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A Study to Compare Anti-HIV Drugs Given Twice a Day or Once a Day, With or Without Direct Observation



A Study to Compare Anti-HIV Drugs Given Twice a Day or Once a Day, With or Without Direct Observation

For Condition: HIV Infections
Status: Recruiting
Sponsor(s): National Institute of Allergy and Infectious Diseases (NIAID) ,
Synopsis: Anti-HIV drug therapy works best when the drugs are taken exactly as prescribed by a doctor. Because anti-HIV therapy often involves multiple drugs, some people have difficulty taking them all correctly. The easier it is to take anti-HIV drugs, the more likely people will take them as prescribed and get the best results. This study will see if people are more successful in taking anti-HIV drugs once a day or twice a day. It also will determine if having a health care professional oversee each weekday dose helps people control their HIV infection. The study will compare taking a three-drug combination twice a day versus taking a three-drug combination just once a day. The study will also compare patients taking the drugs on their own to patients taking the drugs in the presence of a clinical worker. Viral load (amount of HIV in the blood) and drug side effects will be measured.
Details: While many factors contribute to the success or failure of antiretroviral therapy for HIV, among the most important are factors that influence adherence to a treatment regimen, such as duration of therapy, dosing frequency, pill burden, side effects, and patient behaviors. Inconsistent adherence or nonadherence to antiretroviral therapy can result in suboptimal drug exposure. Suboptimal drug exposure can, in turn, impact short- and long-term patient outcomes by increasing the likelihood of drug resistant HIV mutants and subsequent virologic and clinical failure. It is therefore essential to design treatment regimens that promote long-term adherence to potent antiretroviral therapy. This study will evaluate the relative contribution of reduced-frequency dosing and directly observed therapy on the magnitude and durability of virologic suppression in patients treated with potent antiretroviral therapy. Patients will be randomly assigned to one of three study arms. Arms A, B, and C receive the same daily dosage of lopinavir/ritonavir (LPV/r), emtricitabine (FTC), and stavudine extended release (d4T XR) or tenofovir DF (TDF). In Arm A, drugs are self-administered for 48 weeks; LPV/r is taken twice daily and FTC and d4T XR or TDF once daily. In Arm B, all drugs are self-administered once daily for 48 weeks. In Arm C, drugs are taken once a day under directly observed therapy during Weeks 0-24, and then by self-administration during Weeks 25-48. Adherence to the regimen is measured using an electronic drug monitoring system. Viral load, CD4 and CD8 T cell responses, population pharmacokinetics, and quality of life indicators are measured throughout the study. The tolerability and safety of the treatment regimens are also monitored.
Eligibility:
Study Type:
  Interventional, Treatment, Randomized, Open Label, Uncontrolled, Parallel Assignment, Safety/Efficacy Study
Minimum Age/Maximum Age: 13 Years/
Genders: Both
Protocol Entry Criteria: Inclusion Criteria - HIV infection - Age 13 years or older and have written consent of guardian if under 18 - Weigh at least 88 pounds - Viral load of 2000 copies/ml or more within 90 days before study entry - Have not taken anti-HIV drugs for more than 7 days - Agree to use acceptable methods of contraception Exclusion Criteria - Pregnant or breastfeeding - In jail - Sensitive or allergic to any part of the study drugs - Treated with acute systemic therapy for a serious infection or other serious medical illness within 7 days prior to study entry, unless the participant has completed 7 days of therapy and is clinically stable - Recent serious illness, including pancreatitis or peripheral neuropathy - Alcohol or illicit drug abuse - Taken any of the following within 14 days before study entry: investigational drugs, anti-HIV vaccines, drugs that may cause pancreatitis or peripheral neuropathy, or drugs that are associated with CYP3A - Treated for cancer (not including minimal Kaposi's sarcoma) within 30 days before study entry - History of mental illness that might interfere with the study
Total Enrollment: 375

Location and Contact Information:

Overall Study Official:
DonnaMildvan,  Study Chair,  Beth Israel Medical Center

Rhode Island Hospital *Recruiting*
Providence,  Rhode Island,  02906
United States
Recruiting Joan  Gormley 401-793-4396

