HIV-1 Infection Clinical Trial
Official title:
A Prospective, Multicenter, Open, Randomized Phase 2a Trial to Confirm a Sustained Virological Suppression Defined as HIV-RNA <50 Copies/ml of 3 Different Doses of Fozivudine in Context to a Standard Zidovudine Based Antiretroviral Therapy Regimen After 24 Weeks of Treatment in ART naïve, Non Subtype B HIV-1 Infected Individuals From Tanzania and Ivory Coast
A prospective, multicenter, open, randomized Phase 2a trial to confirm a sustained virological suppression defined as HIV-RNA <50 copies/ml of 3 different doses of Fozivudine in context to a standard Zidovudine based antiretroviral therapy regimen after 24 weeks of treatment in ART naïve, non subtype B HIV-1 infected individuals from Tanzania and Ivory Coast.
The study will evaluate four different oral 1st line antiretroviral regimens: three study
arms will contain different doses of Fozivudine (FZD) plus Lamivudine (3TC) in a twice daily
or once daily application plus once daily Efavirenz. The 4th study arm will contain standard
Zidovudine (AZT)/Lamivudine (3TC) twice daily in a fixed dose combination plus once daily
Efavirenz. The treatment duration will be 24 weeks.
In a pharmacokinetic Sub-Study Pharmacokinetic (PK) characteristics will be determined under
controlled conditions in a sub population to evaluate PK values of the study drugs.
Primary Objective
The primary objective is to confirm a sustained virological suppression (HIV RNA <50
copies/ml) after 24 weeks of treatment between three different doses of Fozivudine (FZD)
based antiretroviral 1st line treatment regimen in context to a standard Zidovudine (ZDV)
based treatment regimen in non subtype B HIV-1 infected individuals from Africa.
Secondary Objectives
1. HIV-RNA log10 reduction of HIV-RNA at 2, 4 and 8 weeks of treatment between different
arms
2. Virological response (HIV RNA <50 copies/ml) at 8 and 12 weeks of treatment between
different arms
3. Virological response (HIV RNA <400 copies/ml) at 8, 12 and 24 weeks of treatment between
different arms
4. Immunologic response: variation in CD4 lymphocytes between different arms
5. Drug toxicity, particularly anaemia, neutropenia and gastrointestinal adverse events
6. Resistance pattern for in patients with virological failure
7. Clinical trial capacity building of African study sites within the FATI network
8. Establishment of a Fozivudine Drug developing consortium (NET) including members of
pharmaceutical manufacturers in Asia, Africa and Europe.
9. Development and piloting of a capacity development monitoring and evaluation framework
Pharmacological Objectives
1. Pharmacokinetic assessments after the first intake of study drugs in a subset of study
participants (Pharmacokinetic sub study)
2. Pharmacokinetic assessments at steady state after four weeks of study drugs in a subset
of study participants (Pharmacokinetic sub study)
Study Population and Study Duration
A total of 120 ART naive HIV-1 infected individuals with the indication to start
antiretroviral treatment according to WHO and country guidelines will be enrolled at two
study sites in Côte d'Ivoire and Tanzania. Each of the two sites will enroll 60 participants
(15 participants per arm). For the PK Sub-Study 6 participants per study arm (total 24
participants will be included.
A minimum of 30% gender representation (female or male) participants will be requested per
site. Recruitment, screening and enrollment of study participants are expected to be
completed after 9 months. Patient treatment is 24 weeks. So patient related study procedures
will take 15 months.
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