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A Study to Evaluate the Long-Term Effectiveness of Three Anti-HIV Drug Regimens in HIV Infected Patients Who Have Never Been Exposed to Highly Active Antiretroviral Therapy (HAART)
This study has been completed.
Sponsored by: National Institute of Allergy and Infectious Diseases (NIAID)
Information provided by: National Institute of Allergy and Infectious Diseases (NIAID)
ClinicalTrials.gov Identifier: NCT00000922
  Purpose

The purpose of this study is to determine whether it is better to start an anti-HIV regimen containing a protease inhibitor (PI), a non-nucleoside reverse transcriptase inhibitor (NNRTI), or a PI in combination with an NNRTI. This study will also examine which treatment regimen is best as a first treatment for HIV infection.


Condition Intervention
HIV Infections
Drug: Indinavir sulfate
Drug: Abacavir sulfate
Drug: Nelfinavir mesylate
Drug: Efavirenz
Drug: Nevirapine
Drug: Lamivudine
Drug: Stavudine
Drug: Didanosine

MedlinePlus related topics: AIDS AIDS Medicines
Drug Information available for: Abacavir Abacavir sulfate Lamivudine Indinavir Indinavir Sulfate Didanosine Stavudine Nelfinavir Nelfinavir Mesylate Efavirenz Nevirapine
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Randomized, Open Label, Uncontrolled, Parallel Assignment, Efficacy Study
Official Title: A Randomized, Open-Label Study of the Long-Term Effectiveness of Three Initial Highly Active Antiretroviral Therapy (HAART) Strategies in HAART-Niave, HIV-Infected Persons

Further study details as provided by National Institute of Allergy and Infectious Diseases (NIAID):

Primary Outcome Measures:
  • Change in CD4 count from baseline to the average of all readings obtained at the regular follow-up visits beginning at Month 32
  • time to disease progression, death, or CD4 count less than 200 cells/mm3 at the 4 Month visit for those patients with a baseline CD4 cell count of more than or equal to 200 cells/mm3

Estimated Enrollment: 1710
Detailed Description:

Highly active antiretroviral therapy (HAART) regimens containing PIs, NNRTIs, or nucleoside reverse transcriptase inhibitors (NRTIs) have been shown to slow disease progression. However, the long-term consequences of initial therapy with a PI, an NNRTI, or both a PI and an NNRTI are not yet known, nor is the impact on future anti-HIV treatment regimens. Patients who experience virologic failure on a particular HAART regimen typically have not been studied for subsequent response to other HAART regimens. It is possible that a regimen which is initially the most potent may not be optimal if it limits the effectiveness of subsequent anti-HIV treatment regimens.

Patients will be randomized to one of three HAART treatment arms:

  • Arm 1 participants will receive one or two PIs plus two NRTIs.
  • Arm 2 participants will receive one NNRTI plus two NRTIs.
  • Arm 3 participants will receive one or two PIs plus an NNRTI plus one or two NRTIs.

Before randomization to a treatment arm, patients will be given the option of preselecting the drugs they will use or allowing randomization to study-specified drugs. The study-specified PIs will be indinavir (IDV), nelfinavir (NFV), or two PIs of patient and doctor choice. The study-specified NNRTIs will be nevirapine (NVP) or efavirenz (EFV). The study-specified NRTIs will be abacavir (ABC) plus lamivudine (3TC) or didanosine (ddI) plus stavudine (d4T).

The study sites will provide ABC, 3TC, ddI, or d4T to all patients who are assigned to take these medications. All other anti-HIV drugs for initial and subsequent treatment regimens are obtained by clinician prescription. At Months 1 and 4 and then every 4 months thereafter, patients will receive a medical history update, physical exam, and questionnaire. Blood samples will also be drawn to measure CD4 cell count, viral load, and genotypic antiretroviral resistance. Changes in treatment regimens may occur at any time.

