HIV Infections Clinical Trial
Official title:
Short-Cycle Therapy in Adolescents Following Continuous Therapy With Established Viral Suppression: The Impact on Viral Load Suppression
This study will determine if taking anti-HIV drugs 4 days a week will control HIV-1 viral replication in patients who have already had at least 6 months of documented viral suppression with full-time treatment. If this strategy is shown to be safe in this study, a larger study will be undertaken to determine if the strategy can decrease overall drug exposure and help young people adjust more easily to a chronic medication schedule.
HIV infected adolescents who require therapy face a lifetime of antiretroviral treatment.
Highly active antiretroviral therapy (HAART) is associated with short- and long-term
complications, and concerns are mounting about the cumulative effect of these complications
as adolescents enter the third and fourth decade of life. A management strategy that can
suppress the virus and decrease overall drug exposure is needed. In addition, the scheduling
requirements for antiretroviral therapies interfere with the socialization and independence
that an adolescent must accomplish to gain skills for a successful adult life. Not
surprisingly, nonadherence to prescribed medications is common in teens. This multicenter,
prospective, proof of concept trial will evaluate Short Cycle Therapy (SCT) in adolescents
with sustained viral suppression of at least 6 months. While maintenance of viral load
suppression can be viewed as either a safety or efficacy endpoint, the trial is constructed
as an assessment of safety.
Eligible participants who have been on standard HAART therapy consisting of a Protease
Inhibitor will switch to SCT therapy(4 days on treatment, 3 days off treatment each week) at
entry. Participants will be seen in the clinic every other Monday during the first month,
then monthly up to 24-weeks and then once every two months until the end of the 48-week
study period. Plasma HIV RNA levels and CD4 cell counts will be performed at every visit.
Medication adherence by self-report will be conducted every 2 weeks until week 24 and every
4-weeks thereafter until week 48. Fasting serum triglycerides and cholesterol will be
measured at baseline, at week 24 and at the end of the study.
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