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Discontinuation of Antiretroviral Therapy in Patients With Asymptomatic HIV Infection

Completed
Conditions
HIV Infections
Registration Number
NCT00050284
Lead Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)
Brief Summary

The purpose of this study is to determine whether patients who have asymptomatic HIV infection can discontinue antiretroviral therapy (ART) without adverse clinical, virologic, or immunologic consequences. This study will also assess the virologic, immunologic, and clinical outcomes in any patients who restart ART.

Detailed Description

Patients who can discontinue ART without a significant loss of virologic or immunologic control and without an increase in clinical events may be spared the expense and adverse effects of treatment. However, the consequences of treatment discontinuation in patients with asymptomatic HIV infections are not well understood. This study will follow the clinical and immunologic progression of HIV infection in patients who have low HIV viral load and preserved CD4+ cell counts at the time ART is stopped.

Patients will fast for at least 8 hours prior to the first study visit. At this visit, blood will be drawn and body measurements will be taken. Patients will then discontinue their ART. Patients taking nonnucleoside reverse transcriptase inhibitors (NNRTIs) will stop taking NNRTIs 48 hours before withdrawing their other ART drugs. Study visits will occur every 4 to 8 weeks for the first year, then every 12 weeks for the second year. Blood will be taken at most visits, and patients will be asked to fast for at least 8 hours prior to Week 12 and 24 visits and again every 6 months. Patients who reinitiate ART for any reason will be registered to Step 2 and followed for 24 weeks.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
158
Inclusion Criteria
  • HIV infection
  • ART with 2 or more drugs for 6 or more months
  • CD4+ cell count(s) > 350 cells/mm3 immediately prior to initiation of first ART
  • CD4+ cell count > 350 cells/mm3 within 45 days prior to study entry
  • Plasma viral load < 55,000 copies/ml within 45 days prior to study entry
  • Willingness to discontinue ART at study entry
  • Negative serum or urine pregnancy test within 14 days prior to study entry
Exclusion Criteria
  • Pregnancy or breast-feeding
  • Systemic cancer chemotherapy, systemic investigational agents, or immunomodulators within 30 days prior to study entry
  • Drug or alcohol use or dependence that would interfere with adherence to study requirements
  • Illness requiring systemic treatment and/or hospitalization until the patient either completes therapy or has been clinically stable on therapy for at least 30 days prior to study entry
  • Chronic medical condition that would have a negative impact on the participation of the patient or would be expected to result in significant use of the medical care system
  • History of an HIV-related illness or complication in CDC categories B and C
  • Nonadherence to ART
  • Active infection with hepatitis B and currently taking adefovir at doses > 10 mg or 3TC and/or TDF

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (34)

Harbor General/UCLA

🇺🇸

Torrance, California, United States

St. Louis Connect Care

🇺🇸

St. Louis, Missouri, United States

Univ of Texas, Southwestern Medical Ctr

🇺🇸

Dallas, Texas, United States

Northwestern Univ

🇺🇸

Chicago, Illinois, United States

Rush-Presbyterian / St.Lukes (Chicago)

🇺🇸

Chicago, Illinois, United States

Methodist Hosp of Indiana

🇺🇸

Indianapolis, Indiana, United States

Wishard Hosp

🇺🇸

Indianapolis, Indiana, United States

The Miriam Hospital

🇺🇸

Providence, Rhode Island, United States

Stanley Street Treatment and Resource

🇺🇸

Providence, Rhode Island, United States

Univ of Pittsburgh

🇺🇸

Pittsburgh, Pennsylvania, United States

Rhode Island Hosp

🇺🇸

Providence, Rhode Island, United States

Comprehensive Care Clinic

🇺🇸

Nashville, Tennessee, United States

Univ of California, San Diego Antiviral Research Ctr

🇺🇸

San Diego, California, United States

Univ of Southern California

🇺🇸

Los Angeles, California, United States

Univ of California San Francisco

🇺🇸

San Francisco, California, United States

Santa Clara Valley Med Ctr

🇺🇸

Stanford, California, United States

Stanford Univ

🇺🇸

Stanford, California, United States

Willow Clinic

🇺🇸

Stanford, California, United States

Univ of Minnesota

🇺🇸

Minneapolis, Minnesota, United States

Cook County Hosp Core Ctr

🇺🇸

Chicago, Illinois, United States

Washington Univ (St. Louis)

🇺🇸

St. Louis, Missouri, United States

Indiana Univ Hosp

🇺🇸

Indianapolis, Indiana, United States

Beth Israel Med Ctr

🇺🇸

New York, New York, United States

Chelsea Clinic

🇺🇸

New York, New York, United States

NYU/Bellevue

🇺🇸

New York, New York, United States

The Cornell Clinical Trials Unit

🇺🇸

New York, New York, United States

Duke Univ Med Ctr

🇺🇸

Durham, North Carolina, United States

Presbyterian Med Ctr- Univ of PA

🇺🇸

Norristown, Pennsylvania, United States

Univ of Cincinnati

🇺🇸

Cincinnati, Ohio, United States

Univ of Pennsylvania, Philadelphia

🇺🇸

Philadelphia, Pennsylvania, United States

Univ of North Carolina

🇺🇸

Chapel Hill, North Carolina, United States

San Mateo County AIDS Program

🇺🇸

Stanford, California, United States

Georgetown Univ Med Ctr

🇺🇸

Washington, District of Columbia, United States

Univ of Hawaii

🇺🇸

Honolulu, Hawaii, United States

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