A Randomized Study of Daily and Intermittent Prophylactic Regimens for the Prevention of Disseminated Mycobacterium Avium Complex (MAC) and Fungal Infections in HIV-Infected Patients

NCT ID: NCT00002122

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

Clinical Phase

PHASE3

Total Enrollment

720 participants

Study Classification

INTERVENTIONAL

Brief Summary

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PRIMARY: To determine the efficacy of azithromycin and rifabutin alone and in combination for the prevention of disseminated Mycobacterium avium Complex (MAC) infection in HIV-infected patients. To determine the efficacy of daily versus weekly fluconazole for the prevention of deep fungal infections in this patient population.

SECONDARY: To determine the incidence of bacterial (including mycobacterial) infections, cryptosporidiosis, and toxoplasmosis in azithromycin versus non-azithromycin containing regimens. To determine the incidence of oropharyngeal and vaginal candidiasis in patients treated with daily versus weekly fluconazole. To compare survival and outcomes of primary endpoints in the treatment arms.

Detailed Description

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Patients are randomized to receive azithromycin alone, rifabutin alone, or the two drugs in combination for MAC prophylaxis. Patients in each treatment group further receive one of two doses of concomitant fluconazole for deep fungal prophylaxis, unless specifically excluded for fluconazole randomization. Patients are followed for 1 to 2 years.

Conditions

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Mycoses Mycobacterium Avium-Intracellulare Infection HIV Infections

Study Design

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Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Interventions

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Azithromycin

Intervention Type DRUG

Rifabutin

Intervention Type DRUG

Fluconazole

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

Concurrent Medication:

Allowed:

* Preventive therapy with isoniazid for M. tuberculosis.
* Maintenance therapy for CMV retinitis.

Patients must have:

* HIV infection or history of an AIDS-defining condition by CDC criteria.
* One documented CD4 count \< 100 cells/mm3 within 12 months prior to study entry.
* NO active MAC disease, MAC bacteremia, or active mycobacterial infection (tuberculous or nontuberculous).
* NO acute opportunistic infection.
* Life expectancy of more than 6 months.
* Consent of parent or guardian if less than legal age of consent.

Exclusion Criteria

Co-existing Condition:

Patients with the following symptoms or conditions are excluded:

ALL PATIENTS -

* Unexplained fevers, elevation in alkaline phosphatase, pancytopenia, abnormal liver function tests, or odynophagia for which the diagnoses of MAC and fungal infections have not been excluded.
* Serious hypersensitivity reactions to macrolides or rifampin.
* Unable to tolerate oral medications. FOR FLUCONAZOLE RANDOMIZATION -
* Serious hypersensitivity reaction to fluconazole.
* Active fungal infection (cryptococcosis, histoplasmosis, blastomycosis, aspergillosis, Candida esophagitis, thrush, vaginal candidiasis).
* Positive baseline urine cryptococcal culture.

Concurrent Medication:

Excluded for fluconazole randomization:

* Maintenance therapy for deep fungal infections.
* Chronic therapy with ketoconazole or fluconazole.
Minimum Eligible Age

12 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Pfizer

INDUSTRY

Sponsor Role lead

Locations

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Los Angeles County - USC Med Ctr

Los Angeles, California, United States

Site Status

UCI Med Ctr

Orange, California, United States

Site Status

UCSD Treatment Ctr / Dept of Medicine and Pediatrics

San Diego, California, United States

Site Status

Santa Clara Valley Med Ctr

San Jose, California, United States

Site Status

Harbor - UCLA Med Ctr

Torrance, California, United States

Site Status

Georgetown Univ Med Ctr

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

Site Status

George Washington Univ Med Ctr

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

Site Status

Univ of Massachusetts Med Ctr

Worcester, Massachusetts, United States

Site Status

Univ of Pennsylvania

Philadelphia, Pennsylvania, United States

Site Status

Univ of Texas Southwestern Med Ctr

Dallas, Texas, United States

Site Status

Baylor College of Medicine

Houston, Texas, United States

Site Status

Houston Veterans Administration Med Ctr

Houston, Texas, United States

Site Status

Countries

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United States

References

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Havlir DV, Mccutchan JA, Bozzette SA, Dunne M. A double-blind, randomized study of weekly azithromycin, daily rifabutin, and combination azithromycin and rifabutin for the prevention of Mycobactetum avium complex (MAC) in AIDS patients. Conf Retroviruses Opportunistic Infect. 1996 Jan 28-Feb 1;3rd:90

Reference Type BACKGROUND

Other Identifiers

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066-174

Identifier Type: -

Identifier Source: secondary_id

226A

Identifier Type: -

Identifier Source: org_study_id