Effect of Tenofovir Disoproxil Fumarate on Lipid Levels in HIV Infected Adults on Stable Anti-HIV Drug Therapy

NCT ID: NCT00109603

Last Updated: 2012-10-30

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

NA

Total Enrollment

17 participants

Study Classification

INTERVENTIONAL

Study Start Date

2005-05-31

Study Completion Date

2007-11-30

Brief Summary

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The purpose of this study is to determine the effect of the anti-HIV drug tenofovir disoproxil fumarate (TDF) on lipid levels in HIV infected adults on stable anti-HIV drug therapy.

Study hypothesis: The addition of TDF to stable background antiretroviral therapy in HIV infected individuals with dyslipidemia will result in a reduction of non-HDL after 12 weeks of treatment.

Detailed Description

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Use of highly active antiretroviral therapy (HAART) has resulted in significant reductions in morbidity and mortality among HIV infected people. However, significant adverse effects, including dyslipidemia, have been associated with HAART. Dyslipidemia may cause elevations in serum total cholesterol, low-density lipoprotein (LDL) cholesterol, and triglyceride concentrations, as well as a decrease in high-density lipoprotein (HDL) concentrations. Dyslipidemia is of particular concern for patients receiving HAART because the condition is associated with increased risk for cardiovascular events. TDF is an antiretroviral that has exhibited favorable lipid effects in several studies in HIV infected people, but the mechanism for the observed lipid-lowering effect of TDF is unknown. This study will evaluate the efficacy of TDF on lowering non-HDL in HIV infected adults currently on stable HAART. HAART itself will not be provided by this study.

This study will last 32 weeks. Participants will be randomly assigned to one of two study arms. Arm A participants will receive 12 weeks of TDF daily, 4 weeks of no TDF, 12 weeks of placebo daily, then 4 weeks of no TDF. Arm B participants will receive 12 weeks of placebo daily, 4 weeks of no TDF, 12 weeks of TDF daily, then 4 weeks of no TDF. Participants will continue to take their currently prescribed stable HAART regimen for the duration of the study. There will be 13 study visits over the 32 weeks of the study. Clinical assessments will occur at all visits; blood and urine collection will occur at most visits.

Conditions

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HIV Infections Dyslipidemia Hyperlipidemia Hypercholesterolemia Hypertriglyceridemia

Keywords

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Treatment Experienced TDF

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Interventions

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Tenofovir disoproxil fumarate

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* HIV infected
* HIV viral load less than 400 copies/ml within 28 days prior to study entry
* Treatment with stable HAART for at least 90 days prior to study entry. Patients who have taken TDF, didanosine, unboosted atazanavir, or adefovir within 90 days prior to study entry are not eligible.
* Fasting triglycerides of 150 mg/dl or greater AND less than 1000 mg/dl within 28 days prior to study entry or fasting non-HDL cholesterol 100 mg/dl or greater AND less than 250 mg/dl within 28 days prior to study
* Hepatitis B virus surface antigen negative within 6 months prior to study entry
* Have adhered to a lipid-lowering diet and exercise program for at least 28 days prior to study screening, and willing to continue both for the duration of the study
* Willing to continue any current use of hormone replacement therapy or oral contraceptives for the duration of the study. Participants must have been on a stable dose of these medications for at least 28 days prior to study entry to be eligible.
* Willing to use acceptable means of contraception

Exclusion Criteria

* Any lipid-lowering agents within 28 days prior to study entry
* Nephrotoxins, such as foscarnet and amphotericin B, within 28 days prior to study entry
* Systemic cancer chemotherapy within 60 days prior to study entry
* Hormonal anabolic therapies or systemic steroids within 6 months prior to study entry
* Allergy or sensitivity to the study drug or its formulation
* Uncontrolled diabetes, as defined by the protocol, within 28 days prior to study entry
* Current hypothyroidism which has been treated for less than 28 days prior to study entry
* History of coronary heart disease, known atherosclerotic disease, cerebrovascular disease, peripheral vascular disease, abdominal aortic aneurysm, or arterial blockage
* Any acute illness within 28 days prior to study entry that, in the opinion of the investigator, may interfere with the study
* Current drug or alcohol abuse that, in the opinion of the investigator, may interfere with the study
* Pregnancy or breastfeeding
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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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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Judith Aberg, MD

