A Study to Evaluate the Effects of Azithromycin on MAC Disease Prevention in HIV-Positive Patients

NCT ID: NCT00000947

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

NA

Total Enrollment

850 participants

Study Classification

INTERVENTIONAL

Study Completion Date

2000-07-31

Brief Summary

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This study is designed to find out whether HIV-positive patients whose immune systems have improved after receiving anti-HIV treatment should take azithromycin to prevent Mycobacterium avium complex (MAC) disease. This study also examines the possibility of putting off MAC prevention treatment in patients who respond well to anti-HIV drug therapy.

Azithromycin is approved for the prevention of MAC disease in people with HIV and low CD4 cell counts. However, some people who have taken azithromycin have been found to carry antibiotic-resistant bacteria (germs that can grow despite the presence of drugs used to kill them). It is not known whether the risks associated with taking azithromycin outweigh the risk of getting MAC disease.

Detailed Description

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The need for MAC prophylaxis in advanced HIV disease is recognized. Prophylactic therapy is complicated, however, due to drug toxicity, potential drug interactions, patient noncompliance with multiagent regimens, microbial drug resistance, and high treatment costs. This study assesses the feasibility of deferring MAC prophylaxis in patients whose CD4+ cell counts rebound in response to antiretroviral therapy.

In this double-blind, placebo-controlled trial, patients are randomized to receive azithromycin weekly or matching placebo. Patients are switched to open-label azithromycin if they have an average CD4+ cell count less than 50 cells/mm3 on 2 consecutive counts obtained at least 48 hours apart (preferably no more than 60 days).

\[AS PER AMENDMENT 10/23/97: SUBSTUDY CPCRA 054: A subset of participants of CPCRA 048 have oropharyngeal swabs taken at baseline and 4 months after randomization. Antibiotic susceptibility tests are then performed on isolates of S. pneumoniae.\] \[AS PER AMENDMENT 9/3/99: Participants in protocol version 3.0 are followed for data collection purposes every 4 months for 18 months until January 31, 2001. Data collection includes CD4 cell counts, viral RNA measurements, macrolide susceptibility in MAC isolates, and antibiotic susceptibility of isolates from bacterial pneumonia episodes.\]

Conditions

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Mycobacterium Avium-intracellulare Infection HIV Infections

Keywords

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AIDS-Related Opportunistic Infections Placebos Mycobacterium avium-intracellulare Infection Acquired Immunodeficiency Syndrome Antitubercular Agents Azithromycin Drug Resistance, Microbial CD4 Lymphocyte Count Antibiotics Time Factors Anti-HIV Agents Pneumonia, Bacterial Streptococcus pneumoniae

Study Design

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Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Interventions

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Azithromycin

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

You may be eligible for this study if you:

* Are HIV-positive.
* Have 2 CD4 counts over 100 cells/mm3 at least 30 days apart.
* Have a history of CD4 counts under 50 cells/mm3.
* Are at least 13 years old (need consent if under 18).
* Are in reasonably good health.
* Are expected to live for at least 6 months.
* Are receiving anti-HIV medications at study entry.

Exclusion Criteria

You will not be eligible for this study if you:

* Have/had MAC disease.
* Have been unable to take azithromycin in the past.
* Are on any medications that act against MAC.
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

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Wafaa El-Sadr

Role: STUDY_CHAIR

William Burman

Role: STUDY_CHAIR

Locations

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Community Consortium / Jon Kaiser Wellness Ctr

San Francisco, California, United States

Site Status

Community Consortium / UCSF

San Francisco, California, United States

Site Status

Denver CPCRA / Denver Public Hlth

Denver, Colorado, United States

Site Status

Washington Reg AIDS Prog / Dept of Infect Dis

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

Site Status

AIDS Research Consortium of Atlanta

Atlanta, Georgia, United States

Site Status

AIDS Research Alliance - Chicago

Chicago, Illinois, United States

Site Status

Louisiana Comm AIDS Rsch Prog / Tulane Univ Med

New Orleans, Louisiana, United States

Site Status

LSMUC / Lions Clinic

New Orleans, Louisiana, United States

Site Status

Catherine McAuley Health Ctr

Detroit, Michigan, United States

Site Status

Wayne State Univ - WSU/DMC / Univ Hlth Ctr

Detroit, Michigan, United States

Site Status

Henry Ford Hosp

Detroit, Michigan, United States

Site Status

Southern New Jersey AIDS Cln Trials / Dept of Med

Camden, New Jersey, United States

Site Status

North Jersey Community Research Initiative

Newark, New Jersey, United States

Site Status

Partners in Research / New Mexico

Albuquerque, New Mexico, United States

Site Status

Harlem AIDS Treatment Grp / Harlem Hosp Ctr

New York, New York, United States

Site Status

The Research and Education Group

Portland, Oregon, United States

Site Status

Philadelphia FIGHT

Philadelphia, Pennsylvania, United States

Site Status

Saint Joseph's Hosp

Philadelphia, Pennsylvania, United States

Site Status

Richmond AIDS Consortium / Div of Infect Diseases

Richmond, Virginia, United States

Site Status

Countries

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United States

References

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Burman W, El-Sadr W, Grant L, Matts J, Zeh D, Gallagher B, Hafner R, Crane L, Gordin F. Low rates of all opportunistic infections among patients with advanced HIV disease responding to antiretroviral therapy - the CPCRA 048 Cohort. 7th Conf Retroviruses Opportunistic Infect. 2000 Jan 30-Feb 2 (abstract no 241)

Reference Type BACKGROUND

El-Sadr WM, Manneheimer S, Grant L, Matts J. Use of PCP and MAC prophylaxis among eligible patients with and without CD4+ rebound. 39th Intersci Conf Antimicrob Agents Chemother. 1999 Sept 26-29

Reference Type BACKGROUND

El-Sadr WM, Burman W, Grant L, Matts JP, Zeh D, Crane L, Gallagher B, Gordin F, Hafner R. Prophylaxis for Mycobacterium avium Complex can be deferred among patients with a past CD4 count <50 cells/mm3 who responded to antiretroviral therapy: results of a placebo-controlled trial (CPCRA 048). 7th Conf Retroviruses Opportunistic Infect. 2000 Jan 30-Feb 2 (abstract no 247)

Reference Type BACKGROUND

El-Sadr WM, Burman WJ, Grant LB, Matts JP, Hafner R, Crane L, Zeh D, Gallagher B, Mannheimer SB, Martinez A, Gordin F. Discontinuation of prophylaxis against Mycobacterium avium complex disease in HIV-infected patients who have a response to antiretroviral therapy. Terry Beirn Community Programs for Clinical Research on AIDS. N Engl J Med. 2000 Apr 13;342(15):1085-92. doi: 10.1056/NEJM200004133421503.

Reference Type BACKGROUND
PMID: 10766581 (View on PubMed)

Other Identifiers

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11600

Identifier Type: REGISTRY

Identifier Source: secondary_id

CPCRA 048

Identifier Type: -

Identifier Source: org_study_id