A Study to Evaluate the Impact of Stopping Treatment for the Prevention of Pneumonia in HIV-Positive Patients Receiving Anti-HIV Drugs Who Have Increased CD4 Cell Counts

NCT ID: NCT00000908

Last Updated: 2005-06-24

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

Total Enrollment

250 participants

Study Classification

OBSERVATIONAL

Brief Summary

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The purpose of this study is to see how often Pneumocystis carinii pneumonia (PCP) occurs in HIV-positive patients who have stopped taking medications that help prevent PCP.

The risk of developing PCP may be decreased when an HIV-positive patient's CD4 cell counts (cells of the immune system which fight infection) are more than 200 cells/mm3. This study looks at whether it is acceptable to stop PCP prevention treatment in these patients.

Detailed Description

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The risk of developing PCP may be decreased with treatment-induced recovery of CD4 counts to \> 200 cells/mm3. Few data exist to confirm or negate the continued necessity of PCP prophylaxis for such patients. This study will assess the effects of discontinuing therapy.

Subjects are asked to discontinue PCP prophylaxis if antiretroviral therapy has resulted in a sustained CD4 increase greater than 200 cells/mm3 on two measurements at least 12 weeks apart. They will be evaluated for symptoms and CD4 counts every 8 weeks as well as plasma for HIV-RNA every 16 weeks for 18 months. Subjects whose CD4 count falls to less than 150 cells/mm3 or between 150 and 200 cells/mm3 will have the CD4 count re-evaluated immediately or within 4 weeks. If the second CD4 count is less than 200 cells/mm3 for either case, conventional PCP prophylaxis will be resumed and the subject will be followed on study. Subjects will be followed during study by physical exams and laboratory tests at Weeks 4, 8, and every 8 weeks thereafter.

Conditions

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Pneumonia, Pneumocystis Carinii HIV Infections

Study Design

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Observational Model Type

NATURAL_HISTORY

Eligibility Criteria

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Inclusion Criteria

You may be eligible for this study if you:

* Are HIV-positive.
* Have had 1 CD4 cell count of less than 100 cells/mm3 and have never had PCP, or have had at least 2 CD4 cell counts over 200 cells/mm3 and have had PCP within 6 months prior to study entry.
* Have received PCP prevention medication within 3 months of study entry.
* Are at least 13 years old (need consent if under 18).
* Are taking anti-HIV (antiretroviral) medication at study entry.

Exclusion Criteria

You will not be eligible for this study if you:

* Have active PCP or symptoms of PCP within 2 weeks of study entry.
* Have a fever lasting more than 2 weeks.
* Have oral candidiasis (thrush).
Minimum Eligible Age

13 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

Principal Investigators

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Susan Koletar

Role: STUDY_CHAIR

Alison Heald

Role: STUDY_CHAIR

Robert Murphy

Role: STUDY_CHAIR

Locations

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Univ of Alabama at Birmingham

Birmingham, Alabama, United States

Site Status

Kaiser Foundation Hosp

Harbor City, California, United States

Site Status

Kaiser Permanente LAMC

Los Angeles, California, United States

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Univ of Southern California / LA County USC Med Ctr

Los Angeles, California, United States

Site Status

Willow Clinic

Menlo Park, 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

San Francisco Gen Hosp

San Francisco, California, United States

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Santa Clara Valley Med Ctr / AIDS Community Rsch Consortium

San Jose, California, United States

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Marin County Specialty Clinic

San Rafael, California, United States

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San Mateo AIDS Program / Stanford Univ

Stanford, California, United States

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Stanford Univ Med Ctr

Stanford, California, United States

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Univ of Colorado Health Sciences Ctr

Denver, Colorado, United States

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Howard Univ

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

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Univ of Miami School of Medicine

Miami, Florida, United States

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Emory Univ

Atlanta, Georgia, United States

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Queens Med Ctr

Honolulu, Hawaii, United States

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Univ of Hawaii / Leahi Hosp

Honolulu, Hawaii, United States

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Northwestern Univ Med School

Chicago, Illinois, United States

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Cook County Hosp

Chicago, Illinois, United States

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Rush Presbyterian - Saint Luke's Med Ctr

Chicago, Illinois, United States

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Louis A Weiss Memorial Hosp

Chicago, Illinois, United States

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Indiana Univ Hosp

Indianapolis, Indiana, United States

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Division of Inf Diseases/ Indiana Univ Hosp

Indianapolis, Indiana, United States

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Methodist Hosp of Indiana / Life Care Clinic

Indianapolis, Indiana, United States

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Johns Hopkins Hosp

Baltimore, Maryland, United States

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Harvard (Massachusetts Gen Hosp)

Boston, Massachusetts, United States

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Boston Med Ctr

Boston, Massachusetts, United States

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Beth Israel Deaconess - West Campus

Boston, Massachusetts, United States

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Beth Israel Deaconess Med Ctr

Boston, Massachusetts, United States

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Univ of Minnesota

Minneapolis, Minnesota, United States

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St Louis Regional Hosp / St Louis Regional Med Ctr

St Louis, Missouri, United States

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Univ of Nebraska Med Ctr

Omaha, Nebraska, United States

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SUNY / Erie County Med Ctr at Buffalo

Buffalo, New York, United States

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Beth Israel Med Ctr

New York, New York, United States

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Bellevue Hosp / New York Univ Med Ctr

New York, New York, United States

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Chelsea Ctr

New York, New York, United States

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Cornell Univ Med Ctr

New York, New York, United States

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Mount Sinai Med Ctr

New York, New York, United States

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St Mary's Hosp (Univ of Rochester/Infectious Diseases)

Rochester, New York, United States

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Univ of Rochester Medical Center

Rochester, New York, United States

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Univ of North Carolina

Chapel Hill, North Carolina, United States

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Duke Univ Med Ctr

Durham, North Carolina, United States

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Univ of Cincinnati

Cincinnati, Ohio, United States

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Univ of Kentucky Lexington

Cincinnati, Ohio, United States

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Case Western Reserve Univ

Cleveland, Ohio, United States

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MetroHealth Med Ctr

Cleveland, Ohio, United States

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Ohio State Univ Hosp Clinic

Columbus, Ohio, United States

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Philadelphia Veterans Administration Med Ctr

Philadelphia, Pennsylvania, United States

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Univ of Pennsylvania at Philadelphia

Philadelphia, Pennsylvania, United States

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Univ of Pittsburgh Med Ctr

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

Univ of Puerto Rico

San Juan, , Puerto Rico

Site Status

Countries

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United States Puerto Rico

References

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Koletar SL, Heald AE, Finkelstein D, Hafner R, Currier JS, McCutchan JA, Vallee M, Torriani FJ, Powderly WG, Fass RJ, Murphy RL; ACTG 888 Study Team. A prospective study of discontinuing primary and secondary Pneumocystis carinii pneumonia prophylaxis after CD4 cell count increase to > 200 x 106 /l. AIDS. 2001 Aug 17;15(12):1509-15. doi: 10.1097/00002030-200108170-00008.

Reference Type BACKGROUND
PMID: 11504983 (View on PubMed)

Other Identifiers

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ACTG 888

Identifier Type: -

Identifier Source: org_study_id