A Study of Anal Cancer Development in HIV Infected People
- Conditions
- Anus NeoplasmsHIV Infections
- Registration Number
- NCT00107679
- Brief Summary
The purpose of this study is to compare the development of abnormal cell growth or cancer in the anal region of individuals who are receiving one of two different anti-HIV treatment strategies.
- Detailed Description
Human papillomavirus (HPV) is a common viral infection among men and women. Individuals with HPV are at risk for anal dysplasia, a condition that may lead to anal cancer. It has been observed that HIV progresses more rapidly in individuals coinfected with HPV and HIV, compared to people with either disease alone. Studies that have investigated the effect of highly active antiretroviral therapy (HAART) on the progression of anal dysplasia have been contradictory and inconclusive. The role of CD4 count and HIV suppression and their contributions to the progression of anal disease needs to be determined. This trial is a substudy of a study of management of antiretroviral therapy (SMART). In the SMART study, patients will participate in one of two strategies: a drug conservation (DC) strategy and a viral suppression (VS) strategy. Participants in the DC group will stop or defer HAART, then receive episodic HAART treatment for the minimum time needed to maintain a CD4 cell count of at least 250 cells/mm3. Participants in the VS group will receive HAART to maintain a viral load as low as possible, regardless of CD4 count. This study will compare the times to development of high-grade anal dysplasia or anal cancer in participants who are currently enrolled in the SMART study.
Patients will participate in this substudy and the main SMART study at the same time. At the baseline visit, participants will undergo an anal swab; some female participants will have a cervical swab as well. Participants will provide a detailed sexual history including sexually transmitted infections, a history of anal-related conditions, and a history of alcohol and recreational drug use. These procedures will be repeated at each annual follow-up visit. Some participants may undergo additional anal cytology and high-resolution anoscopy with biopsy. Participants will be followed until they develop high-grade anal dysplasia or anal cancer or when the SMART study closes, whichever comes first.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 560
- Coenrollment in the SMART study
- Normal anal cytology result. If baseline anal cytology is abnormal, high-resolution anoscopy must be performed and specimens must be obtained.
- Parent or guardian willing to provide informed consent, if applicable
- Current or prior history of anal or cervical cancer
- Permanent or irreversible bleeding disorder that would interfere with biopsy of the anal canal
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method Time to high-grade anal dysplasia or anal cancer
- Secondary Outcome Measures
Name Time Method Time to anal cancer time to low-grade or high-grade anal dysplasia time to cervical HPV infection time to cervical HPV infection with a specific strain, for types 16, 18, or 31 time to anal HPV infection time to anal HPV infection with a specific strain, for types 16, 18, or 31 time to high-grade anal dysplasia time from low-grade anal dysplasia to normal
Trial Locations
- Locations (13)
LA Gay & Lesbian Community Service Ctr., Lamba Med. Group CRS
🇺🇸Los Angeles, California, United States
Castro-Mission Health Ctr. CRS
🇺🇸San Francisco, California, United States
Univ. of Colorado Health Science Ctr. CRS
🇺🇸Denver, Colorado, United States
Eastside Family Health Ctr. CRS
🇺🇸Denver, Colorado, United States
Washington DC VAMC, Washington Regional AIDS Program, Infectious Diseases CRS
🇺🇸Washington, District of Columbia, United States
Univ. of Florida, Div. of Infectious Diseases CRS
🇺🇸Jacksonville, Florida, United States
CRI-Boston CRS
🇺🇸Boston, Massachusetts, United States
Henry Ford Hosp. CRS
🇺🇸Detroit, Michigan, United States
Harlem Hospital Ctr./Columbia University CRS (Gordin CTU)
🇺🇸New York, New York, United States
Kaiser Immune Deficiency Clinic of Portland CRS
🇺🇸Portland, Oregon, United States
Scroll for more (3 remaining)LA Gay & Lesbian Community Service Ctr., Lamba Med. Group CRS🇺🇸Los Angeles, California, United States