Effects of Two Anti-HIV Drug Regimens on Quality of Life and Health Care Use Among SMART Study Participants

NCT ID: NCT00385632

Last Updated: 2014-04-21

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

Total Enrollment

1224 participants

Study Classification

OBSERVATIONAL

Study Start Date

2002-01-31

Study Completion Date

2008-11-30

Brief Summary

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The purpose of this study is to compare the effects of two different anti-HIV drug regimens on quality of life and health care utilization among SMART study participants.

Detailed Description

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Advances in antiretroviral therapy (ART) have dramatically reduced mortality and morbidity rates for HIV infected people. However, HIV infection is a costly disease to treat. With improvement in survival, quality of life and the long-term cost of HIV treatment have become increasingly important to the majority of individuals infected with HIV. Different HIV treatment regimens may lead to variations in quality of life and health care costs over the course of treatment. In the SMART study, participants were randomly assigned to one of two treatment groups:

* Group 1 participants followed a drug conservation (DC) regimen in which ART was stopped or deferred until CD4 cell count dropped below 250 cells/mm3, initiated until CD4 cell count was at least 350 cells/mm3, and then followed by episodic ART based on CD4 cell count.
* Group 2 participants followed a viral suppression (VS) regimen in which ART was continued to keep viral loads as low as possible, regardless of CD4 cell count.

The purpose of this study is to compare how the DC and VS regimens affect quality of life, symptom severity, health care utilization, and resulting costs among SMART study participants.

At baseline, participants will complete questionnaires regarding quality of life, symptoms, health care utilization, current insurance, and socioeconomic status. Body appearance and signs of HIV disease progression will also be assessed at this time. Follow-up evaluations on quality of life and symptoms will be repeated at Months 4, 8, and 12 and annually thereafter. Follow-up evaluations of all other baseline measures will occur once a year.

Conditions

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HIV Infections

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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1

Participants following a drug conservation (DC) regimen in which ART was stopped or deferred until CD4 cell count dropped below 250 cells/mm3, initiated until CD4 cell count was at least 350 cells/mm3, and then followed by episodic ART based on CD4 cell count

Antiretroviral Regimens

Intervention Type DRUG

Various antiretroviral therapy combinations already being administered to participants

2

Participants following a viral suppression (VS) regimen in which ART was continued to keep viral loads as low as possible, regardless of CD4 cell count

Antiretroviral Regimens

Intervention Type DRUG

Various antiretroviral therapy combinations already being administered to participants

Interventions

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Antiretroviral Regimens

Various antiretroviral therapy combinations already being administered to participants

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Coenrollment in the SMART study
* Parent or guardian willing to provide informed consent, if applicable
Minimum Eligible Age

13 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Community Programs for Clinical Research on AIDS

NETWORK

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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Wafaa El-Sadr, MD, MPH

Role: STUDY_CHAIR

Harlem AIDS Treatment Group, Harlem Hospital Center

James Neaton, PhD

Role: STUDY_CHAIR

CPCRA Statistical and Data Management Center/CCBR

Locations

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UCSF, Fresno, School of Medicine, Dept. of Internal Medicine CRS

