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Trial to Study the Effect of Dose of Herpes Simplex Virus-2 (HSV-2) Suppressive Therapy on HSV and HIV
This study is currently recruiting participants.
Verified by University of Washington, April 2009
First Received: September 7, 2007   Last Updated: April 10, 2009   History of Changes
Sponsors and Collaborators: University of Washington
GlaxoSmithKline
Information provided by: University of Washington
ClinicalTrials.gov Identifier: NCT00527618
  Purpose

To compare the effect of daily valacyclovir 1 gram orally twice daily versus acyclovir 400 mg orally twice daily on the frequency of genital HSV reactivation and on plasma and genital HIV-1 levels among HSV-2/HIV-1 co-infected individuals. The investigators hypothesize that both treatments will reduce genital HSV and systemic and genital HIV-1.


Condition Intervention Phase
Genital Herpes
HIV Infections
Drug: valacyclovir
Drug: acyclovir
Phase IV

MedlinePlus related topics: AIDS Herpes Simplex
Drug Information available for: Acyclovir Valaciclovir Valacyclovir hydrochloride
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Randomized, Open Label, Active Control, Crossover Assignment, Efficacy Study
Official Title: A Randomized, Open-Label, Crossover Trial of the Effect of Dosing of Daily HSV-2 Suppressive Therapy on HSV Reactivation and Plasma and Genital HIV-1 Levels Among HIV-1/ HSV-2 co-Infected Persons

Further study details as provided by University of Washington:

Primary Outcome Measures:
  • The primary endpoints are the presence and quantity of genital HSV and the level of HIV-1 RNA in plasma and genital secretions of participants while on 400 mg twice daily of acyclovir versus while on 1000 mg twice daily of valacyclovir. [ Time Frame: 26 weeks ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • To evaluate the effect of valacyclovir 1 gram orally twice daily on prevention of days with genital herpes lesions compared with acyclovir 400 mg orally twice daily. [ Time Frame: 26 weeks ] [ Designated as safety issue: No ]
  • To evaluate the safety of valacyclovir 1 gram orally twice daily in HIV-1 seropositive persons. [ Time Frame: 26 weeks ] [ Designated as safety issue: Yes ]

Estimated Enrollment: 38
Study Start Date: December 2007
Estimated Study Completion Date: December 2010
Estimated Primary Completion Date: January 2010 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
1: Experimental
valacyclovir 1 gram orally twice daily
Drug: valacyclovir
1 gram orally twice daily
2: Active Comparator
acyclovir 400 mg orally twice daily
Drug: acyclovir
400 mg orally twice daily

Detailed Description:

We propose to conduct a randomized, open-label, cross-over study of 38 individuals who are HIV-1 seropositive and HSV-2 seropositive. Both men and women will be recruited for the study. Participants must not be on antiretroviral therapy and must not be planning to initiate antiretroviral therapy during the anticipated study period. Participants will be randomized 1:1 to receive acyclovir 400 mg twice daily or valacyclovir 1000 mg twice daily. After 12 weeks on the initial treatment, each participant will be crossed over to the alternative treatment arm for 12 weeks. The treatment periods will be separated by a 2-week washout period. During the first four weeks of each treatment period (i.e., Weeks 1-4 and Weeks 15-18), participants will provide self-collected genital swabs daily for HSV detection. Each week during the entire study period, participants will provide plasma and genital samples for HIV-1 detection.

Open-label acyclovir and valacyclovir will be used for this trial, as the primary outcome measures (genital HSV and plasma and genital HIV-1) are unlikely to be influenced by knowledge of treatment assignment. However, laboratory staff performing plasma and genital HIV-1 measurements will not be aware of treatment assignment.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Age 18 years or older
  • Documented HIV-1 seropositive
  • Not on HIV-1 antiretroviral therapy nor planning to initiate antiretroviral therapy during the study period
  • Detectable HIV-1 plasma viral load
  • HSV-2 seropositive as determined by western blot
  • Not intending to move out of the area for the duration of study participation
  • Willing and able to provide independent written informed consent
  • Willing and able to undergo clinical evaluations
  • Willing and able to take study drug as directed
  • Willing and able to adhere to follow-up schedule

Exclusion Criteria:

  • Known history of adverse reaction to acyclovir, valacyclovir, or famciclovir
  • Planned open label use of acyclovir, valacyclovir, or famciclovir
  • History of evidence of CMV disease
  • Known medical history of seizures
  • Known renal insufficiency, defined as serum creatinine greater than 1.5 mg/dl
  • AST or ALT greater than 3 times upper limit of normal
  • Hematocrit less than 30 %
  • Neutropenia, defined as absolute neutrophil count less than 1000
  • Thrombocytopenia, defined as platelet count less than 75,000
  • History of thrombotic microangiopathy
  • For women, pregnancy as confirmed by a urine pregnancy test
  • Any other condition which, in the opinion of the principal investigator, may compromise the ability to follow study procedures and complete the study
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00527618

Contacts
Contact: Jared Baeten, MD, PhD 206-720-4340 jbaeten@u.washington.edu

Locations
United States, Washington
University of Washington Virology Research Clinic Recruiting
Seattle, Washington, United States, 98122
Contact     206-720-4340     vrc@u.washington.edu    
Sponsors and Collaborators
University of Washington
GlaxoSmithKline
Investigators
Principal Investigator: Jared Baeten, MD, PhD University of Washington
Study Director: Anna Wald, MD, MPH University of Washington
  More Information

No publications provided

Responsible Party: University of Washington ( Jared Baeten )
Study ID Numbers: 31203-D, GSK VAL111009 - VAL140
Study First Received: September 7, 2007
Last Updated: April 10, 2009
ClinicalTrials.gov Identifier: NCT00527618     History of Changes
Health Authority: United States: Institutional Review Board

Keywords provided by University of Washington:
Herpes Simplex Virus 2
Human Immunodeficiency Virus
Treatment Naive

Study placed in the following topic categories:
Herpes Simplex
Sexually Transmitted Diseases, Viral
Skin Diseases
Herpes Genitalis
Acquired Immunodeficiency Syndrome
Genital Diseases, Male
Antiviral Agents
Immunologic Deficiency Syndromes
Herpesviridae Infections
Valacyclovir
Virus Diseases
Genital Diseases, Female
Skin Diseases, Infectious
Acyclovir
HIV Infections
Sexually Transmitted Diseases
DNA Virus Infections
Retroviridae Infections

Additional relevant MeSH terms:
Anti-Infective Agents
Sexually Transmitted Diseases, Viral
Slow Virus Diseases
Infection
Genital Diseases, Female
Valacyclovir
Therapeutic Uses
Retroviridae Infections
Herpes Simplex
RNA Virus Infections
Immune System Diseases
Skin Diseases
Herpes Genitalis
Acquired Immunodeficiency Syndrome
Genital Diseases, Male
Antiviral Agents
Pharmacologic Actions
Immunologic Deficiency Syndromes
Herpesviridae Infections
Virus Diseases
Skin Diseases, Viral
Skin Diseases, Infectious
HIV Infections
Sexually Transmitted Diseases
Lentivirus Infections
DNA Virus Infections

ClinicalTrials.gov processed this record on May 07, 2009