Univ of Rochester Med Ctr *Recruiting*
Rochester,  New York,  14215
United States
Recruiting Carol  Greisberger 585-275-2740

Univ of Maryland, Institute of Human Virology *Recruiting*
Baltimore,  Maryland,  21201
United States
Recruiting Susan  LaSalvia 410-706-2785

Bellevue Hosp / New York Univ Med Ctr *Recruiting*
New York City,  New York,  10016
United States
Recruiting Maura  Laverty 212-263-6565

Indiana Univ Hosp *Recruiting*
Indianapolis,  Indiana,  46202-5250
United States
Recruiting Beth  Zwickl 317-274-8456

Johns Hopkins Univ *Recruiting*
Baltimore,  Maryland,  21287
United States
Recruiting Charles  Raines 410-614-4487

Univ of Pennsylvania, Philadelphia *Recruiting*
Philadelphia,  Pennsylvania,  19104
United States
Recruiting Joseph  Quinn 215-349-8092

Beth Israel Deaconess - West Campus *No longer recruiting*
Boston,  Massachusetts,  02215
United States
No longer recruiting  

Beth Israel Med Ctr *Recruiting*
New York City,  New York,  10003
United States
Recruiting Ann  Marshak 212-420-4432

Univ of Puerto Rico *Recruiting*
San Juan,  ,  00936-5067
Puerto Rico
Recruiting Raquel  Colon-Otero 787-767-9192

Univ of North Carolina *Recruiting*
Chapel Hill,  North Carolina,  27514
United States
Recruiting Cheryl  Marcus 919-843-8761

Miriam Hosp/Brown Univ *Recruiting*
Providence,  Rhode Island,  02906
United States
Recruiting Joan  Gormley 401-793-4396

Stanley Street Treatment and Resource *Recruiting*
Providence,  Rhode Island,  02906
United States
Recruiting Joan  Gormley 401-793-4396

Univ of Washington *Recruiting*
Seattle,  Washington,  98104
United States
Recruiting Jeanne  Conley 206-731-8877

Methodist Hosp of Indiana *Recruiting*
Indianapolis,  Indiana,  46202-1261
United States
Recruiting Sarah  Ryan 317-929-2917

The Moses H. Cone Memorial Hosp *Recruiting*
Greensboro,  North Carolina,  27401-1004
United States
Recruiting Lisa  Dasnoit 336-832-8062

Univ of Miami *Recruiting*
Miami,  Florida,  33136
United States
Recruiting Leslie  Thompson 305-243-3838

Univ of Colorado Health Sciences Ctr *Recruiting*
Denver,  Colorado,  80262
United States
Recruiting M.  Ray 303-372-5535

University of Hawaii *Recruiting*
Honolulu,  Hawaii,  96816-2396
United States
Recruiting Debra  Ogata-Arakaki 808-737-2751

University of Witwatersrand *Recruiting*
Parktown/Gauteng,  Johnnesburg, 
South Africa
Recruiting Pauline  Vunandlala 01-27-11-717-2810

MetroHealth Med Ctr *Recruiting*
Cleveland,  Ohio,  44109-1998
United States
Recruiting Ann  Conrad 216-778-5489

Ohio State University *Recruiting*
Columbus,  Ohio, 
United States
Recruiting Todd  Lusch 614-293-8112

Wishard Hosp *Recruiting*
Indianapolis,  Indiana,  46202
United States
Recruiting Scott  Hamilton 317-630-6023

Univ of California, Davis Med Ctr *Recruiting*
Sacramento,  California,  95814
United States
Recruiting Susan  Hulse 916-734-8637

Community Health Network, Inc *Recruiting*
Rochester,  New York,  14642-0001
United States
Recruiting Carol  Greisberger 585-275-2740


Additional Information:
Study ID Numbers:
  ACTG A5073;  AACTG A5073
Study Start Date: 
Record last reviewed: May 2004
Additional information available at: clinicaltrials.gov
Clinicaltrials.gov Reference link: NCT00036452

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