Fresno, California, United States

Site Status

Dr. M. Estes Med. Practice CRS

Mill Valley, California, United States

Site Status

Dr. Robert Scott Med. Practice CRS

Oakland, California, United States

Site Status

East Bay AIDS Ctr. CRS

Oakland, California, United States

Site Status

Dr. Shawn Hassler Med. Practice CRS

San Francisco, California, United States

Site Status

Positive Health Program Clinic (San Francisco Gen. Hosp.) CRS

San Francisco, California, United States

Site Status

Dr. Virginia Cafaro Med. Practice CRS

San Francisco, California, United States

Site Status

Dr. William Owen Med. Practice CRS

San Francisco, California, United States

Site Status

Castro-Mission Health Ctr. CRS

San Francisco, California, United States

Site Status

San Francisco VAMC, Infectious Diseases Clinic CRS

San Francisco, California, United States

Site Status

UCSF PHP, Gen. Internal Medicine Practice CRS

San Francisco, California, United States

Site Status

Beacon Clinic at Boulder CRS

Boulder, Colorado, United States

Site Status

Denver Infectious Diseases Consultants CRS

Denver, Colorado, United States

Site Status

Kaiser Permanente of Denver CRS

Denver, Colorado, United States

Site Status

Univ. of Colorado Health Science Ctr. CRS

Denver, Colorado, United States

Site Status

Denver Public Health CRS

Denver, Colorado, United States

Site Status

Eastside Family Health Ctr. CRS

Denver, Colorado, United States

Site Status

Denver VAMC CRS

Denver, Colorado, United States

Site Status

Denver Public Health CRS - INSIGHT

Denver, Colorado, United States

Site Status

Western Infectious Disease Consultants CRS

Wheat Ridge, Colorado, United States

Site Status

Univ. of Connecticut Health Ctr. CRS

Farmington, Connecticut, United States

Site Status

Yale Univ. School of Medicine, NE ProACT - New Haven CRS

New Haven, Connecticut, United States

Site Status

Hosp. of St. Raphael CRS

New Haven, Connecticut, United States

Site Status

VAMC West Haven CRS

West Haven, Connecticut, United States

Site Status

Georgetown Wellness Clinic

Georgetown, Delaware, United States

Site Status

Christiana Care Health Services HIV Program CRS

Wilmington, Delaware, United States

Site Status

Washington DC VAMC, Washington Regional AIDS Program, Infectious Diseases CRS

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

Site Status

Miami VAMC CRS

Miami, Florida, United States

Site Status

Atlanta VAMC CRS

Decatur, Georgia, United States

Site Status

Klein & Slotten Medical Associates CRS

Chicago, Illinois, United States

Site Status

Cook County Hosp. CORE Ctr.

Chicago, Illinois, United States

Site Status

Univ. of Illinois Family Ctr. for Infectious Disease CRS

Chicago, Illinois, United States

Site Status

Univ. of Chicago Hosps. CRS

Chicago, Illinois, United States

Site Status

Lakeshore Infectious Disease Associates CRS

Chicago, Illinois, United States

Site Status

North Side Family Medicine CRS

Chicago, Illinois, United States

Site Status

Northwestern Memorial Physicians Group CRS

Chicago, Illinois, United States

Site Status

Earl K. Long Med. Ctr., LSU - Mid City EIC Clinic CRS

Baton Rouge, Louisiana, United States

Site Status

James Osterberger, MD (Private Med. Practice) CRS

Baton Rouge, Louisiana, United States

Site Status

Med. Ctr. of Louisiana at New Orleans, HIV Outpatient Clinics CRS

New Orleans, Louisiana, United States

Site Status

Tulane University Health Sciences Center, Louisiana Community AIDS Research Program(LaCARP) CRS

