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A Clinical Trial to Evaluate the Efficacy and Safety of Elvitegravir / Cobicistat / Emtricitabine / Tenofovir Alafenamide as a First-line Treatment in Naïve Patients With HIV-1 Infection With Severe Immunosuppression

Phase 4
Completed
Conditions
HIV Infections
Severe Immunosuppression
Interventions
Registration Number
NCT03693508
Lead Sponsor
Fundacion SEIMC-GESIDA
Brief Summary

Phase IV, open, multicentre and single-arm study. 50 HIV infection naive patients with severe immunosuppression will be recruited to evaluate the efficacy and safety of elvitegravir / cobicistat / emtricitabine / tenofovir alafenamide as a first-line treatment.

Detailed Description

The patients included in the study will be treated during 48 weeks and will have to perform the selection/basal visit, week 4 visit, week 8 visit, week 12 visit, week 24 visit, week 48 visit and follow up visit.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
50
Inclusion Criteria
  • Patients able to give their written consent to participate in the study after having received information about the design, the purposes of the study, the possible risks that may arise from it and the possibility of withdrawing from it at any time. moment
  • Adult patients (age ≥18 years) of both sexes
  • Patients with HIV-1 infection with severe immunosuppression, defined by a concentration of CD4 + lymphocytes <200 cells / μL
  • Patients who are allowed to perform a genotypic resistance test to inhibitors of intregrase, emtricitabine or tenofovir
  • Creatinine clearance ≥ 30 ml / min before the start of treatment
  • Alanine transaminase (ALT) / Aspartate transaminase (AST) levels not higher than five times normal levels, total bilirubin with normal values, neutrophils> 1000 cells / μL,> 50000 platelets / μL,> Hb level of 85 g / L and serum amylase levels <1 , 5 times higher normal limit before the start of treatment
Exclusion Criteria
  • Patient who undergoes a concomitant treatment not allowed. Patient with documented intolerance or hypersensitivity to the study medication, or who is contraindicated to use it, attending a technical file
  • Patient receiving therapies with interferon, interleukin 2, cytotoxic chemotherapy or immunosuppressants at the baseline visit.
  • Patients with neoplasms, an exception of skin cancer and anus cancer in situ (stage 0)
  • Patient with any medical or psychological, sociological or geographical alteration, toxic habit (drugs, alcohol) that, a criterion of the researcher, may interfere in the fulfillment of the study by the patient. These conditions will be discussed with the patient before their inclusion in the trial
  • Patients with any medical or psychological alteration that, a criterion of the investigator, an involuntary factor of the patient's ability to understand and complement the questionnaires and scales used in the study
  • Patient in a treatment with any type of drug / product under investigation or who is participating in a clinical trial that uses a product under investigation, with the exception of studies in which the study treatment was completed more than 12 weeks ago
  • Pregnant women, in breastfeeding period or with a positive pregnancy test in the selection period; women of childbearing age and sexually active who are not willing to use an adequate contraceptive method during the study and up to 3 months after the administration of the last dose of study treatment. Some women in adulthood have undergone permanent infertility procedures or amenorrheic procedures for less than 12 months
  • Patients with severe hepatic impairment (Child-Pugh Class C).

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Arm 1Genvoya®Naive HIV patients with severe immunosuppression.
Primary Outcome Measures
NameTimeMethod
Percentage of patients with undetectable plasma viral loadWeek 48

study the effectiveness of the combination of TAF/FTC/EVG-cb

Secondary Outcome Measures
NameTimeMethod
Proportion of patients with virological failureFrom basal visit until week 48

Proportion of patients who interrupt the treatment prematurely by others reasons (other than an adverse event, death or loss of effectiveness) and whose last viral load at the time of abandonment was ≥50 copies / mL.

Time to virological suppressionFrom basal until week 48

viral load \<50 copies / mL

Change in the CD4+ lymphocyte countWeek 48
Time to virological failureFrom basal until week 48

Viral load ≥50 copias/mL

Incidence of genotypic resistance in patients with virological failureFrom basal until week 48
Changes in viral loadWeeks 4, 8, 12, 24, 36 and 48

plasma concentration of HIV RNA

Proportion of patients who have a CD4+ lymphocyte count > 200 cells / μLWeek 48
Mean time to reach a CD4 + lymphocyte count> 200 cells / μLFrom basal until week 48
Proportion of patients with virological failure while receiving antiretroviral treatment (ART), having previously been suppressed .From basal until week 48

virological failure defined by protocol as viral load\> 1000 copies / mL at week 24 or 2 consecutive viral loads\> 50 copies / mL (at least 2 weeks apart)

Trial Locations

Locations (6)

H. Ramón y Cajal

🇪🇸

Madrid, Spain

H. Doce de Octubre

🇪🇸

Madrid, Spain

Hospital Infanta Leonor

🇪🇸

Madrid, Spain

H. Clínico San Carlos

🇪🇸

Madrid, Spain

Hospital virgen del Rocío

🇪🇸

Sevilla, Spain

Hospital Costa del Sol

🇪🇸

Marbella, Malaga, Spain

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