Treatment De-Intensification and Residual HIV-1 in Youth

NCT ID: NCT00867854

Last Updated: 2017-02-28

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

34 participants

Study Classification

OBSERVATIONAL

Study Start Date

2009-02-28

Study Completion Date

2011-10-31

Brief Summary

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This laboratory-based sub-study of ATN 061 and ATN 071 will examine the effect of early treatment followed by treatment de-intensification to atazanavir/ritonavir (ATV/r) monotherapy on steady-state frequencies of replication-competent CD4+ T cell Human Immunodeficiency Virus (HIV)-1 reservoirs or cell-associated infectivity (CAI) and persistent low-level viremia (LLV), and their contribution to successful long-term control of HIV-1 replication among HIV-1 infected adolescents and young adults.

Detailed Description

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Conditions

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HIV-1 HIV Infections

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

PROSPECTIVE

Study Groups

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Experimental

25 evaluable subjects from the experimental arm of ATN 061 who undergo de-intensification to boosted atazanavir (ATV) with VL suppression of \< 100 copies/ml and CD4+ T cells \> 350 cells/mm3 at week 48 and maintain VL suppression to \< 400 copies/ml with stable CD4+ T cell counts after week 48.

Blood draw

Intervention Type OTHER

This sub-study does not involve additional treatment of any ATN 061 or ATN 071 study subjects. The only intervention involved is the requirement for whole blood collection (40 ml and 60 ml) to be drawn at the same time as four ATN 061 study visits (36, 48, 56, and 80 weeks) for subjects co-enrolled into ATN 061. When these time points coincide with ATN 061 Central Laboratory samples, the 60 ml blood sample will not be collected. For subjects co-enrolled into ATN 071, there are also two samples of whole blood collection (40 ml and 60 ml) required to be drawn at four time points but at weeks 36, 48, 56, and 80 after the initiation of HAART.

Control

25 evaluable subjects from ATN 071 will also be enrolled. These subjects will have initiated HAART according to current DHHS guidelines (CD4+ T cells \< 350 cells/mm3), had viral load suppression to \< 100 copies/ml at 24 through 48 weeks on HAART and maintained suppression to \< 400 copies/ml through week 80.

Blood draw

Intervention Type OTHER

This sub-study does not involve additional treatment of any ATN 061 or ATN 071 study subjects. The only intervention involved is the requirement for whole blood collection (40 ml and 60 ml) to be drawn at the same time as four ATN 061 study visits (36, 48, 56, and 80 weeks) for subjects co-enrolled into ATN 061. When these time points coincide with ATN 061 Central Laboratory samples, the 60 ml blood sample will not be collected. For subjects co-enrolled into ATN 071, there are also two samples of whole blood collection (40 ml and 60 ml) required to be drawn at four time points but at weeks 36, 48, 56, and 80 after the initiation of HAART.

Interventions

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Blood draw

This sub-study does not involve additional treatment of any ATN 061 or ATN 071 study subjects. The only intervention involved is the requirement for whole blood collection (40 ml and 60 ml) to be drawn at the same time as four ATN 061 study visits (36, 48, 56, and 80 weeks) for subjects co-enrolled into ATN 061. When these time points coincide with ATN 061 Central Laboratory samples, the 60 ml blood sample will not be collected. For subjects co-enrolled into ATN 071, there are also two samples of whole blood collection (40 ml and 60 ml) required to be drawn at four time points but at weeks 36, 48, 56, and 80 after the initiation of HAART.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

061 Participants

* Currently on treatment with an ATV/r-based HAART regimen (ATV/r, FTC, TDF is the preferred regimen);
* HIV-1 viral load \< 100 copies at week 24;
* CD4+ T cell count \> 350 cells/mm3 at week 24; and
* Able to provide informed consent for the sub-study and adhere to the protocol.

071 Participants
* Initiated HAART according to current DHHS guidelines (CD4+ T cells \< 350 cells/ mm3);
* Currently on treatment with a PI-containing HAART regimen; subjects taking a protease inhibitor OTHER than ATV/r must receive approval by the team via the ATN QNS;
* Plasma HIV-1 viral load \< 100 copies at week 24 on HAART; measurement to be collected from clinical care results contained in the medical record at the clinical site within +/- 30 days of week 24 on therapy;
* CD4+ T cell count \> 350 cells/mm3 at week 24 on HAART; measurement to be collected from clinical care results contained in the medical record at the clinical site within +/- 30 days of week 24 on therapy; and
* Able to provide informed consent for the sub-study and adhere to the protocol.

Exclusion Criteria

* Currently enrolled in the Standard Care Arm of ATN 061;
* Pregnancy or breast feeding;
* Severe (Grade ≥ 3) anemia or other conditions that would not allow adequate blood volume to be drawn;
* Active treatment for systemic infections;
* Treatment with immune modulators, including immunosuppressive or immune modulating therapy (IL-2, intravenous gammaglobulin, and therapeutic or other experimental vaccines including HIV-1 vaccine given for primary prevention at any time (short courses (\<14 days) of prednisone for reactive airway disease (RAD) are permitted);
* Active hepatitis B infection as defined by Hepatitis B antigen (Ag) positive;
* Disallowed Medications (see Section 5.3.2);
* Active drug or alcohol use or dependence that, in the opinion of the site personnel, would interfere with adherence to the study; or
* History of chronic renal insufficiency or Grade 3 or greater serum creatinine.

* History of an Acquired Immunodeficiency Syndrome (AIDS)-defining illness;
* Meets any ATN 061 premature study discontinuation criteria.
Minimum Eligible Age

18 Years

Maximum Eligible Age

24 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute on Drug Abuse (NIDA)

NIH

Sponsor Role collaborator

National Institute of Mental Health (NIMH)

NIH

Sponsor Role collaborator

University of North Carolina, Chapel Hill

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Deborah Persaud, M.D.

Role: STUDY_CHAIR

Adolescent Trials Network

Locations

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Children's Hospital of Los Angeles

Los Angeles, California, United States

Site Status

University of California at San Francisco

San Francisco, California, United States

Site Status

Children's National Medical Center

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

Site Status

Howard University - IMPAACT Site

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

Site Status

Children's Diagnostic and Teatment Center

Fort Lauderdale, Florida, United States

Site Status

University of Miami School of Medicine

Miami, Florida, United States

Site Status

University of South Florida College of Medicine

Tampa, Florida, United States

Site Status

John Stroger Jr. Hospital of Cook County

Chicago, Illinois, United States

Site Status

Children's Memorial Hospital

Chicago, Illinois, United States

Site Status

Tulane Medical Center

New Orleans, Louisiana, United States

Site Status

University of Maryland

Baltimore, Maryland, United States

Site Status

Johns Hopkins University - IMPAACT Site

Baltimore, Maryland, United States

Site Status

Mount Sinai Medical Center

New York, New York, United States

Site Status

Montefiore Medical Center

The Bronx, New York, United States

Site Status

Children's Hospital of Philadelphia

Philadelphia, Pennsylvania, United States

Site Status

St. Jude Children's Research Hospital

Memphis, Tennessee, United States

Site Status

University of Puerto Rico

San Juan, , Puerto Rico

Site Status

Countries

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United States Puerto Rico

Related Links

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Other Identifiers

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ATN 081

Identifier Type: -

Identifier Source: org_study_id

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