Comparison of Brovavir Versus Acyclovir in the Treatment of Herpes in HIV-Infected Patients

NCT ID: NCT00000953

Last Updated: 2011-03-01

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

PHASE2

Total Enrollment

180 participants

Study Classification

INTERVENTIONAL

Brief Summary

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To compare the efficacy of oral sorivudine (brovavir) and oral acyclovir for the treatment of localized herpes zoster in HIV-infected patients.

HIV-infected patients are at high risk for herpesvirus infections, including varicella-zoster virus ( VZV ) infections, also called shingles. Acyclovir, an approved drug, is widely used to treat VZV infections in the HIV population. Since no data from controlled studies are available to define the role of antiviral therapy for VZV infections in HIV-infected patients, a study is needed to test the relative efficacy of brovavir, an experimental antiviral drug, versus that of acyclovir.

Detailed Description

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HIV-infected patients are at high risk for herpesvirus infections, including varicella-zoster virus ( VZV ) infections, also called shingles. Acyclovir, an approved drug, is widely used to treat VZV infections in the HIV population. Since no data from controlled studies are available to define the role of antiviral therapy for VZV infections in HIV-infected patients, a study is needed to test the relative efficacy of brovavir, an experimental antiviral drug, versus that of acyclovir.

One hundred-eighty patients are randomized to receive either brovavir or acyclovir as follows: brovavir or its matching placebo once daily and acyclovir or its matching placebo five times daily. Treatment continues for 10 days. Entry into the study must occur within 72 hours of lesion development. Patients are followed in person daily or at regular intervals during study drug administration and on days 14, 21, and 28, and then monthly by telephone for 11 months thereafter.

Conditions

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HIV Infections Chickenpox

Study Design

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Primary Study Purpose

TREATMENT

Interventions

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Sorivudine

Intervention Type DRUG

Acyclovir

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

Concurrent Medication:

Allowed:

* Medication for concurrent conditions (e.g., insulin, antihypertensives, bronchodilators, digoxin) or antibacterials or antifungals to treat concurrent infections at other sites or superinfection of the zoster lesion.
* Anti-inflammatory, analgesic (including narcotic analgesic), or antipyretic agents.
* Antidepressants and antipsychotics such as amitriptyline and/or fluphenazine.
* Nerve blocks.
* AZT, ddI, ddC, and amantadine.
* Low-dose corticosteroids for treatment of an underlying (not zoster-related) disease.
* Immune modulators without varicella-zoster virus activity (e.g., GM-CSF, gp160 vaccine).

Patients must have:

* HIV infection.
* Localized, cutaneous herpes zoster (shingles).
* Zoster-associated rash present for 3 or fewer days prior to entry.

Prior Medication:

Allowed:

* Zidovudine.
* ddI.
* ddC.

Exclusion Criteria

Co-existing Condition:

Patients with the following conditions and symptoms are excluded:

* Chickenpox.
* Evidence of visceral dissemination (organ involvement, i.e., brain, liver, or lung) and/or cutaneous dissemination (more than 20 vesicles in dermatomes beyond contiguous dermatomes) of zoster.
* Zoster-like lesion caused by organism other than VZV (e.g., HSV, enterovirus, or Mycoplasma).
* Bacterial superinfection of zoster lesion.
* Zosteriform lesion previously treated with topical antiviral agents.
* Acute, life-threatening opportunistic infection requiring treatment (ongoing suppressive or prophylactic maintenance therapy other than ganciclovir or foscarnet is permitted).
* Concurrent severe disease that may either impair ability to take oral medication in capsule or tablet form or limit survival during the 10-day treatment period or during acute phase follow-up (28 days).
* Suspected acute deterioration of renal or hepatic function.
* Mental impairment that precludes ability to comply with protocol.
* Any condition that would render the patient unsuitable for treatment.

Concurrent Medication:

Excluded during acute phase of study:

* Antiviral medications other than AZT, ddI, ddC, or anti-Parkinson's drugs (i.e., amantadine).
* Interferon.
* Isoprinosine.
* Levamisole.
* Transfer factor.
* Topical virucidal agents, oxidizing agents, DMSO, cell division-stimulating/healing agents, or astringents.
* Topical anesthetics (such as capsaicin or xylocaine).
* Topical creams or ointments that may interfere with evaluation of zoster lesions.
* Cimetidine.
* Fluorouracil or its derivatives, flucytosine, or cyclophosphamide (during drug administration and for 2 weeks thereafter).
* High-dose corticosteroids.
* Anticoagulant therapy (heparin locks and low-dose warfarin sodium permitted).
* Probenecid or derivatives.
* Treatment for any acute, life-threatening opportunistic infection (suppressive or prophylactic maintenance therapy other than ganciclovir or foscarnet is permitted).

Use of the following drugs is discouraged during the long-term phase of the study:

* Antiviral agents with VZV activity.
* Immunomodulators with presumed VZV activity.
* VZV immune globulin.
* Capsaicin.
* Cimetidine.