Role: STUDY_CHAIR

NYU Langone Health

Marisa Tungsiripat, MD

Role: STUDY_CHAIR

The Cleveland Clinic

Locations

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University of Southern California

Los Angeles, California, United States

Site Status

University of California, San Diego Antiviral Research Center

San Diego, California, United States

Site Status

University of Colorado Health Sciences Center, Denver

Denver, Colorado, United States

Site Status

University of Miami

Miami, Florida, United States

Site Status

Indiana University Hospital

Indianapolis, Indiana, United States

Site Status

Methodist Hospital of Indiana

Indianapolis, Indiana, United States

Site Status

Wishard Hospital

Indianapolis, Indiana, United States

Site Status

University of Maryland, Institute of Human Virology

Baltimore, Maryland, United States

Site Status

Johns Hopkins University

Baltimore, Maryland, United States

Site Status

Washington University (St. Louis)

St Louis, Missouri, United States

Site Status

Beth Israel Medical Center

New York, New York, United States

Site Status

NYU/Bellevue

New York, New York, United States

Site Status

Duke University Medical Center

Durham, North Carolina, United States

Site Status

University of Cincinnati

Cincinnati, Ohio, United States

Site Status

Case Western Reserve University

Cleveland, Ohio, United States

Site Status

MetroHealth Medical Center

Cleveland, Ohio, United States

Site Status

University of Pennsylvania, Philadelphia

Philadelphia, Pennsylvania, United States

Site Status

University of Pittsburgh

Pittsburgh, Pennsylvania, United States

Site Status

University of Texas, Galveston

Galveston, Texas, United States

Site Status

University of Puerto Rico

San Juan, , Puerto Rico

Site Status

Countries

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United States Puerto Rico

References

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Dube MP, Stein JH, Aberg JA, Fichtenbaum CJ, Gerber JG, Tashima KT, Henry WK, Currier JS, Sprecher D, Glesby MJ; Adult AIDS Clinical Trials Group Cardiovascular Subcommittee; HIV Medical Association of the Infectious Disease Society of America. Guidelines for the evaluation and management of dyslipidemia in human immunodeficiency virus (HIV)-infected adults receiving antiretroviral therapy: recommendations of the HIV Medical Association of the Infectious Disease Society of America and the Adult AIDS Clinical Trials Group. Clin Infect Dis. 2003 Sep 1;37(5):613-27. doi: 10.1086/378131. Epub 2003 Aug 15. No abstract available.

Reference Type BACKGROUND
PMID: 12942391 (View on PubMed)

Grinspoon S, Carr A. Cardiovascular risk and body-fat abnormalities in HIV-infected adults. N Engl J Med. 2005 Jan 6;352(1):48-62. doi: 10.1056/NEJMra041811. No abstract available.

Reference Type BACKGROUND
PMID: 15635112 (View on PubMed)

Martinez E, Tuset M, Milinkovic A, Miro JM, Gatell JM. Management of dyslipidaemia in HIV-infected patients receiving antiretroviral therapy. Antivir Ther. 2004 Oct;9(5):649-63.

Reference Type BACKGROUND
PMID: 15535403 (View on PubMed)

Mehta N, Reilly M. Atherosclerotic cardiovascular disease risk in the HAART-treated HIV-1 population. HIV Clin Trials. 2005 Jan-Feb;6(1):5-24. doi: 10.1310/HT0W-NX2N-U2BM-7LUU.

Reference Type BACKGROUND
PMID: 15765307 (View on PubMed)

Stein JH. Managing cardiovascular risk in patients with HIV infection. J Acquir Immune Defic Syndr. 2005 Feb 1;38(2):115-23. doi: 10.1097/01.qai.0000147525.26746.07.

Reference Type BACKGROUND
PMID: 15671795 (View on PubMed)

Tungsiripat M, Kitch D, Glesby MJ, Gupta SK, Mellors JW, Moran L, Jones L, Alston-Smith B, Rooney JF, Aberg JA. A pilot study to determine the impact on dyslipidemia of adding tenofovir to stable background antiretroviral therapy: ACTG 5206. AIDS. 2010 Jul 17;24(11):1781-4. doi: 10.1097/QAD.0b013e32833ad8b4.

Reference Type RESULT
PMID: 20495438 (View on PubMed)

Other Identifiers

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ACTG A5206

Identifier Type: -

Identifier Source: org_study_id