Safety and Efficacy of Zidovudine for Asymptomatic HIV-Infected Individuals

NCT ID: NCT00000736

Last Updated: 2021-11-03

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

3200 participants

Study Classification

INTERVENTIONAL

Study Completion Date

1995-02-28

Brief Summary

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To determine if treatment with zidovudine (AZT) will delay or prevent the onset of AIDS or AIDS related complex (ARC) in individuals infected with HIV but who do not have symptoms of AIDS or ARC. Also, to compare the dose of AZT found to be useful in AIDS and severe ARC with a lower dose to see if side effects can be reduced.

Results from several studies show that a high percentage of people infected with HIV will eventually develop AIDS or ARC unless an effective treatment is found. Because AZT is known to prolong survival in patients with AIDS or severe ARC and has acceptable toxicity in advanced disease, it is reasonable to try it in less advanced cases.

Detailed Description

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Results from several studies show that a high percentage of people infected with HIV will eventually develop AIDS or ARC unless an effective treatment is found. Because AZT is known to prolong survival in patients with AIDS or severe ARC and has acceptable toxicity in advanced disease, it is reasonable to try it in less advanced cases.

Patients entered in the study are randomly assigned to one of two doses of AZT or to placebo (inactive medication). Patients take 3 capsules 5 times a day (every 4 hours from 8 am until 12 pm).

The capsules contain either AZT or placebo and are identical in appearance so that neither patient nor physician knows which treatment the patient is receiving. The higher dose corresponds to the dose found to be useful in patients with AIDS or severe ARC. Patients visit the clinic every 2 weeks for the first 16 weeks, then once a month after that for evaluation. Treatment will continue until the results from the study have been analyzed, which could be as long as 3 years. If side effects occur, the dose of study medication will be decreased or temporarily stopped. If the side effects are severe, then study medication will be stopped permanently.

AMENDED: Effective with Version 4 (900226), dosing for ALL patients on Phase 2 study drug, regardless of CD4+ substudy, will proceed as open-label AZT. Original treatment assignments employed in the \> 500 cells/mm3 substudy during the period from August 16, 1989 through the release of this new version. Also, toxicity management and dose modification of AZT for patients receiving Phase 2 study drug have been changed.

Conditions

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HIV Infections

Keywords

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Acquired Immunodeficiency Syndrome AIDS-Related Complex Zidovudine

Study Design

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Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Interventions

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Zidovudine

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

Patients must:

* Be HIV seropositive and asymptomatic.
* Have normal neurologic exam as defined by the Micro Neuro-AIDS assessment.

Concurrent Medication

* Required: Prophylaxis for Pneumocystis carinii pneumonia (PCP). Aerosolized pentamidine is preferred but if not possible, Trimethoprim / sulfamethoxazole 1 DS tablet per day or Dapsone 50 - 100 mg per day is allowed.

Exclusion Criteria

* Active drug or alcohol abuse sufficient to prevent adequate compliance with study therapy in the investigator's opinion.

Co-existing Condition:

Patients with the following diseases or conditions are excluded:

* Hemophilia.
* Oral candida infection documented by morphology or by response to antifungal therapy within 2 years of study entry.
* Oral hairy leukoplakia at any time prior to study entry.
* Herpes zoster infection (including single dermatome infection) within 2 years of study entry.
* Active diarrhea as defined by 3 or more liquid stools per day.
* Temperature \> 37.8 degrees C.
* Grade 1 impairment on two or more items (mild AIDS dementia complex) in the ACTG Micro Neuro-AIDS Assessment.
* Prior history of malignancy other than cutaneous basal cell carcinomas or cervical carcinoma in situ.

Patients with the following are excluded from entry:

* AIDS or AIDS-related complex defining symptoms.
* Significant, chronic underlying medical illnesses which would impair continuous participation in this 3-year clinical trial.
* Hemophilia.

Prior Medication: Excluded:

* Chemoprophylaxis for Pneumocystis carinii pneumonia (PCP).
* Other experimental medications.
* Excluded within 60 days of study entry:
* Antiretroviral drugs or immunomodulators (biologic response modifiers).
* Excluded within 120 days of study entry:
* Systemic corticosteroids.

