Interleukin-2 Plus Anti-HIV Therapy in HIV-Infected Children With Weakened Immune Systems

NCT ID: NCT00006066

Last Updated: 2021-11-01

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

PHASE1

Total Enrollment

92 participants

Study Classification

INTERVENTIONAL

Study Completion Date

2006-06-30

Brief Summary

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The purpose of this study is to determine the safety of a drug called interleukin-2 (IL-2) given with anti-HIV therapy in children with HIV infection. This study will also determine the best dose of IL-2 to give children.

IL-2 is an important substance produced by the body's white blood cells that helps the body fight infection. People with HIV infection do not produce enough IL-2. It is hoped that IL-2 treatment will help boost the immune system in people with HIV infection. It has not been studied very much in children and doctors need to know what doses are safe to give.

Detailed Description

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One of the challenges in effective combination therapy in HIV-infected patients is the ability to achieve immune reconstitution. IL-2 is hypothesized to restore and/or preserve the immune system when added to potent antiretroviral regimens. This study will evaluate restoration of immune functions of CD4 cells and will also determine the best way to deliver IL-2 in a safe and effective way.

Part I: Patients add a 5-day course of subcutaneous IL-2 every 8 weeks for up to 48 weeks (6 cycles) to their HAART therapy. Three dose levels of IL-2 are administered. \[AS PER AMENDMENT 5/3/01: It is strongly recommended, but not required, that\] the first and second cycles of IL-2 are given in the hospital on an inpatient basis. The parent or patient is trained to give the injections and has the option of administering subsequent injections at home. Patients are monitored for CD4 and CD8 cell count and viral load. Enrollment into Part 1 begins at the lowest dose level; assuming no serious toxicities (Grade 3 or higher) occur, patients are enrolled into higher dose levels. The highest tolerated dose is established.

Part 2: After the highest tolerated dose is established in Part 1, additional patients are randomized to receive HAART alone (Arm 1), HAART with high-dose IL-2 (Arm 2), or HAART with low-dose IL-2 (Arm 3). High-dose IL-2 is given twice daily at the highest dose tolerated in Part 1 for 5 days every 8 weeks for 6 cycles. Low-dose IL-2 is given once a day every day for 48 weeks. For Arms 2 and 3 \[AS PER AMENDMENT 5/3/01: (except patients in the pharmacokinetic substudy), it is strongly recommended, but not required, that\] IL-2 is given the first week on an inpatient basis by hospital personnel. As in Part 1, there is the option of administering the remaining injections at home. Intensive toxicity monitoring, routine lymphocyte subsets, and quantitative HIV RNA are performed on all patients at specified time points during the study. The first 12 patients in Arms 2 and 3 have pharmacokinetic testing with frequent blood samples drawn at intervals, some of which require staying up to 12 hours at the clinic. Diphtheria/tetanus immunizations and bacteriophage phi X174 immunizations are administered to all patients to determine antibody responses.

Conditions

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HIV Infections

Keywords

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Injections, Subcutaneous Interleukin-2 Dose-Response Relationship, Drug Drug Therapy, Combination Immunocompromised Host CD4 Lymphocyte Count Anti-HIV Agents

Study Design

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Primary Study Purpose

TREATMENT

Interventions

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Diphtheria & Tetanus Toxoids & Acellular Pertussis Vaccine Adsorbed

Intervention Type BIOLOGICAL

Diphtheria and Tetanus Toxoids Adsorbed

Intervention Type BIOLOGICAL

Tetanus and Diphtheria Toxoids Adsorbed

Intervention Type BIOLOGICAL

Bacteriophage phi X 174

Intervention Type DRUG

Aldesleukin

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

A child may be eligible for this trial if he/she:

* Is HIV-positive.
* Is 2 to 18 years old (consent of parent or guardian required if under 18).
* Has received 12 or more weeks of anti-HIV drug therapy, consisting of at least 3 drugs. This combination may include a nucleoside reverse transcriptase inhibitor (NRTI), a nonnucleoside reverse transcriptase inhibitor, or a protease inhibitor, or 3 NRTIs. Combinations of NRTIs may not include abacavir (ABC). Patients may have taken ABC if it was not in combination with 2 other NRTIs. (This reflects a change in the requirement for anti-HIV therapy.)
* Has a plasma HIV RNA level of less than 10,000 copies/ml.
* Has evidence of a weakened immune system (based on CD4 cell counts and absolute CD4 percentage less than 25 percent). (This reflects a change in how a weakened immune system is defined.)
* Has a parent or guardian who is willing to comply with study requirements.
* Has symptoms of HIV infection.

Exclusion Criteria

A child will not be eligible for this study if he/she:

* Has an active opportunistic (AIDS-related) infection.
* Is pregnant.
* Is taking certain medications, such as steroids or other drugs that affect the immune system, within 6 weeks prior to study entry.
* Is taking ABC.
* Is taking certain antibodies.
Minimum Eligible Age

2 Years

Maximum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

NIH

Sponsor Role collaborator

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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Savita Pahwa

Role: STUDY_CHAIR

Locations

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Long Beach Memorial Med. Ctr., Miller Children's Hosp.

Long Beach, California, United States

Site Status

Usc La Nichd Crs

Los Angeles, California, United States

Site Status

UCSD Maternal, Child, and Adolescent HIV CRS

San Diego, California, United States

Site Status

UCSF Pediatric AIDS CRS

San Francisco, California, United States

Site Status

Children's National Med. Ctr. Washington DC NICHD CRS

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

Site Status

Children's National Med. Ctr., ACTU

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

Site Status

Univ. of Miami Ped. Perinatal HIV/AIDS CRS

Miami, Florida, United States

Site Status

USF - Tampa NICHD CRS

Tampa, Florida, United States

Site Status

Tulane/LSU Maternal/Child CRS

New Orleans, Louisiana, United States

Site Status

HMS - Children's Hosp. Boston, Div. of Infectious Diseases

Boston, Massachusetts, United States

Site Status

Nyu Ny Nichd Crs

New York, New York, United States

Site Status

Columbia IMPAACT CRS

New York, New York, United States

Site Status

SUNY Upstate Med. Univ., Dept. of Peds.

Syracuse, New York, United States

Site Status

Univ. of Puerto Rico Ped. HIV/AIDS Research Program CRS

San Juan, , Puerto Rico

Site Status

Countries

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United States Puerto Rico

Other Identifiers

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10607

Identifier Type: REGISTRY

Identifier Source: secondary_id

PACTG 402

Identifier Type: -

Identifier Source: secondary_id

ACTG 402

Identifier Type: -

Identifier Source: org_study_id