Mesalamine to Reduce T Cell Activation in HIV Infection
试验速览
- 阶段
- 4 期
- 状态
- 已完成
- 入组人数
- 33
- 试验地点
- 1
- 主要终点
- Log(10) Change in % Activated (CD38+HLA-DR+)CD8+ T Cells During the First 12 Weeks of Study
研究概览
简要总结
The objective of this study is to determine whether 12 weeks of mesalamine therapy added to a standard HIV treatment decreases systemic immune activation and inflammation in HIV-infected patients, possibly resulting in better recovery of the immune system. The study hypothesis is that decreasing inflammation directly in the gut may decrease both of these potential causes of chronic inflammation, potentially resulting in an immunologic benefit.
详细描述
While most HIV-infected patients can now achieve nearly complete viral suppression on currently available HIV medications, they still have at least a 10-year shorter life expectancy than the general population and are at higher risk for diseases associated with accelerated aging including cardiovascular disease and non-AIDS-defining cancers. Persistent inflammation and immune activation are believed to drive this increased risk. Despite suppression of viral replication in peripheral blood by effective HIV medications, HIV may continue to be expressed at low levels by T cells in the lining of the gut and may also result in translocation of bacterial products across the lining of the gut, driving persistent inflammation. We believe that decreasing inflammation directly in the gut may decrease both of these potential causes of chronic inflammation, potentially resulting in an immunologic benefit. Mesalamine is an oral anti-inflammatory drug used to treat patients with inflammatory bowel disease, acts locally on the gut tissue to decrease inflammation, and is associated with very few side effects. If mesalamine therapy reduces immune activation and inflammation in our study, it would prompt larger studies to see if mesalamine decreases clinical outcomes like cardiovascular disease, cancer, and mortality in this setting.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Crossover
- 主要目的
- Treatment
- 盲法
- Double (Participant, Investigator)
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •HIV-1 infection, as documented by any licensed ELISA test kit and confirmed by Western blot at any time prior to study entry.
- •Stable antiretroviral therapy for at least 6 months.
- •Screening CD4+ T cell count below 350 cells/mm3
- •All available CD4+ T cell counts in the last year and at screening <350 cells/mm3
- •Screening plasma HIV RNA levels below level of detection (< 40 copies RNA/mL).
- •All available plasma HIV RNA levels within past year below the level of detection. Isolated detectable values < 500 c/ml are allowed if HIV RNA levels before and after this time point are undetectable.
- •>90% adherence to therapy within the preceding 30 days, as determined by self-report.
- •Both male and female subjects are eligible. Females of childbearing potential must have negative pregnancy test at screening and agree to use a double-barrier method of contraception during the study.
排除标准
- •Patients who are intending to modify antiretroviral therapy in the next 24 weeks for any reason.
- •Serious illness requiring hospitalization or parental antibiotics within preceding 3 months.
- •Exposure to any immunomodulatory drug in the past 16 weeks.
- •Active hepatitis C or hepatitis B which will require treatment in the subsequent 24 weeks.
- •Screening absolute neutrophil count <1,000 cells/mm3, platelet count <50,000 cells/mm3, Hgb < 8mg/dL
- •Pancreatitis or lipase greater than 2 times the upper limit of normal.
- •Renal insufficiency with creatinine clearance less than 50 ml/min
- •Elevated transaminases greater than 2.5 times the upper limit of normal.
- •Evidence of decompensated cirrhosis, heart failure.
- •Pregnant or breastfeeding women
研究组 & 干预措施
Mesalamine
干预措施: Mesalamine (5-aminosalicylic acid, Apriso) (Drug)
Placebo
干预措施: Placebo (Drug)
结局指标
主要结局
Log(10) Change in % Activated (CD38+HLA-DR+)CD8+ T Cells During the First 12 Weeks of Study
时间窗: Week 0, Week 12
次要结局
- Log(10) Change in % Activated (CD38+HLA-DR+)CD8+ T Cells After Treatment Crossover(Week 12, Week 24)