HIV Infections Clinical Trial
Official title:
An Open-Label Randomized Clinical Trial to Evaluate the Efficacy and Safety of Short Course Antiretroviral Therapy for Acute or Recent HIV-1 Infection in Zimbabwe and the United States
The purpose of this study is to determine the safety and effectiveness of an anti-HIV drug regimen followed by treatment interruption in people recently infected with HIV. This study will also compare the effects of a treatment regimen including treatment interruption with a treatment plan based on clinical indicators.
About 6 months after infection, HIV viral load reaches a temporarily stable level known as
virus set point. Virus set point is different for each patient and can be a predictor for
disease progression. Preliminary studies indicate that early, short-term antiretroviral
therapy (ART) given to people newly infected with HIV may lead to lower virus set points and
preserved CD4 counts. However, the length of short-term treatment needed to balance the
possible adverse effects of ART with the achievement of lower virus set point is not yet
known. By lowering the virus set point and maintaining CD4 counts, the need for long-term
ART may be postponed. The purpose of this study is to determine the safety and efficacy of a
short course of ART on producing a lower virus set point in adults recently infected with
HIV.
This study will last at least 28 weeks. Participants will be randomly assigned to one of two
arms. Arm A will receive ART for 12 weeks as emtricitabine/tenofovir disoproxil fumarate
(TDF/FTC) daily and lopinavir/ritonavir (LPV/RTV) in tablet form twice daily. After 12
weeks, treatment will be interrupted unless the CD4 count is measured to be less than 350
cells/mm^3 on two consecutive occasions during treatment interruption. If that occurs
therapy will be resumed. Participants in Arm B will receive no treatment until cluster of
differentiation 4 (CD4) counts drop below 350 cells/mm^3, indicating ART is needed. Study
visits will occur at study entry, at Weeks 2 and 4, and every 4 weeks thereafter. At each
study visit, a physical exam, blood collection, and completion of an adherence questionnaire
will occur. Participants are encouraged to enroll in a related substudy that will evaluate
HIV viral load in genital secretions.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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