Prior Treatment: Excluded within 3 months of study entry:

* Blood transfusion.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute of Allergy and Infectious Diseases (NIAID)

NIH

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Volberding P

Role: STUDY_CHAIR

Locations

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Los Angeles County - USC Med Ctr

Los Angeles, California, United States

Site Status

UCLA CARE Ctr

Los Angeles, California, United States

Site Status

Summitt Med Ctr / San Francisco Gen Hosp

Oakland, California, United States

Site Status

Palo Alto Veterans Adm Med Ctr / Stanford Univ

Palo Alto, California, United States

Site Status

Univ of California / San Diego Treatment Ctr

San Diego, California, United States

Site Status

San Francisco AIDS Clinic / San Francisco Gen Hosp

San Francisco, California, United States

Site Status

Stanford at Kaiser / Kaiser Permanente Med Ctr

San Francisco, California, United States

Site Status

Children's Hosp of San Francisco

San Francisco, California, United States

Site Status

San Francisco AIDS Clinic

San Francisco, California, United States

Site Status

Stanford Univ School of Medicine

Stanford, California, United States

Site Status

Harbor UCLA Med Ctr

Torrance, California, United States

Site Status

George Washington Univ Med Ctr

Washington D.C., District of Columbia, United States

Site Status

Northwestern Univ Med School

Chicago, Illinois, United States

Site Status

Rush Presbyterian - Saint Luke's Med Ctr

Chicago, Illinois, United States

Site Status

Johns Hopkins Hosp

Baltimore, Maryland, United States

Site Status

Harvard (Massachusetts Gen Hosp)

Boston, Massachusetts, United States

Site Status

Beth Israel Deaconess - West Campus

Boston, Massachusetts, United States

Site Status

Beth Israel Deaconess Med Ctr

Boston, Massachusetts, United States

Site Status

Univ of Minnesota

Minneapolis, Minnesota, United States

Site Status

St Louis Regional Hosp / St Louis Regional Med Ctr

St Louis, Missouri, United States

Site Status

SUNY / Erie County Med Ctr at Buffalo

Buffalo, New York, United States

Site Status

City Hosp Ctr at Elmhurst / Mount Sinai Hosp

Elmhurst, New York, United States

Site Status

Beth Israel Med Ctr / Peter Krueger Clinic

New York, New York, United States

Site Status

Bellevue Hosp / New York Univ Med Ctr

New York, New York, United States

Site Status

Cornell Univ Med Ctr

New York, New York, United States

Site Status

Mem Sloan - Kettering Cancer Ctr

New York, New York, United States

Site Status

Saint Luke's - Roosevelt Hosp Ctr

New York, New York, United States

Site Status

Mount Sinai Med Ctr

New York, New York, United States

Site Status

Univ of Rochester Medical Center

Rochester, New York, United States

Site Status

SUNY - Stony Brook

Stony Brook, New York, United States

Site Status

SUNY / State Univ of New York

Syracuse, New York, United States

Site Status

Bronx Municipal Hosp Ctr/Jacobi Med Ctr

The Bronx, New York, United States

Site Status

Jack Weiler Hosp / Bronx Municipal Hosp

The Bronx, New York, United States

Site Status

Montefiore Med Ctr / Bronx Municipal Hosp

The Bronx, New York, United States

Site Status

Bronx Veterans Administration / Mount Sinai Hosp

The Bronx, New York, United States

Site Status

Duke Univ Med Ctr

Durham, North Carolina, United States

Site Status

Holmes Hosp / Univ of Cincinnati Med Ctr

Cincinnati, Ohio, United States

Site Status

Univ Hosp of Cleveland / Case Western Reserve Univ

Cleveland, Ohio, United States

Site Status

Columbus Children's Hosp

Columbus, Ohio, United States

Site Status

Ohio State Univ Hosp Clinic

Columbus, Ohio, United States

Site Status

Univ of Pittsburgh Med School

Pittsburgh, Pennsylvania, United States

Site Status

Julio Arroyo

West Columbia, South Carolina, United States

Site Status

Univ of Washington

Seattle, Washington, United States

Site Status

Countries

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United States

References

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Volberding PA, Lagakos SW, Grimes JM, Stein DS, Balfour HH Jr, Reichman RC, Bartlett JA, Hirsch MS, Phair JP, Mitsuyasu RT, et al. The duration of zidovudine benefit in persons with asymptomatic HIV infection. Prolonged evaluation of protocol 019 of the AIDS Clinical Trials Group. JAMA. 1994 Aug 10;272(6):437-42.

