HIV Infections Clinical Trial
— InterACTOfficial title:
Study of Therapeutic Efficacy, Safety and Pharmacokinetic Interactions Between Artemether-lumefantrine and Nevirapine-based Antiretrovirals in HIV-infected Patients With Uncomplicated Falciparum-malaria in Muheza, Northeastern Tanzania
As HIV/AIDS is spreading in malaria-endemic countries, many patients here will need
concomitant treatment for both infections. Effective combination treatments are available
for both malaria (artemisinin-based combination treatments, ACTs) and HIV/AIDS
(antiretroviral combination treatments, ARTs), and these treatments are presently
recommended for concomitant use by ministries of health in many endemic countries, including
Tanzania. However, theoretically some of these drugs may be involved in harmful interactions
with each other, as they share common cytochrome enzymes involved in their metabolism. Such
interactions could lead to less effective treatments and/or adverse effects, as a
consequence of reduced or increased drug levels, respectively. Only little clinical and
pharmacological information is however yet available to guide clinicians and policy-makers
on this issue.
The main aim of the InterACT study in Tanzania is to conduct a series of detailed
observational studies of clinical and paraclinical safety, therapeutic efficacy and
pharmacokinetic interactions between the currently nationally recommended first-line
treatment for malaria, artemether-lumefantrine, and first-line antiretroviral treatments,
primarily nevirapine-based combinations, for HIV/AIDS. The studies will be conducted among
patients with uncomplicated malaria, who attend the HIV/AIDS Care and Treatment Clinic and
Muheza Designated District Hospital in Muheza, north-eastern Tanzania, which is an area
characterized by intense transmission of Plasmodium falciparum malaria and with a prevalence
of HIV around 8-10%. The study is expected to inform guidelines for the treatment of malaria
in patients with HIV/AIDS in Tanzania, and elsewhere.
Status | Completed |
Enrollment | 830 |
Est. completion date | January 2013 |
Est. primary completion date | October 2012 |
Accepts healthy volunteers | No |
Gender | Both |
Age group | 15 Years to 60 Years |
Eligibility |
Inclusion Criteria: - HIV-positive and HIV-negative patients with confirmed P. falciparum infection in the presence of either measured fever (> 37.5°C) or a history of fever within the previous 24 hours; for HIV-positive patients also afebrile patients are eligible in the presence of other symptoms of malaria (e.g., coughing, diarrhea, headache, nausea, body weakness, body pain). - Not being pregnant or lactating. - Absence of history of clinically significant hypersensitivity reactions to any of the study medicines being evaluated. - For HIV-positive patients on cART, successful adherence to treatment without prominent adverse events for a period of a minimum of six weeks prior to the date of enrollment will be required. - Easy access to the health facility (travel time < 1 hour) and the ability to attend the stipulated follow-up visits. - Informed consent provided by the patient or by a parent/guardian Exclusion Criteria: - Patients below body weight of 10 kilograms (for under fives). - Existence of underlying chronic severe illness (e.g., cardiac, renal or hepatic disease). - No use within the previous four weeks prior to enrollment of any other antimalarial or other drug with antimalarial activity (with the exception of drugs required as part of standard treatment of HIV/AIDS, e.g., sulfamethoxazole and trimethoprim). |
Allocation: Non-Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
Country | Name | City | State |
---|---|---|---|
Tanzania | Muheza Designated District Hospital | Muheza | Tanga Region |
Lead Sponsor | Collaborator |
---|---|
University of Copenhagen | London School of Hygiene and Tropical Medicine, National Institute for Medical Research, Tanzania |
Tanzania,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Clinical and parasitological efficacy of artemether-lumefantrine; incidence and severity of treatment-related clinical and paraclinical adverse events; changes in pharmacokinetic profiles of artemether-lumefantrine. | 42 days of post-treatment follow-up | Yes | |
Secondary | Changes in pharmacokinetic profiles of nevirapine-based and other used antiretrovirals; | 42 days of post-treatment follow-up | Yes |
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