HIV Infection Clinical Trial
Official title:
Elvitegravir/Cobicistat/Tenofovir DF/Emtricitabine With Darunavir in Treatment-experienced Patients: Quality Control Monitoring of a Treatment Simplification Strategy
The study aims to assess the safety and efficacy of darunavir 800mg plus the co-formulated
elvitegravir/cobicistat/tenofovir disoproxil fumarate (DF)/emtricitabine (Stribild) tablet as
a simplification strategy for the treatment of HIV infection in HIV-infected subjects who
have had previous antiretroviral treatment experience with multiple-drug regimens.
We hypothesize that elvitegravir/cobicistat/tenofovir DF/emtricitabine with darunavir will
offer a safe and efficacious treatment simplification strategy for HIV positive patients
currently receiving multiple-drug regimens to control their HIV infection.
Eligible, consenting subjects will be assessed at baseline and weeks 2, 12, 24, 36, and 48.
Study medications will be dispensed at all visits except week 2, and all participants will
commence taking open-label darunavir 800mg in conjunction with the co-formulated tenofovir
DF/emtricitabine/cobicistat/elvitegravir (Stribild) tablet, both taken together once daily
with food, following study procedures at baseline.
Assessments at the study visits will include:
1. Complete physical exam including height and weight at baseline; symptom-directed
physical exam and weight at other visits
2. Adverse clinical events including serious adverse events (hospitalizations etc.) and
medication changes at every visit.
3. HIV RNA every 4 weeks.
4. CD4 and CD8 absolute counts and % at all visits except week 2.
5. Platelet count, aspartate amino transferase (AST), creatinine, estimated glomerular
filtration rate (eGFR), phosphorus, urinalysis, and urine albumin to creatinine ratio
(UACR) at each visit.
6. Fasting lipids (total, HDL, and LDL cholesterol and triglycerides), apolipoprotein B,
high-sensitivity C- reactive protein (hsCRP) at baseline, week 24, and week 48.
7. Pregnancy test for women of child-bearing potential (as defined above) at every visit
except week 2. In addition, pregnancy tests will be performed monthly for women of
child-bearing potential; between study visits these may be done at home.
8. A plasma sample (3 mL) will be collected and stored once at baseline for all subjects,
and used for measurement of darunavir trough (pre-dose) concentration in subjects
receiving darunavir in their pre-study regimen.
9. All subjects will take their study medication under observation in the clinic on Day 14,
and plasma samples (3mL) for pharmacokinetic testing will be drawn immediately pre-dose
and at 1, 2, 3, 4, 5, 6, and 8 hours post-dose. Subjects will return the following day
before taking their Day 15 dose for a 24-hour post-dose sample.
10. Peripheral blood mononuclear cells (PBMCs) will be collected and stored at baseline for
possible future study-related testing.
11. The following questionnaires will be completed by participants prior to other study
procedures at baseline and at weeks 24 and 48: MOS-HIV quality of life questionnaire;
HIVTSQ; ACTG treatment adherence questionnaire; and the medication adherence self-report
inventory (MASRI).
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