Reference Type BACKGROUND
PMID: 7913730 (View on PubMed)

Choi S, Lagakos SW, Schooley RT, Volberding PA. CD4+ lymphocytes are an incomplete surrogate marker for clinical progression in persons with asymptomatic HIV infection taking zidovudine. Ann Intern Med. 1993 May 1;118(9):674-80. doi: 10.7326/0003-4819-118-9-199305010-00003.

Reference Type BACKGROUND
PMID: 8096373 (View on PubMed)

Volberding PA, Lagakos SW, Grimes JM, Stein DS, Rooney J, Meng TC, Fischl MA, Collier AC, Phair JP, Hirsch MS, et al. A comparison of immediate with deferred zidovudine therapy for asymptomatic HIV-infected adults with CD4 cell counts of 500 or more per cubic millimeter. AIDS Clinical Trials Group. N Engl J Med. 1995 Aug 17;333(7):401-7. doi: 10.1056/NEJM199508173330701.

Reference Type BACKGROUND
PMID: 7616988 (View on PubMed)

Vella S, Giuliano M, Dally LG, Agresti MG, Tomino C, Floridia M, Chiesi A, Fragola V, Moroni M, Piazza M, et al. Long-term follow-up of zidovudine therapy in asymptomatic HIV infection: results of a multicenter cohort study. The Italian Zidovudine Evaluation Group. J Acquir Immune Defic Syndr (1988). 1994 Jan;7(1):31-8.

Reference Type BACKGROUND
PMID: 7903380 (View on PubMed)

Volberding PA, Lagakos SW, Koch MA, Pettinelli C, Myers MW, Booth DK, Balfour HH Jr, Reichman RC, Bartlett JA, Hirsch MS, et al. Zidovudine in asymptomatic human immunodeficiency virus infection. A controlled trial in persons with fewer than 500 CD4-positive cells per cubic millimeter. The AIDS Clinical Trials Group of the National Institute of Allergy and Infectious Diseases. N Engl J Med. 1990 Apr 5;322(14):941-9. doi: 10.1056/NEJM199004053221401.

Reference Type BACKGROUND
PMID: 1969115 (View on PubMed)

Volberding P. The value of the CD4+ count of 500 cells/microliters. Drugs. 1995;49 Suppl 1:4-8; discussion 38-40. doi: 10.2165/00003495-199500491-00004.

Reference Type BACKGROUND
PMID: 7614901 (View on PubMed)

Lenderking WR, Gelber RD, Cotton DJ, Cole BF, Goldhirsch A, Volberding PA, Testa MA. Evaluation of the quality of life associated with zidovudine treatment in asymptomatic human immunodeficiency virus infection. The AIDS Clinical Trials Group. N Engl J Med. 1994 Mar 17;330(11):738-43. doi: 10.1056/NEJM199403173301102.

Reference Type BACKGROUND
PMID: 7906386 (View on PubMed)

Wu AW, Rubin HR, Mathews WC, Ware JE Jr, Brysk LT, Hardy WD, Bozzette SA, Spector SA, Richman DD. A health status questionnaire using 30 items from the Medical Outcomes Study. Preliminary validation in persons with early HIV infection. Med Care. 1991 Aug;29(8):786-98. doi: 10.1097/00005650-199108000-00011.

Reference Type BACKGROUND
PMID: 1875745 (View on PubMed)

Jacobson MA, Gundacker H, Hughes M, Fischl M, Volberding P. Zidovudine side effects as reported by black, Hispanic, and white/non-Hispanic patients with early HIV disease: combined analysis of two multicenter placebo-controlled trials. J Acquir Immune Defic Syndr Hum Retrovirol. 1996 Jan 1;11(1):45-52. doi: 10.1097/00042560-199601010-00006.

Reference Type BACKGROUND
PMID: 8528732 (View on PubMed)

Other Identifiers

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10995

Identifier Type: REGISTRY

Identifier Source: secondary_id

ACTG 019

Identifier Type: -

Identifier Source: org_study_id