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Kinetics of HIV-RNA Decay in Seminal Plasma of Men Treated by Dolutegravir at the Time of Primary HIV Infection

Phase 3
Completed
Conditions
HIV Infection Primary
Interventions
Registration Number
NCT02976259
Lead Sponsor
Institut de Médecine et d'Epidémiologie Appliquée - Fondation Internationale Léon M'Ba
Brief Summary

Sponsor: IMEA - Fondation Internationale Léon Mba C.H.U. Bichat - Claude Bernard 46, Rue Henri Huchard - 75018 PARIS Tél. : 01.40. 25. 63. 65 - Fax : 01.40.25.63.56

Coordinating investigator:

Dr Caroline Lascoux Combe Hôpital Saint Louis Service Maladies Infectieuses

1 avenue Claude Vellefaux - 75010 PARIS Tél. : 01 42 49 49 73 - Fax : 01 42 49 47 43 E-mail : caroline.lascoux-combe@aphp.fr

Participating country : FRANCE

Primary objective : Comparing the kinetic of HIV-RNA decay in blood plasma and in seminal plasma in patients starting a triple combination regimen with dolutegravir + tenofovir DF (TDF) + emtricitabine (FTC) at the time of PHI.

Secondary objectives :

* Comparison of HIV-1 RNA level in plasma (threshold 20 and 1 copies/ml) and in seminal plasma (threshold 60 copies/ml) at each visit D0, W2, W4, W8, W12, W24, W36, W48

* To assess the frequency of intermittent shedding in seminal plasma once virological suppression has been achieved and until W48

* Evolution of cellular HIV-1 DNA level in PBMC and in non-sperm cells between D0 and W48

* Comparison of dolutegravir concentration in blood plasma and seminal plasma

* Study of risk factors associated with viral persistence of HIV-RNA in the seminal plasma

* Analysis by deep sequencing of the viral population (quasi-species) in both compartments (blood plasma and seminal plasma) before virological suppression has been achieved (i.e. at D0 and W12)

Inclusion criteria :

* Patients diagnosed at the time of primary HIV infection (PHI) (i) a negative or indeterminate HIV ELISA associated with a positive antigenemia or plasma HIV RNA, (ii) a western blot profile compatible with ongoing seroconversion (incomplete western blot with absence of antibodies to pol proteins (p34, p68)) or (iii) an initially negative test for HIV antibodies followed within 3 months by a positive HIV serology

* Treatment including dolutegravir (DTG 50mg) + tenofovir/emtricitabine (TDF/FTC 245 mg/200 mg) initiated by the referee physician within a maximum of 15 days after diagnosis of PHI

* Genotypic sensitivity to TDF, FTC and DTG

* Patient with medical care insurance

Exclusion criteria :

* Chronic infection

* Infection or co-infection with HIV-2

Study treatment : Dolutegravir and tenofovir/emtricitabine Number of subjets : 20 patients (exploratory study)

Detailed Description

Secondary objectives :

* Comparison of HIV-1 RNA level in plasma (threshold 20 and 1 copies/ml) and in seminal plasma (threshold 60 copies/ml) at each visit D0, W2, W4, W8, W12, W24, W36, W48

* To assess the frequency of intermittent shedding in seminal plasma once virological suppression has been achieved and until W48

* Evolution of cellular HIV-1 DNA level in PBMC and in non-sperm cells between D0 and W48

* Comparison of dolutegravir concentration in blood plasma and seminal plasma

* Study of risk factors associated with viral persistence of HIV-RNA in the seminal plasma

* Analysis by deep sequencing of the viral population (quasi-species) in both compartments (blood plasma and seminal plasma) before virological suppression has been achieved (i.e. at D0 and W12)

Inclusion criteria :

* Patients diagnosed at the time of primary HIV infection (PHI) (i) a negative or indeterminate HIV ELISA associated with a positive antigenemia or plasma HIV RNA, (ii) a western blot profile compatible with ongoing seroconversion (incomplete western blot with absence of antibodies to pol proteins (p34, p68)) or (iii) an initially negative test for HIV antibodies followed within 3 months by a positive HIV serology

* Treatment including dolutegravir (DTG 50mg) + tenofovir/emtricitabine (TDF/FTC 245 mg/200 mg) initiated by the referee physician within a maximum of 15 days after diagnosis of PHI

* Genotypic sensitivity to TDF, FTC and DTG

* Patient with medical care insurance

Exclusion criteria :

* Chronic infection

* Infection or co-infection with HIV-2

Study treatment : Dolutegravir and tenofovir/emtricitabine Number of subjets : 20 patients (exploratory study)

Recruitment & Eligibility

Status
COMPLETED
Sex
Male
Target Recruitment
20
Inclusion Criteria
  • Patients diagnosed at the time of primary HIV infection (PHI) (i) a negative or indeterminate HIV ELISA associated with a positive antigenemia or plasma HIV RNA, (ii) a western blot profile compatible with ongoing seroconversion (incomplete western blot with absence of antibodies to pol proteins (p34, p68)) or (iii) an initially negative test for HIV antibodies followed within 3 months by a positive HIV serology
  • Treatment including dolutegravir (DTG 50mg) + tenofovir/emtricitabine (TDF/FTC 245 mg/200 mg) initiated by the referee physician within a maximum of 15 days after diagnosis of PHI
  • Genotypic sensitivity to TDF, FTC and DTG
  • Patient with medical care insurance
Read More
Exclusion Criteria
  • Chronic infection
  • Infection or co-infection with HIV-2
Read More

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Patient HIV primary infectionDolutegravirHIV primary infection Patient male receiving Dolutegravir
Primary Outcome Measures
NameTimeMethod
Comparing the kinetic of HIV-RNA decay in blood plasma and in seminal fluid2 weeks, 4 weeks, 8 weeks, 12 weeks, 24 weeks, 36 weeks and 48 weeks

Measure of HIV-RNA level in blood plasma and seminal fluid at each point and comparaison about the decay between both

Secondary Outcome Measures
NameTimeMethod
Analysis by deep sequencing of the viral population (quasi-species) in both compartments (blood plasma and seminal plasma) before virological suppression has been achievedDay 0 and 12 weeks
Comparison of dolutegravir concentration in blood plasma and seminal fluid2 weeks, 4 weeks, 8 weeks, 12 weeks, 24 weeks, 36 weeks and 48 weeks

Measure of doltegravir concentration in blood and seminal fluid at each points and comparaison of the value between the 2 compartments

The evolution of HIV proviral DNA in the peripheral blood mononuclear cells (PBMC) and in seminal fluidDay 0 and 48 weeks
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