Patients with the following prior conditions are excluded:

* History of immediate hypersensitivity or serum sickness reaction or idiosyncratic reaction (such as hepatic necrosis or Stevens-Johnson syndrome) to any nucleoside analog antiviral agent or to any anticancer therapy with cytolytic agents.

Prior Medication:

Excluded within 1 month prior to entry:

* Any investigational drugs or treatments not licensed for any indication (other than ddI or ddC).

Excluded within 2 weeks prior to entry:

* Any systemic antiviral therapy, including ganciclovir, foscarnet, vidarabine, acyclovir, or ribavirin.
* Any antiretroviral drug other than zidovudine, ddI, and ddC.
* Immune globulin (e.g., IgG, VZIG).

Excluded within 72 hours prior to entry:

* Cyclophosphamide.
* Flucytosine.
* Fluorouracil or its derivatives.

Alcohol or drug abuse.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Bristol-Myers Squibb

INDUSTRY

Sponsor Role collaborator

Glaxo Wellcome

INDUSTRY

Sponsor Role collaborator

National Institute of Allergy and Infectious Diseases (NIAID)

NIH

Sponsor Role lead

Principal Investigators

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Crumpacker C

Role: STUDY_CHAIR

Locations

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Univ of Alabama at Birmingham

Birmingham, Alabama, United States

Site Status

Univ of Southern California / LA County USC Med Ctr

Los Angeles, California, United States

Site Status

UCLA Med Ctr

Los Angeles, California, United States

Site Status

Veterans Administration Med Ctr

Martinez, California, United States

Site Status

Infectious Disease Med Group

Oakland, California, United States

Site Status

San Diego Naval Hosp

San Diego, California, United States

Site Status

Mount Zion Med Ctr

San Francisco, California, United States

Site Status

Univ of Colorado Health Sciences Ctr

Denver, Colorado, United States

Site Status

George Washington Univ Med Ctr

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

Site Status

Veterans Administration Med Ctr / Community AIDS Program

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

Site Status

Med College of Georgia

Augusta, Georgia, United States

Site Status

Univ of Hawaii / Leahi Hosp

Honolulu, Hawaii, 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

Natl Institutes of Health / NIAID

Bethesda, Maryland, United States

Site Status

Massachusetts Gen Hosp / Harvard Med School

Boston, Massachusetts, United States

Site Status

Beth Israel Hosp

Boston, Massachusetts, United States

Site Status

Brigham and Women's Hosp

Boston, Massachusetts, United States

Site Status

New England Deaconess Hosp

Boston, Massachusetts, United States

Site Status

Washington Univ

St Louis, Missouri, United States

Site Status

Univ of New Mexico

Albuquerque, New Mexico, United States

Site Status

Beth Israel 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

SUNY / Health Sciences Ctr at Stony Brook

Stony Brook, New York, United States

Site Status

SUNY / Health Sciences Ctr at Syracuse

Syracuse, New York, United States

Site Status

Carolinas Med Ctr

Charlotte, North Carolina, United States

Site Status

Univ Dermatology Associates

Cincinnati, Ohio, United States

Site Status

Ohio State Univ / ACTU-Univ Clinic

Columbus, Ohio, United States

Site Status

Dayton Veterans Administration Med Ctr

Dayton, Ohio, United States

Site Status

Med College of Ohio

Toledo, Ohio, United States

Site Status

Portland Veterans Adm Med Ctr / Rsch & Education Grp

Portland, Oregon, United States

Site Status

Dallas Veterans Administration Med Ctr

Dallas, Texas, United States

Site Status

Univ of Texas, Southwestern Med Ctr of Dallas

Dallas, Texas, United States

Site Status

Univ TX Galveston Med Branch

Galveston, Texas, United States

Site Status

Baylor College of Medicine

Houston, Texas, United States

Site Status

Univ TX San Antonio Health Science Ctr

San Antonio, Texas, United States

Site Status

Scott and White Hosp

Temple, Texas, United States

Site Status

Univ of Virginia Health Sciences Ctr

Charlottesville, Virginia, United States

Site Status

Virginia Clinical Research Inc

Norfolk, Virginia, United States

Site Status

Salem Veterans Administration Med Ctr

Salem, Virginia, United States

Site Status

Univ of Washington

Seattle, Washington, United States

Site Status

Great Lakes Hemophilia Foundation

Wauwatosa, Wisconsin, United States

Site Status

Countries

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United States

References

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Gnann J, et al. Sorivudine (BV-araU) versus acyclovir for Herpes zoster in HIV-infected patients. Conf Retroviruses Opportunistic Infect. 1996 Jan 28-Feb 1;3rd:55

Reference Type BACKGROUND

Other Identifiers

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Protocol -38/-022

Identifier Type: -

Identifier Source: secondary_id

ACTG 169

Identifier Type: -

Identifier Source: org_study_id

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