Second-line Therapy

NCT ID: NCT01788891

Last Updated: 2016-05-11

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

300 participants

Study Classification

OBSERVATIONAL

Study Start Date

2011-01-31

Study Completion Date

2015-07-31

Brief Summary

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This study will help identify which ARV candidates should be prioritized for pediatric use in resource-limited settings

Detailed Description

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Children in resource-limited settings are increasing experiencing treatment failure, as defined by virologic, immunologic, and/or clinical criteria. There are few studies of HIV resistance mutations in children failing first line NNRTI therapy in resource limited settings. The emergence of treatment failure and drug resistance in children on ART emphasizes the urgency for developing evidence-based second-line and salvage treatment strategies. Pediatric treatment is complicated by a number of factors, including having fewer numbers of ARVs approved by drug safety agencies and the lack of pediatric formulations. This further shortens the list of available second-line ARVs as compared to adults.

Despite the growing number of children on second-line therapy worldwide, there are limited data on efficacy of second-line PI therapy in children after NRTI-NNRTI failure. There are currently no options for third-line/salvage regimens for children in resource-limited settings. New drugs and drug classes are approved for use in children by the US FDA but are not routinely available outside of high-income settings.

Also, there are no data on the resistance patterns of children failing second-line therapy in resource-limited settings to guide clinical management and ARV procurement. Clinicians need evidence-based guidelines for how to manage children with treatment failure, and access to the drugs necessary to construct potent and durable third-line regimens.

TASER-P is a longitudinal observational cohort study to monitor for treatment failure to second-line ART in Asian children.

Conditions

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Treatment Failure of Second-line ART in Asian HIV-infected Children

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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second-line pediatric cohort

Asian HIV-positive children \<18 years old who are receiving HIV care at one of the participating TREAT Asia Pediatric HIV Observational Database (TApHOD) sites that have been identified for TASER-P participation will be monitored for treatment failure of second-line ART

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* Age \< 18 years old
* Have confirmed HIV infection
* Are being switched to or treated with second-line ART. Second-line ART is defined as the second regimen with a major antiretroviral class switch. For example, a switch from an NNRTI-based to a PI-based regimen or vice versa
* Caregivers give informed consent. Children will be asked to give assent if they know their HIV status and have reached the minimum age to give assent according to each site's institutional review board regulations

Exclusion Criteria

* Started mono- or dual- therapy as the first ART therapy
* Failing first-line triple nucleoside reverse transcriptase inhibitor regimen
* Are being switched to or treated with second-line ART without failure of first-line therapy (i.e., for toxicity)
* Caregiver +/- child (if asked to give assent) refuses to participate in this study
* Have not been enrolled in TApHOD
Maximum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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amfAR, The Foundation for AIDS Research

OTHER

Sponsor Role collaborator

Dr Cipto Mangunkusumo General Hospital

OTHER

Sponsor Role collaborator

Pediatric Institute, Hospital Kuala Lumpur

UNKNOWN

Sponsor Role collaborator

Chiang Mai University

OTHER

Sponsor Role collaborator

Srinagarind Hospital, Khon Kaen University

OTHER

Sponsor Role collaborator

Mahidol University

OTHER

Sponsor Role collaborator

Children's Hospital Number 1, Ho Chi Minh City, Vietnam

OTHER

Sponsor Role collaborator

Number 2 Children's Hospital, Ho Chi Minh City

OTHER

Sponsor Role collaborator

Kirby Institute

OTHER_GOV

Sponsor Role collaborator

University of California, San Francisco

OTHER

Sponsor Role collaborator

The HIV Netherlands Australia Thailand Research Collaboration

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Nia Kurniati, MD

Role: PRINCIPAL_INVESTIGATOR

Dr Cipto Mangunkusumo General Hospital

Kamarul Razali, MD

Role: PRINCIPAL_INVESTIGATOR

Kuala Lumpur General Hospital

Tavitiya Sudjaritruk, MD

Role: PRINCIPAL_INVESTIGATOR

Research Institute for Health Sciences, Chiang Mai University

Pope Kosalaraksa, MD

Role: PRINCIPAL_INVESTIGATOR

Srinagarind Hospital, Khon Kaen Hospital

Kulkanya Chokephaibulkit, MD

Role: PRINCIPAL_INVESTIGATOR

Siriraj Hospital

Truong Huu Khanh, MD

Role: PRINCIPAL_INVESTIGATOR

Children's Hospital Number 1

Do Chau Viet, MD

Role: PRINCIPAL_INVESTIGATOR

Children's Hospital Number 2

Jintanat Ananworanich, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

The HIV Netherlands Australia Thailand Research Collaboration

Annette Sohn, MD

Role: PRINCIPAL_INVESTIGATOR

TREAT Asia

Locations

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Mangunkusumo General Hospital

Jakarta, , Indonesia

Site Status

Hospital Kuala Lumpur

Kuala Lumpur, , Malaysia

Site Status

Srinagarind Hospital, Khon Kaen University

Khon Kaen, Changwat Khon Kaen, Thailand

Site Status

Research Institute for Health Sciences

Chiang Mai, Chiang Mai, Thailand

Site Status

HIV-NAT

Bangkok, , Thailand

Site Status

Siriraj Hospital

Bangkok, , Thailand

Site Status

Children's Hospital Number 1

Ho Chi Minh City, , Vietnam

Site Status

Children's Hospital Number 2

Ho Chi Minh City, , Vietnam

Site Status

Countries

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Indonesia Malaysia Thailand Vietnam

Related Links

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http://www.hivnat.org

HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT)'s website

Other Identifiers

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HIV-NAT 149

Identifier Type: -

Identifier Source: org_study_id

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