HIV Clinical Trial
Official title:
An Open, Prospective Study to Compare the Safety and Efficacy of Raltegravir vs. Atazanavir / Ritonavir, Both in Combination With Tenofovir DF and Emtricitabine, in the Treatment of HIV-infection in ART Naive Subjects With HCV Co-infection.
Current European AIDS Clinical Society (EACS) guidelines for the treatment of HIV infection
recommend a combination antiretroviral regimen composed of two nucleoside reverse
transcriptase inhibitors plus a ritonavir boosted protease inhibitor or a non-nucleoside
reverse transcriptase inhibitor.
The non-nucleoside reverse transcriptase inhibitors licensed for naïve patients - nevirapine
and efavirenz - have both been asociated with increased rates of hepatotoxicity (nevirapine)
and CNS toxicity (efavirenz) in HIV/HCV co-infected patients. Although PI-based therapy has
dramatically reduced morbidity and mortality, it has been limited by complex dosing regimens
and toxicities, leading to adherence challenges. Varying degree of liver insufficiency may
necessitate pharmacokinetic monitoring of the protease inhibitor and may necessitate dose
adjustments. In HIV/HCV co-infected patients HAART based on another class of antiretrovirals
than NNRTI or PI may thus offer advantages with regard to adverse events and thus long-term
efficacy.
The overall intention of this trial is to examine in a non-inferiority design the safety and
efficacy of a raltegravir based HAART with a standard-of-care HAART in HIV-/HCV co-infected
patients. The standard of care used in this study will be atazanavir/ritonavir. All patients
will in addition receive a fixed combination of tenofovir and emtricitabine.
The primary end-point is the rate of hepatotoxic events, defined by ALT elevations.
n/a
Allocation: Randomized, Endpoint Classification: Safety Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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