New Orleans, Louisiana, United States

Site Status

New Orleans VAMC CRS

New Orleans, Louisiana, United States

Site Status

CRI-Boston CRS

Boston, Massachusetts, United States

Site Status

CRI-Springfield CRS

Springfield, Massachusetts, United States

Site Status

Henry Ford Hosp. CRS

Detroit, Michigan, United States

Site Status

Univ. of Mississippi Med. Ctr., Div. of Infectious Diseases CRS

Jackson, Michigan, United States

Site Status

Michigan State Univ., Infectious Disease Clinic CRS

Lansing, Michigan, United States

Site Status

Mt. Clemens Gen. Hosp. CRS

Mount Clemens, Michigan, United States

Site Status

Providence Hosp,-Newland Med. Assoc Inc CRS

Southfield, Michigan, United States

Site Status

ID Care Inc. - Hillsborough CRS

Hillsborough, New Jersey, United States

Site Status

Cathedral Healthcare System, St. Michael's Med. Ctr. CRS

Newark, New Jersey, United States

Site Status

New Jersey Community Research Initiative, Jeffrey Bomser Clinic CRS

Newark, New Jersey, United States

Site Status

St. Joseph's Hosp. & Med. Ctr. of New Jersey CRS

Paterson, New Jersey, United States

Site Status

Raritan Bay Med. Ctr., Perth Amboy Division CRS

Perth Amboy, New Jersey, United States

Site Status

ID Care - Randolph CRS

Randolph Township, New Jersey, United States

Site Status

Infectious Disease Specialists of N.J., North Jersey Community Research Initiative CRS

Union, New Jersey, United States

Site Status

St. Vincent Hosp. & Med. Ctr. CRS

New York, New York, United States

Site Status

Metropolitan Hosp. Ctr. CRS

New York, New York, United States

Site Status

Harlem Hospital Ctr./Columbia University CRS (Gordin CTU)

New York, New York, United States

Site Status

Harlem Hosp. Ctr., Outpatient Clinics (New York) CRS

New York, New York, United States

Site Status

Jacobi Med. Ctr., Ambulatory Care Pavillion CRS

The Bronx, New York, United States

Site Status

Legacy Community Health Services, Inc. CRS

Houston, Texas, United States

Site Status

Baylor College of Medicine, Thomas St. Clinic CRS

Houston, Texas, United States

Site Status

Houston AIDS Research Team CRS

Houston, Texas, United States

Site Status

Michael E. DeBakey VAMC CRS

Houston, Texas, United States

Site Status

Thomas Street Clinic CRS

Houston, Texas, United States

Site Status

Univ. Clinical Research Ctr., Memorial Hermann Hosp. CRS

Houston, Texas, United States

Site Status

South Texas Veterans Health Care System, Immunosuppression Clinic CRS

San Antonio, Texas, United States

Site Status

Countries

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United States

References

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Anis AH, Guh D, Hogg RS, Wang XH, Yip B, Craib KJ, O'Shaughnessy MV, Schechter MT, Montaner JS. The cost effectiveness of antiretroviral regimens for the treatment of HIV/AIDS. Pharmacoeconomics. 2000 Oct;18(4):393-404. doi: 10.2165/00019053-200018040-00007.

Reference Type BACKGROUND
PMID: 15344307 (View on PubMed)

Byrne MW, Honig J. Health-related quality of life of HIV-infected children on complex antiretroviral therapy at home. J Assoc Nurses AIDS Care. 2006 Mar-Apr;17(2):27-35. doi: 10.1016/j.jana.2006.01.003.

Reference Type BACKGROUND
PMID: 16800165 (View on PubMed)

Liu C, Ostrow D, Detels R, Hu Z, Johnson L, Kingsley L, Jacobson LP. Impacts of HIV infection and HAART use on quality of life. Qual Life Res. 2006 Aug;15(6):941-9. doi: 10.1007/s11136-005-5913-x.

Reference Type BACKGROUND
PMID: 16900275 (View on PubMed)

Lowy A, Page J, Jaccard R, Ledergerber B, Somaini B, Weber R, Szucs T. Costs of treatment of Swiss patients with HIV on antiretroviral therapy in hospital-based and general practice-based care: a prospective cohort study. AIDS Care. 2005 Aug;17(6):698-710. doi: 10.1080/09540120412331336689.

Reference Type BACKGROUND
PMID: 16036256 (View on PubMed)

Related Links

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http://clinicaltrials.gov/show/NCT00027352

Click here for more information on CPCRA 065

Other Identifiers

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SMART

Identifier Type: -

Identifier Source: secondary_id

10112

Identifier Type: REGISTRY

Identifier Source: secondary_id

CPCRA 065A

Identifier Type: -

Identifier Source: org_study_id

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