A Study of Increased Lactic Acid and Abnormal Fat Distribution in HIV-Positive Patients

NCT ID: NCT00005764

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

PHASE4

Total Enrollment

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2000-05-31

Brief Summary

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The purpose of this study is to see if the findings of increased lactic acid and abnormal fat distribution get better when d4T is replaced with abacavir, abacavir plus lamivudine, or Combivir (a pill containing lamivudine plus zidovudine) in HIV-positive patients taking anti-HIV therapy including stavudine (d4T).

Detailed Description

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Patients are allocated as follows: a) zidovudine-naive patients switch Combivir for d4t and b) zidovudine-experienced or -intolerant patients switch abacavir for d4t. Providers may choose between Combivir or abacavir as a switch for d4t when screening lactate levels are 2.2 mmol/L or more. Additionally, providers may choose to switch a maximum of 2 drugs, one of which must be d4t, in the regimen. Each patient receives 48 weeks of therapy. Visits are made at Weeks 2, 4, 8, 12, 16, 20, 24, 32, 40, and 48. Tests, including biopsies, are performed to measure changes in body fat distribution and changes in lactate levels. Virologic and immunologic outcomes, changes in physical signs of lipodystrophy, changes in self-reports of health-related quality-of-life survey and the Body Image Questionnaire, changes in lipid profile and other markers of metabolism, and safety parameters are evaluated also.

Conditions

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HIV Infections Lipodystrophy

Keywords

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HIV-1 Zalcitabine Didanosine Drug Therapy, Combination Zidovudine Stavudine Lamivudine Blood Reverse Transcriptase Inhibitors Anti-HIV Agents Lipodystrophy Combivir Lactic Acid abacavir

Study Design

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Primary Study Purpose

TREATMENT

Interventions

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Lamivudine/Zidovudine

Intervention Type DRUG

Abacavir sulfate

Intervention Type DRUG

Lamivudine

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

Patients may be eligible for this study if they:

* Are HIV-positive.
* Are at least 18 years old.
* Agree not to have intercourse 2 weeks before, during, and 2 weeks after study or agree to use effective methods of birth control.
* Have had HIV-1 RNA levels less than 400 copies/ml on the 2 most recent measurements.
* Have at least 1 of the following situations:
* (a) at least 1 of the following: (1) decrease in facial fat, (2) decrease in fat in lower limbs, or (3) decrease in fat in buttocks area; or
* (b) an increase in lactate level greater than 2.2 mmol/L at the screening visit plus at least 1 of the following: (1) decrease in facial fat, (2) decrease in fat in lower limbs, or (3) decrease in fat in the buttocks area; or
* (c) an increase in lactate level greater than 2.2 mmol/L at screening visit plus at least 2 of the following: (1) shortness of breath, (2) weakness, (3) fast heartbeat, (4) recent weight loss (10 lbs. within the past 2 months), (5) pain and/or bloating in the abdomen, (6) nausea and/or vomiting and/or lack of appetite; or
* (d) lactate level greater than 3.2 mmol/L at the screening visit.
* Are able to read at a sixth-grade level.
* Have taken d4T consistently for the 6 months before entering study.

Exclusion Criteria

Patients will not be eligible for this study if they:

* Have diabetes or kidney failure.
* Have any condition that makes them unable to participate in this study.
* Are unable to take medications by mouth.
* Have serious medical conditions, such as congestive heart failure or other heart disease, which would affect the safety of the patient.
* Are taking or have taken abacavir plus Retrovir or Combivir.
* Are pregnant or breast-feeding.
* Are enrolled in other clinical studies.
* Have had a reaction to or are unable to take abacavir and have taken Retrovir in the past.
* Have taken hydroxyurea within the past 3 days or plan to take this drug during the study.
* Have had chemotherapy or radiation therapy within 4 weeks prior to screening visit (except for local treatment for Kaposi's sarcoma) or plan to have such treatment during the study.
* Have taken drugs that affect the immune system, such as systemic corticosteroids, interleukins, vaccines, or interferons, within 4 weeks prior to the screening visit.
* Have had an HIV vaccine within 3 months of the screening visit.
* Have taken recombinant Human Growth Hormone (r-hGH), megestrol acetate, medicines containing oxandrolone, oxymetholone, nandrolone, DHEA, or other testosterone derivatives, or glucocorticoids or other systemic steroids (except inhaled and topical steroids) in the last 4 months or plan to take these drugs during the study.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Glaxo Wellcome

INDUSTRY

Sponsor Role lead

Locations

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THE Clinic

Los Angeles, California, United States

Site Status

Tower Infectious Disease Med Ctr

Los Angeles, California, United States

Site Status

St Lukes Medical Group

San Diego, California, United States

Site Status

UCSD Treatment Ctr

San Diego, California, United States

Site Status

Dupont Circle Physicians Group

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

Site Status

North Broward Hosp District / HIV Clinical Research

Fort Lauderdale, Florida, United States

Site Status

Duval County Health Department

Jacksonville, Florida, United States

Site Status

Infectious Disease Research Institute Inc

Tampa, Florida, United States

Site Status

Northstar Med Clinic

Chicago, Illinois, United States

Site Status

Jersey Shore Med Ctr

Neptune City, New Jersey, United States

Site Status

South Jersey Infectious Diseases Inc

Somers Point, New Jersey, United States

Site Status

Infectious Disease Specialists of NJ

Union, New Jersey, United States

Site Status

Infectious Diseases Assoc of Brooklyn

Brooklyn, New York, United States

Site Status

Long Island College Hospital

Brooklyn, New York, United States

Site Status

Mt Vernon Hospital

Mount Vernon, New York, United States

Site Status

Dr Lawrence Fontana

New York, New York, United States

Site Status

Liberty Medical / Cabrini Hospital / Dept of Infec Diseases

New York, New York, United States

Site Status

Howard Grossman

New York, New York, United States

Site Status

Boriken Neighborhood Health Center

New York, New York, United States

Site Status

Bronx Veterans Affairs Med Ctr

The Bronx, New York, United States

Site Status

Univ of North Carolina / SOCA

Chapel Hill, North Carolina, United States

Site Status

Summa Health System

Akron, Ohio, United States

Site Status

Case Western Reserve Univ

Cleveland, Ohio, United States

Site Status

Philadelphia Veterans Administration Med Ctr

Philadelphia, Pennsylvania, United States

Site Status

Anderson Clinical Research

Pittsburgh, Pennsylvania, United States

Site Status

Central Texas Clinical Research

Austin, Texas, United States

Site Status

Gathe, Joseph, M.D.

Houston, Texas, United States

Site Status

Diversified Med Practices, PA

Houston, Texas, United States

Site Status

Univ of Texas / Med School at Houston

Houston, Texas, United States

Site Status

Hampton Roads Med Specialists

Hampton, Virginia, United States

Site Status

Swedish Med Ctr

Seattle, Washington, United States

Site Status

Countries

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United States

Other Identifiers

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ESS40010

Identifier Type: -

Identifier Source: secondary_id

238T

Identifier Type: -

Identifier Source: org_study_id