HIV Infections Clinical Trial
Official title:
An Observational Study of Viral and Immune Dynamics in Subjects With Acute HIV Infection: A Study of the UCSD Acute/Early HIV Infection (AEHIV) Clinical Studies Unit
The purpose of this study is to monitor patients who have recently been infected with HIV in
order to learn how their immune systems respond to HIV infection and to study how the virus
multiplies in their bodies.
Patients who have been infected with HIV recently are considered to have acute, or early,
HIV infection. During this period, viral load (level of HIV in the body) rises sharply to a
high level at first but then decreases significantly on its own. Doctors are not sure why
this decrease in viral load happens and how the body is able to accomplish this. In this
study, patients with acute HIV infection will be monitored so that doctors can study their
immune systems to try to learn more about this rise and fall in viral load.
Two theories offer possible explanations for the early decline of viral loads seen in acute
HIV infection. The first is that CD4 target cell numbers are depleted, so the reduction in
permissive target cells limits viral replication. A second is that the host develops an
HIV-specific cytotoxic T lymphocyte (CTL) immune response that limits viral replication
during the initial high viral titer. Consequently, enhanced clearance of HIV-infected cells
results in a decline of plasma HIV RNA. This study examines the latter theory by
characterizing viral and immune dynamics in the blood and lymph nodes of HIV-infected
patients.
Cohort I (HIV-negative volunteers): At study entry a medical history and physical exam is
performed, and volunteers complete a questionnaire. Blood samples are drawn weekly until
Week 12, then at Weeks 14, 16, 20, and 24. Volunteers are followed for 24 weeks. Volunteers
are offered the opportunity to participate in a lymphoid tissue substudy, which involves one
to four sequential gut-associated lymphoid biopsies. Compensation for travel and for the
inconvenience of study participation is provided.
Cohort II: At study entry a patient history and physical exam is performed, and volunteers
complete a questionnaire. Volunteers with a rising plasma HIV RNA during the first three
visits will have frequent sampling of blood and physical exams for two years. Volunteers
continue to be followed thereafter once every 6 months through 5 years of study duration.
Volunteers are offered the opportunity to participate in a lymphoid tissue substudy and/or
the lymphoid kinetics substudy. These substudies require hospitalizations of 24 hours or
less for tissue biopsies and glucose infusion. Compensation for travel and for the
inconvenience of study participation is provided
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