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Optimized Antiretroviral Therapy During Allogeneic Hematopoietic Stem Cell Transplantation in HIV-1 Individuals

Early Phase 1
Completed
Conditions
HIV
Interventions
Registration Number
NCT01836068
Lead Sponsor
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
Brief Summary

To find out if it is possible for HIV-1 patients to maintain antiretroviral medications during allogeneic bone marrow transplant

Detailed Description

Determine the feasibility of maintaining optimal ART in HIV-1 infected patients during allogeneic hematopoietic stem cell transplant (HSCT). The primary outcome is the fraction of patients who maintain any form of anti-retroviral therapy, including enfuvirtide monotherapy, through day 60 post-transplant. If patients are unable to take oral anti-retroviral medications, but are able to tolerate subcutaneous enfuvirtide monotherapy this will be considered maintenance of ART. Failure to maintain ART will be defined as ≥ 24 hours without any anti-retroviral therapy.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
11
Inclusion Criteria
  • HIV-1 infection, as documented by a rapid HIV-1 test or any FDA-approved HIV-1 enzyme or chemiluminescence immunoassay (E/CIA) test kit and confirmed by western blot at any time prior to study entry. Alternatively, two HIV-1 RNA values > 200 copies/mL at least 24 hours apart performed by any laboratory that has CLIA certification, or its equivalent may be used to document infection.
  • Patients must be ≥ 18 years of age.
  • Plan to undergo a Myeloablative, HLA matched or partially HLA-mismatched (haploidentical), related-donor bone marrow transplantation that includes high-dose posttransplantation Cy using bone marrow from a related donor:
  • Plan to undergo a Nonmyeloablative, HLA matched or partially HLA-mismatched, related-donor bone marrow transplantation that includes high-dose posttransplantation Cy using bone marrow from a related donor:
Exclusion Criteria
  • Patients with a known history of enfuvirtide resistance will not be eligible for this trial.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Enfuvirtide monotherapyEnfuvirtideEnfuvirtide 90 mg subcutaneously every 12 hours will be also be administered during any periods when oral medications are not expected to be tolerated for ≥ 24 hours, or during periods when ART is held due to interactions with conditioning regimens in patients who require ritonavir-boosted PI containing ART regimens.
Primary Outcome Measures
NameTimeMethod
Determine the feasibility of maintaining optimal ART in HIV-1 infected patients during allogeneic HSCT24 hours

Failure to maintain anti retroviral therapy for 24 hours

Secondary Outcome Measures
NameTimeMethod
Number of copies of HIV-1 DNA in blood mononuclear cells at baselineBaseline

Measure the number of copies of HIV-1 DNA per million peripheral blood mononuclear cells.

Number of copies of HIV-1 DNA in blood mononuclear cells at 12 weeks12 weeks post-intervention

Measure the number of copies of HIV-1 DNA per million peripheral blood mononuclear cells.

Number of copies of HIV-1 DNA in blood mononuclear cells at 24 weeks24 weeks post-intervention

Measure the number of copies of HIV-1 DNA per million peripheral blood mononuclear cells.

Number of copies of HIV-1 DNA in blood mononuclear cells at 36 weeks36 weeks post-intervention

Measure the number of copies of HIV-1 DNA per million peripheral blood mononuclear cells.

Number of copies of HIV-1 DNA in blood mononuclear cells at 52 weeks52 weeks post-intervention

Measure the number of copies of HIV-1 DNA per million peripheral blood mononuclear cells.

Number of copies of HIV-1 DNA in blood mononuclear cells at 2 years2 years post-intervention

Measure the number of copies of HIV-1 DNA per million peripheral blood mononuclear cells.

Trial Locations

Locations (1)

The Sidney Kimmel Comprehensive Cancer Center

🇺🇸

Baltimore, Maryland, United States

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