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A Study of Valacyclovir Hydrochloride in the Prevention of Life-Threatening Cytomegalovirus Disease in HIV-Infected Patients

Phase 3
Completed
Conditions
Cytomegalovirus Infections
HIV Infections
Registration Number
NCT00001038
Lead Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)
Brief Summary

PRIMARY: To evaluate the efficacy of valacyclovir hydrochloride (BW 256U87) in the prevention of cytomegalovirus (CMV) end-organ disease in HIV/CMV co-infected patients with CD4+ lymphocytes \< 100 cells/mm3. To assess the impact of BW 256U87, high-dose oral acyclovir and low-dose oral acyclovir on survival.

SECONDARY: To evaluate the effect of BW 256U87 on quality of life, the safety of the drug administered concurrently with standard antiretroviral agents and other essential therapies for the treatment and prevention of opportunistic diseases, and the efficacy of BW 256U87 in suppressing activation of other herpesviruses. To evaluate serologic and virologic risk factors for the development of CMV disease, including assessment of HIV activation, and the risk of developing drug-resistant CMV, HSV, and VZV.

Gastrointestinal absorption of acyclovir is not high enough to prevent CMV disease in patients with advanced HIV disease, although there is evidence that high doses of the drug may extend survival. Valacyclovir, a prodrug that is rapidly converted to acyclovir after oral administration, has a higher absorption rate and may therefore provide inhibitory activity against CMV.

Detailed Description

Gastrointestinal absorption of acyclovir is not high enough to prevent CMV disease in patients with advanced HIV disease, although there is evidence that high doses of the drug may extend survival. Valacyclovir, a prodrug that is rapidly converted to acyclovir after oral administration, has a higher absorption rate and may therefore provide inhibitory activity against CMV.

Patients are randomized to receive BW 256U87 alone or acyclovir alone as control at either high-dose or low-dose. The acyclovir controls will provide suppressive therapy for herpes simplex infections and may affect survival.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
1200
Inclusion Criteria

Not provided

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Exclusion Criteria

Not provided

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Study & Design

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

Trial Locations

Locations (35)

Montreal Chest Institute

🇨🇦

Montreal, Quebec, Canada

Southern Alberta HIV Clinic / Foothills Hosp

🇨🇦

Calgary, Alberta, Canada

Yale Univ

🇺🇸

New Haven, Connecticut, United States

Montreal Gen Hosp

🇨🇦

Montreal, Quebec, Canada

Medizinische Universibatspoliklinik Infekbiologie

🇨🇭

Bern, Switzerland

CARE Ctr / UCLA Med Ctr

🇺🇸

Los Angeles, California, United States

Birmingham Veterans Administration Med Ctr

🇺🇸

Birmingham, Alabama, United States

Universita Cattolica del Sacro Cuore

🇮🇹

Rome, Italy

Washington Univ

🇺🇸

St Louis, Missouri, United States

Highland Gen Hosp / San Francisco Gen Hosp

🇺🇸

Oakland, California, United States

Indiana Univ Hosp

🇺🇸

Indianapolis, Indiana, United States

Universitatsklinikum Rudolf Virchow

🇩🇪

Berlin, Germany

Univ of California / San Diego Treatment Ctr

🇺🇸

San Diego, California, United States

Northwestern Univ Med School

🇺🇸

Chicago, Illinois, United States

Kaiser Permanente Med Ctr

🇺🇸

San Francisco, California, United States

Univ of Colorado Health Sciences Ctr

🇺🇸

Denver, Colorado, United States

Mount Sinai Med Ctr

🇺🇸

New York, New York, United States

Harvard (Massachusetts Gen Hosp)

🇺🇸

Boston, Massachusetts, United States

Ohio State Univ Hosp Clinic

🇺🇸

Columbus, Ohio, United States

Girard Med Ctr

🇺🇸

Philadelphia, Pennsylvania, United States

Univ TX Galveston Med Branch

🇺🇸

Galveston, Texas, United States

Sunnybrook Health Science Ctr

🇨🇦

Toronto, Ontario, Canada

Saint Vincent's Hosp Med Centre

🇦🇺

Sydney, Australia

Toronto Hosp

🇨🇦

Toronto, Ontario, Canada

Hvidovre Univ Hosp

🇩🇰

Hvidore, Denmark

South Hosp

🇸🇪

Stockholm, Sweden

Services des Maladies Infectieuses

🇫🇷

Paris Cedex 12, France

Univ of Washington / Madison Clinic

🇺🇸

Seattle, Washington, United States

Westminster Hosp

🇬🇧

London, United Kingdom

Los Angeles County - USC Med Ctr

🇺🇸

Los Angeles, California, United States

Univ of North Carolina School of Medicine

🇺🇸

Chapel Hill, North Carolina, United States

Royal Free Hosp

🇬🇧

London, United Kingdom

Johns Hopkins Hosp

🇺🇸

Baltimore, Maryland, United States

Boston Med Ctr

🇺🇸

Boston, Massachusetts, United States

North Central Bronx Hosp / Bronx Municipal Hosp

🇺🇸

Bronx, New York, United States

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