A Study to Determine How and Why HIV-Infected Subjects on Anti-viral Treatment Develop Lipodystrophy

NCT ID: NCT00006190

Last Updated: 2010-03-02

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

Study Classification

INTERVENTIONAL

Study Start Date

2000-11-30

Study Completion Date

2001-11-30

Brief Summary

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HIV infection is a major global health problem. Survival and quality of life for HIV subjects has tremendously improved with the advent of a class of antivirals called protease inhibitors and the utilization of highly active combination therapy. However, such therapy has been associated with a syndrome called lipodystrophy. This lipodystrophy syndrome causes body shape changes; typically thinning and loss of fat from the arms, legs and face, with increased fat appearing in the abdomen and neck. There are also metabolic changes which occur, and subjects can develop increased triglycerides, increased cholesterol and an increased risk for diabetes as indicated by increasing insulin resistance. This study will take HIV positive subjects who have not yet started antiviral medications (treatment naive)and randomly assign them to one of two treatment arms. These treatment arms will be: Sustiva/Zerit/Epivir vs. Viracept/Zerit/Epivir The subjects will be treated and followed for two years and have extensive metabolic testing, skinfold thickness measurements, MRI scans and other measures to determine if and how they are experiencing changes in metabolism or body shape and to discover the mechanism of why this occurs. Understanding the mechanism should allow researchers to design interventions for subjects who have lipodystrophy and strategies to prevent lipodystrophy from occurring to subjects treated with antivirals in the future.

Detailed Description

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Conditions

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HIV Infections Lipodystrophy

Study Design

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Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

DOUBLE

Interventions

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Nelfinavir mesylate

Intervention Type DRUG

Stavudine

Intervention Type DRUG

Lamivudine

Intervention Type DRUG

Efavirenz

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* CD4 count \> 200 cells/mm
* HIV RNA (viral load) \<= 100,000 copies/ml
* No previous antiviral therapy

Exclusion Criteria

* AIDS or opportunistic infections
* Active intravenous drug users
* Use of: corticosteroids, androgens, lipid-lowering drugs, anti-fungal medications, oxandrolone, megace, dehydroepiandrosterone.
* Subjects with diabetes mellitus
* Subjects who consume \> 2 alcoholic drinks per day
* Pregnant women, premenopausal women unless adequate birth control is in use.
* Acute or chronic liver diseases, liver enzymes elevations \> 2.5 times the upper limit of normal.
* Anemia, an Hct \< 35% for men, or \< 32% for women.
* Abnormal thyroid function tests.
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

NIH

Sponsor Role lead

Principal Investigators

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Dr. Abhimanyu Garg

Role: PRINCIPAL_INVESTIGATOR

UT Southwestern Medical Center

Dr. Dolores Peterson

Role:

UT Southwestern Medical Center

Dr. Ruth Berggren

Role:

UT Southwestern Medical Center

Locations

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UT Southwestern Medical Center

Dallas, Texas, United States

Site Status

Countries

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United States

References

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Hengel RL, Watts NB, Lennox JL. Benign symmetric lipomatosis associated with protease inhibitors. Lancet. 1997 Nov 29;350(9091):1596. doi: 10.1016/s0140-6736(05)64011-1. No abstract available.

Reference Type BACKGROUND
PMID: 9393341 (View on PubMed)

Carr A, Samaras K, Burton S, Law M, Freund J, Chisholm DJ, Cooper DA. A syndrome of peripheral lipodystrophy, hyperlipidaemia and insulin resistance in patients receiving HIV protease inhibitors. AIDS. 1998 May 7;12(7):F51-8. doi: 10.1097/00002030-199807000-00003.

Reference Type BACKGROUND
PMID: 9619798 (View on PubMed)

Viraben R, Aquilina C. Indinavir-associated lipodystrophy. AIDS. 1998 Apr 16;12(6):F37-9. doi: 10.1097/00002030-199806000-00001.

Reference Type BACKGROUND
PMID: 9583592 (View on PubMed)

Shaw AJ, McLean KA, Evans BA. Disorders of fat distribution in HIV infection. Int J STD AIDS. 1998 Oct;9(10):595-9. doi: 10.1258/0956462981921189.

Reference Type BACKGROUND
PMID: 9819110 (View on PubMed)

Kotler DP, Rosenbaum K, Wang J, Pierson RN. Studies of body composition and fat distribution in HIV-infected and control subjects. J Acquir Immune Defic Syndr Hum Retrovirol. 1999 Mar 1;20(3):228-37. doi: 10.1097/00042560-199903010-00003.

Reference Type BACKGROUND
PMID: 10077170 (View on PubMed)

Lo JC, Mulligan K, Tai VW, Algren H, Schambelan M. "Buffalo hump" in men with HIV-1 infection. Lancet. 1998 Mar 21;351(9106):867-70. doi: 10.1016/S0140-6736(97)11443-X.

Reference Type BACKGROUND
PMID: 9525364 (View on PubMed)

Other Identifiers

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R01DK056583-01

Identifier Type: NIH

Identifier Source: secondary_id

View Link

lipod (completed)

Identifier Type: -

Identifier Source: org_study_id

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