  Eligibility

Ages Eligible for Study:   13 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • HIV infected
  • Agree to practice abstinence or to use barrier methods of birth control during the study
  • Are at least 13 years old or have signed informed consent from legal guardian for patients between the ages of 13 and 18

Exclusion Criteria:

  • Have ever taken any anti-HIV drugs
  • Are unable to complete the study for any reason
  • Pregnancy
  • Breastfeeding
  • Any condition that, in the investigator's opinion, may interfere with the study
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00000922

Locations
United States, California
Community Consortium / UCSF
San Francisco, California, United States, 94110
United States, Colorado
Denver CPCRA / Denver Public Hlth
Denver, Colorado, United States, 802044507
United States, Connecticut
Yale Univ School of Medicine / AIDS Program
New Haven, Connecticut, United States, 06510
United States, District of Columbia
Washington Reg AIDS Prog / Dept of Infect Dis
Washington, District of Columbia, United States, 20422
United States, Georgia
AIDS Research Consortium of Atlanta
Atlanta, Georgia, United States, 303081962
United States, Illinois
AIDS Research Alliance - Chicago
Chicago, Illinois, United States, 60657
United States, Louisiana
Louisiana Comm AIDS Rsch Prog / Tulane Univ Med
New Orleans, Louisiana, United States, 70112
United States, Michigan
Henry Ford Hosp
Detroit, Michigan, United States, 48202
Wayne State Univ - WSU/DMC / Univ Hlth Ctr
Detroit, Michigan, United States, 48201
United States, New Jersey
North Jersey Community Research Initiative
Newark, New Jersey, United States, 071032842
Southern New Jersey AIDS Cln Trials / Dept of Med
Camden, New Jersey, United States, 08103
United States, New Mexico
Partners in Research / New Mexico
Albuquerque, New Mexico, United States, 87131
United States, New York
Harlem AIDS Treatment Grp / Harlem Hosp Ctr
New York, New York, United States, 10037
United States, Oregon
The Research and Education Group
Portland, Oregon, United States, 97210
United States, Pennsylvania
Philadelphia FIGHT
Philadelphia, Pennsylvania, United States, 19107
United States, Texas
Univ TX Health Science Ctr
Houston, Texas, United States, 77030
United States, Virginia
Richmond AIDS Consortium / Div of Infect Diseases
Richmond, Virginia, United States, 232980049
Sponsors and Collaborators
Investigators
Study Chair: Rodger D. MacArthur, MD University Health Center, Wayne State University
Study Chair: Richard Novak, MD University of Illinois
  More Information

Click here for more information about didanosine  This link exits the ClinicalTrials.gov site
Click here for more information about stavudine  This link exits the ClinicalTrials.gov site
Click here for more information about nevirapine  This link exits the ClinicalTrials.gov site
Click here for more information about lamivudine  This link exits the ClinicalTrials.gov site
Click here for more information about indinavir sulfate  This link exits the ClinicalTrials.gov site
Click here for more information about abacavir sulfate  This link exits the ClinicalTrials.gov site
Click here for more information about nelfinavir mesylate  This link exits the ClinicalTrials.gov site
Click here for more information about efavirenz  This link exits the ClinicalTrials.gov site
Haga clic aquí para ver información sobre este ensayo clínico en español.  This link exits the ClinicalTrials.gov site
Click here for more information on starting anti-HIV medications  This link exits the ClinicalTrials.gov site
Haga clic aquí para más información acerca de cuándo empezar los medicamentos contra el VIH  This link exits the ClinicalTrials.gov site

Publications of Results:
Other Publications:
Publications indexed to this study:
Study ID Numbers: CPCRA 058
Study First Received: November 2, 1999
Last Updated: September 11, 2008
ClinicalTrials.gov Identifier: NCT00000922  
Health Authority: United States: Federal Government

Keywords provided by National Institute of Allergy and Infectious Diseases (NIAID):
Drug Therapy, Combination
HIV Protease Inhibitors
Reverse Transcriptase Inhibitors
Anti-HIV Agents
Treatment Naive

Study placed in the following topic categories:
Efavirenz
Sexually Transmitted Diseases, Viral
Stavudine
Indinavir
Acquired Immunodeficiency Syndrome
Lamivudine
Immunologic Deficiency Syndromes
Virus Diseases
Nevirapine
Didanosine
HIV Infections
Sexually Transmitted Diseases
Abacavir
Nelfinavir
Retroviridae Infections

Additional relevant MeSH terms:
Antimetabolites
Anti-Infective Agents
HIV Protease Inhibitors
RNA Virus Infections
Anti-HIV Agents
Slow Virus Diseases
Immune System Diseases
Molecular Mechanisms of Pharmacological Action
Enzyme Inhibitors
Infection
Antiviral Agents
Pharmacologic Actions
Protease Inhibitors
Reverse Transcriptase Inhibitors
Anti-Retroviral Agents
Therapeutic Uses
Lentivirus Infections
Nucleic Acid Synthesis Inhibitors

ClinicalTrials.gov processed this record on January 15, 2009