Effects of Anti-HIV Therapy on Nervous System Function

NCT ID: NCT00432003

Last Updated: 2014-04-17

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

297 participants

Study Classification

OBSERVATIONAL

Study Start Date

2005-03-31

Study Completion Date

2007-07-31

Brief Summary

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The purpose of this study is to observe the way two different anti-HIV treatment strategies affect nerve and brain function in adults with HIV.

Detailed Description

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AIDS dementia complex (ADC) is a condition characterized by cognitive impairment, psychomotor slowing, and behavioral change. A milder form of ADC, called HIV minor cognitive/motor disorder (MCMD), is characterized by similar symptoms but has less of an impact on daily functioning. The neurocognitive impairment that results from ADC and MCMD carries an increased risk of poor drug adherence, morbidity, and mortality. It is unclear if highly active antiretroviral therapy (HAART) is effective in preserving neurocognitive function or in preventing or treating neurocognitive impairment. Distal symmetric sensory polyneuropathy (DSPN) and nucleoside-related neuropathy are two other serious conditions that HIV patients are at high risk for. DSPN is thought to be caused by active HIV infection; nucleoside-related neuropathy is thought to be caused by mitochondrial toxicity related to the use of certain antiretrovirals. These 2 conditions may lead to severe pain and discomfort in the feet. It is unknown what connection, if any, there is between DSPN and nucleoside-related neuropathy and the use of HAART. More data are needed on the natural history of these conditions.

This trial is a substudy of a study of management of antiretroviral therapy (SMART). In the SMART study, patients will participate in one of two strategies: a drug conservation (DC) strategy and a viral suppression (VS) strategy. Participants in the DC group will stop or defer HAART, then receive episodic HAART treatment for the minimum time needed to maintain a CD4 cell count of at least 250 cells/mm3. Participants in the VS group will receive HAART to maintain a viral load as low as possible, regardless of CD4 count. The purpose of this study is to compare changes in neurocognitive functioning and peripheral neuropathy symptoms between the 2 strategies of the SMART study.

Patients will participate in this substudy and the main SMART study at the same time. Within 45 days prior to randomization into the main SMART study, participants will have baseline data collected for this substudy. This data will include peripheral neuropathy assessments, treatments for symptoms of peripheral neuropathy. At selected study sites, additional measures will assess neurocognitive function, depression, alcohol and drug use, and education. At 6 months, 12 months, and every 12 months thereafter, peripheral neuropathy symptoms and treatment for the symptoms will be assessed; a pain questionnaire will also be completed. Participants will be followed until the SMART study ends.

Conditions

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HIV Infections

Study Design

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Study Time Perspective

PROSPECTIVE

Eligibility Criteria

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Inclusion Criteria

* Coenrollment in the SMART study

Exclusion Criteria

* Unable to comply with all study requirements
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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Edwina Wright, MBBS, FRACP

Role: STUDY_CHAIR

Infectious Disease Unit, the Alfred Hospital

Locations

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Castro-Mission Health Ctr. CRS

