive raltegravir along with another HIV drug called truvada (commonly used in NPEP) for 28 days after a possible sexual exposure to HIV. They will be monitored closely for adverse events, side effects and for their ability to take the medicine each day for the whole 28 days. The hypothesis in this study states that raltegravir use in NPEP will be safe, well tolerated and result in a high treatment completion rate.
详细描述
This is a single site, 72-week, prospective, open-label, non-randomized trial. One hundred and 50 (150) eligible participants will be assigned to receive RAL 400 mg BID along with tenofovir disoproxil fumarate/emtricitabine (TVD) 1 tablet once daily (3-drug NPEP) for 28-days or TVD 1 tablet once daily (2-drug NPEP) for 28-days according to established Australian guidelines for the use of 3 or 2-drug NPEP following a potential or actual sexual exposure to HIV in men who have sex with men (MSM).1 Based on hospital NPEP data over the past 2 years, it is anticipated that 100 MSM will receive 3-drug (RAL-TVD) NPEP and 50 will receive 2-drug (TVD) NPEP. Follow-up post NPEP is for 23 weeks i.e. to week 24 post exposure.
Primary study objectives:
To describe the safety of 28 days of nonoccupational post-exposure prophylaxis(NPEP) containing raltegravir (RAL) To describe the tolerability of 28 days of NPEP containing RAL To describe on-drug adherence and regimen completion rates of 28 days of NPEP containing RAL
Secondary study objectives:
To investigate whether or not receipt of NPEP decreases, increases or has no impact on HIV risk taking behaviour To describe the effects of RAL and tenofovir disoproxil fumarate/emtricitabine (TVD) on key inflammatory biomarkers in a subset of the main study population
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 70 Years（Adult, Older Adult）
- 性别
- Male
- 接受健康志愿者
- 否
入选标准
- •Eligible MSM who, according to Australian NPEP guidelines, or in the opinion of the investigators, are assessed as eligible for NPEP following a potential or actual sexual exposure to HIV who present to St. Vincent's Hospital, Sydney.
排除标准
- •Non sexual exposures
- •Exposures occurring during sex between a man and a woman
- •HIV infection diagnosed on baseline serological testing including indeterminate serology consistent with possible primary HIV infection
- •Use of any medication contraindicated with RAL or TVD
- •Serum hepatic transaminases (ALT/AST) greater than 5 times the upper limit of normal
- •Serum creatinine greater than 2 times the upper limit of normal#
- •Therapy with adefovir, tenofovir, emtricitabine, lamivudine, or entecavir for hepatitis B
- •Baseline serological evidence of chronic/active hepatitis B
- •Previous NPEP containing RAL in the study period
- •A patient with a history or current evidence of any condition, therapy, or laboratory abnormality, or other circumstance that might confound the results of the study, or interfere with the patient's participation for the full duration of the study
研究组 & 干预措施
Raltegravir, NPEP
Drug: Raltegravir Tablet 400mg taken orally, twice daily with or without food for 28 days along with Truvada 1 tablet taken orally daily for 28 days.
Arms: Raltegravir/Truvada
干预措施: Raltegravir (Drug)
结局指标
主要结局
To describe the safety of 28 days of nonoccupational post-exposure prophylaxis containing raltegravir
时间窗: 28 days on drug with 5 month follow-up
Objective AE and SAE data collection/grading utilising DAIDS data collection tool. Measurement of weight and vital signs, electrolytes, urea, creatinine, eGFR, inorganic phosphate, calcium, liver function, glucose, amylase, lipase, creatine kinase, lactate, urinalysis
To describe on-drug adherence and regimen completion rates of 28 days of NPEP containing raltegravir
时间窗: 28 days
Adherence measurement by self report and pill count at 3 time points during the 28-days of NPEP
To describe the tolerability of 28 days of NPEP containing raltegravir
时间窗: 28 days on-drug and 5 months follow-up
Subjective reporting of AEs with data collection/grading utilising DAIDS-AE
次要结局
- To describe the context of the risk(Baseline visit day 1 of NPEP)
- To investigate whether or not receipt of NPEP decreases, increases or has no impact on future HIV risk taking behaviour(Visit 2 (day 3-5 of study), visit 7 (day 82-84 of study) visit 9 (day 166-168 of study))
- To describe the effects of raltegravir and truvada on key inflammatory biomarkers(Day 1 and day 28 of NPEP)
研究者
Andrew Carr
Professor
St Vincent's Hospital