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Sponsored by: |
National Institute of Allergy and Infectious Diseases (NIAID) |
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Information provided by: | National Institute of Allergy and Infectious Diseases (NIAID) |
ClinicalTrials.gov Identifier: | NCT00000896 |
The purpose of this study is to examine how the level of HIV is reduced in the blood when anti-HIV therapy is initiated. This study will also evaluate whether adding GM-CSF or IL-12 to the anti-HIV drug regimen will increase the rate that HIV is reduced.
The anti-HIV drugs used in this study will include lamivudine (3TC), zidovudine (ZDV), indinavir (IDV), nevirapine (NVP), and stavudine (d4T). All have been used successfully to treat HIV. GM-CSF has been used to treat certain blood disorders; it will be used as an experimental drug in this study. IL-12 (interleukin-12) is a protein found naturally in the body that is thought to boost the immune system. Although GM-CSF and IL-12 have no direct effect against HIV, these drugs may improve the ability of the immune system to fight the virus.
Condition | Intervention |
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HIV Infections |
Drug: Indinavir sulfate Drug: Lamivudine/Zidovudine Biological: Hepatitis A Vaccine (Inactivated) Drug: Interleukin-12 Drug: Nevirapine Drug: Stavudine Drug: Sargramostim |
Study Type: | Interventional |
Study Design: | Treatment, Open Label, Pharmacokinetics Study |
Official Title: | A Randomized Controlled Trial to Compare the Efficacy of a Four Drug Antiretroviral Regimen Alone or in Combination With GM-CSF or IL-12 Administered to HIV-1 Infected Subjects as Measured by the Characteristics of Viral Decay |
Estimated Enrollment: | 24 |
Potent antiretroviral therapies that suppress HIV replication have permitted mathematical modeling of the dynamics of HIV infection and clearance by measurement of the decay of viral load in plasma. When de nova infection is blocked by antiretroviral therapy, the viral load decreases exponentially after a short initial lag time ("shoulder"). This rapid decline is followed by a slower second-phase decay. The intent of this study is to utilize four antiretroviral agents (zidovudine, lamivudine, nevirapine, indinavir) and very frequent measures of viral load to explore the drug-specific kinetics of the "shoulder". The decay of long-lived HIV-infected tissue macrophages is thought to be the major determinant of the slow second phase. Further, the study intends to use immune modulating agents with the potential to increase the turnover of infected macrophages, GM-CSF or IL-12, to accelerate the second phase of viral decay.
Patients are assigned to Group A (16 patients) or to Group B (8 patients). Patients in Group A are randomized to 1 of the following 4 initial treatment arms:
ARM A: Final dose combination (FDC) Zidovudine (ZDV)/Lamivudine (3TC). ARM B: Nevirapine (NVP). ARM C: Indinavir (IDV). ARM D: FDC ZDV/3TC plus NVP plus IDV. The initial regimen is maintained over the first 72 hours and blood for viral dynamic evaluations collected while patients are maintained as inpatients. Then, patients in Arms A, B, and C initiate FDC ZDV/3TC plus NVP plus IDV.
Patients assigned to Group B begin the following 4-drug regimen on Day 0:
ARM E: FDC ZDV/3TC plus NVP plus IDV.
On Day 7, patients in both Groups A and B are randomized to receive one of the following therapies in addition to their 4-drug regimen:
ARM F: GM-CSF daily for 2 weeks, then thrice weekly (MWF). ARM G: IL-12 twice weekly. ARM H: No immune modulation. Patients may be hospitalized to initiate immune modulation or may be treated as outpatients. Immune modulation is discontinued after Week 14. Patients maintain their 4-drug regimen through Week 48. [AS PER AMENDMENT 6/11/99: The study duration has been extended to 96 weeks.] Hepatitis A vaccine (inactivated) is administered on Weeks 16 and 40 [AS PER AMENDMENT 2/13/98: to patients whose baseline hepatitis A serology was negative].
Ages Eligible for Study: | 18 Years and older |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
Inclusion Criteria
You may be eligible for this study if you:
Exclusion Criteria
You will not be eligible for this study if you:
United States, California | |
Univ of California / San Diego Treatment Ctr | |
San Diego, California, United States, 921036325 | |
United States, Colorado | |
Univ of Colorado Health Sciences Ctr | |
Denver, Colorado, United States, 80262 | |
United States, Indiana | |
Indiana Univ Hosp | |
Indianapolis, Indiana, United States, 462025250 | |
United States, New York | |
Aaron Diamond AIDS Rsch Ctr / Rockefeller Univ | |
New York, New York, United States, 10021 |
Study Chair: | Rhonda G. Kost | |
Study Chair: | David Ho |
Study ID Numbers: | ACTG 387 |
Study First Received: | November 2, 1999 |
Last Updated: | September 24, 2008 |
ClinicalTrials.gov Identifier: | NCT00000896 |
Health Authority: | United States: Federal Government |
HIV-1 Drug Therapy, Combination Granulocyte Colony-Stimulating Factor Acquired Immunodeficiency Syndrome Zidovudine Nevirapine |
Stavudine HIV Protease Inhibitors Lamivudine Indinavir Interleukin-12 Reverse Transcriptase Inhibitors |
Sexually Transmitted Diseases, Viral Interleukin-12 Stavudine Indinavir Acquired Immunodeficiency Syndrome Zidovudine Lamivudine |
Immunologic Deficiency Syndromes Virus Diseases Nevirapine HIV Seropositivity HIV Infections Sexually Transmitted Diseases Retroviridae Infections |
Antimetabolites Anti-Infective Agents Slow Virus Diseases Molecular Mechanisms of Pharmacological Action Immunologic Factors Antineoplastic Agents Physiological Effects of Drugs Infection Reverse Transcriptase Inhibitors Anti-Retroviral Agents Therapeutic Uses Angiogenesis Modulating Agents Growth Inhibitors |
Nucleic Acid Synthesis Inhibitors RNA Virus Infections HIV Protease Inhibitors Anti-HIV Agents Immune System Diseases Growth Substances Adjuvants, Immunologic Enzyme Inhibitors Antiviral Agents Angiogenesis Inhibitors Pharmacologic Actions Protease Inhibitors Lentivirus Infections |