San Francisco, California, 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

Western Infectious Disease Consultants CRS

Wheat Ridge, Colorado, United States

Site Status

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

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

Site Status

Univ. of Florida, Div. of Infectious Diseases CRS

Jacksonville, Florida, United States

Site Status

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

Baton Rouge, Louisiana, United States

Site Status

Wayne State Univ. CRS

Detroit, Michigan, United States

Site Status

Henry Ford Hosp. CRS

Detroit, Michigan, United States

Site Status

Michigan State Univ., Infectious Disease Clinic CRS

Lansing, Michigan, United States

Site Status

SUNY Downstate Med. Ctr., HIV Ctr. for Women & Children CRS

Brooklyn, New York, United States

Site Status

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

New York, New York, United States

Site Status

Bronx-Lebanon Hosp. Ctr. CRS

The Bronx, New York, United States

Site Status

Jacobi Med. Ctr., Ambulatory Care Pavillion CRS

The Bronx, New York, United States

Site Status

Montefiore Med. Ctr., AIDS Ctr. CRS

The Bronx, New York, United States

Site Status

Bronx VAMC CRS

The Bronx, New York, United States

Site Status

Univ. of Oklahoma Health Sciences Ctr., Div. of Infectious Diseases CRS

Oklahoma City, Oklahoma, United States

Site Status

The Research & Education Group-Portland CRS

Portland, Oregon, United States

Site Status

Kaiser Immune Deficiency Clinic of Portland CRS

Portland, Oregon, United States

Site Status

Legacy Clinic Emanuel CRS

Portland, Oregon, United States

Site Status

Oregon Health & Sciences Univ. Internal Medicine (L-475) CRS

Portland, Oregon, United States

Site Status

Temple Univ. School of Medicine CRS

Philadelphia, Pennsylvania, United States

Site Status

MediCorp, Infectious Disease Associates CRS

Fredericksburg, Virginia, United States

Site Status

Vernon Harris East End Community Health Ctr. CRS

Richmond, Virginia, United States

Site Status

CrossOver Health Ctr. CRS

Richmond, Virginia, United States

Site Status

VCU Health Systems, Infectious Disease Clinic CRS

Richmond, Virginia, United States

Site Status

Virginia Commonwealth Univ. Medical Ctr. CRS

Richmond, Virginia, United States

Site Status

Med. College of Wisconsin, Infectious Disease Clinic CRS

Milwaukee, Wisconsin, United States

Site Status

Burwood Road Gen. Practice CRS

Burwood, New South Wales, Australia

Site Status

St. Vincent's Hospital CRS

Darlinghurst, New South Wales, Australia

Site Status

Westmead Hospital CRS

Westmead, New South Wales, Australia

Site Status

Melbourne Sexual Health Ctr. CRS

Carlton, Victoria, Australia

Site Status

The Alfred Hosp., Clinical Research - Infectious Diseases Unit CRS

Melbourne, Victoria, Australia

Site Status

Prahran Market Clinic CRS

Melbourne, Victoria, Australia

Site Status

Hosp. Universitario Prof. Edgard SantosCRS

Salvador, Estado de Bahia, Brazil

Site Status

Instituto de Infectologia Emilio Ribas CRS

São Paulo, , Brazil

Site Status

Q.E. II Health Sciences Ctr., Captial District Authority, Victoria Gen. Hosp. CRS

Halifax, Nova Scotia, Canada

Site Status

Windsor Regional Hosp., HIV Care Program CRS

Windsor, Ontario, Canada

Site Status

Bamrasnaradura Institute CRS

Muang, Changwat Nonthaburi, Thailand

Site Status

Chulalongkorn University Hospital CRS

Bangkok, Ratchathewi, Thailand

Site Status

Mahidol Univ., Ramathibodi Hosp., Div of Infectious Disease CRS

Bangkok, Ratchathewi, Thailand

Site Status

Sanpatong Hosp. CRS

Chiang Mai, , Thailand

Site Status

Khon Kaen Univ., Srinagarind Hosp., Div. of Infectious Diseases & Tropical Medicine, Dept. of Medici

Khon Kaen, , Thailand

Site Status

Countries

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United States Australia Brazil Canada Thailand

References

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Antunes F. Central nervous system AIDS--related diseases. Acta Neurochir (Wien). 2004 Oct;146(10):1071-4. doi: 10.1007/s00701-004-0334-0.

Reference Type BACKGROUND
PMID: 15744843 (View on PubMed)

Morgello S, Estanislao L, Simpson D, Geraci A, DiRocco A, Gerits P, Ryan E, Yakoushina T, Khan S, Mahboob R, Naseer M, Dorfman D, Sharp V; Manhattan HIV Brain Bank. HIV-associated distal sensory polyneuropathy in the era of highly active antiretroviral therapy: the Manhattan HIV Brain Bank. Arch Neurol. 2004 Apr;61(4):546-51. doi: 10.1001/archneur.61.4.546.

Reference Type BACKGROUND
PMID: 15096404 (View on PubMed)

Sacktor N. The epidemiology of human immunodeficiency virus-associated neurological disease in the era of highly active antiretroviral therapy. J Neurovirol. 2002 Dec;8 Suppl 2:115-21. doi: 10.1080/13550280290101094.

Reference Type BACKGROUND
PMID: 12491162 (View on PubMed)

Verma S, Estanislao L, Simpson D. HIV-associated neuropathic pain: epidemiology, pathophysiology and management. CNS Drugs. 2005;19(4):325-34. doi: 10.2165/00023210-200519040-00005.

Reference Type BACKGROUND
PMID: 15813646 (View on PubMed)

Related Links

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http://clinicaltrials.gov/ct/show/NCT00027352

Click here for information on CPCRA 065

Other Identifiers

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CPCRA 065F1

Identifier Type: -

Identifier Source: secondary_id

CPCRA 065

Identifier Type: -

Identifier Source: secondary_id

10115

Identifier Type: REGISTRY

Identifier Source: secondary_id

CPCRA 065F

Identifier Type: -

Identifier Source: org_study_id

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