Impact of Antiretroviral Therapy on Cardiac Biomarkers

HIV Infections Clinical Trial

Official title:

Impact of Antiretroviral Therapy on Biomarkers of Inflammation Associated With Cardiovascular Risk

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT00641888
• Other study ID #: 200715922
• Status: Completed
• Phase: N/A
• First received: March 19, 2008
• Last updated: July 6, 2017
• Start date: March 2008
• Est. completion date: October 2014

Study information

• Verified date: July 2017
• Source: University of California, Davis
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

Cardiovascular risk appears to be linked to some degree with inflammation. HIV medications have been linked with cardiovascular risk. In this study we will be measuring levels of chemicals in the body associated with inflammation before and after starting HIV medications in patients with HIV. We hope to understand what happens to these chemicals once a patient with HIV is started on these medications to understand their role in cardiovascular risk.

Description:

With the advent of antiretroviral therapy, death due to opportunistic diseases have seen a major decline among patients with HIV. However, several antiretroviral medications, in particular protease inhibitors (PI), have been associated with increased cardiovascular risk in large cohort studies. The role of inflammation in cardiovascular risk is currently being elucidated. High sensitivity C-reactive protein (hsCRP) has been identified as a strong independent predictor of cardiovascular disease among healthy individuals in several large cohort studies. Other inflammatory biomarkers such as serum amyloid A (SAA) and interleukin-6 (IL-6) have also been correlated with cardiovascular risk. Among patients with HIV, studies have revealed inappropriate immune activation with increased pro-inflammatory cytokines such as IL-6, IL-10, interferon-γ (IFN- γ), and tumor necrosis factor-α (TNF-α). The effects of this immune dysregulation and the impact of antiretroviral therapy on the cytokines and biomarkers associated with cardiovascular risk remain to be delineated.

Objective: Our aims are to characterize the levels of inflammatory biomarkers at the time of antiretroviral initiation, to define the time period over which the biomarkers change and stabilize, and to determine if the type of antiretroviral drug class used has an impact on the rate of alteration of these biomarkers. Given the disparate cardiovascular risk between women and men of similar age groups, we will study the additional impact of gender on these biomarkers. We will also explore whether there is a correlation between change of CD4 T-lymphocyte counts and the response of the biomarkers.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 40
• Est. completion date: October 2014
• Est. primary completion date: October 2014
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 69 Years

Eligibility

Inclusion Criteria:

• Patients with a CD4 count between 200-400 planning on initiating antiretrovirals.

Exclusion Criteria:

• Pregnancy,

• Recent discontinuation of an antiretroviral within the past 30 days,

• Active intravenous drug use,

• Acute febrile illness with temperature > 100 F,

• Diagnosis or symptoms of acute infection within the past 30 days,

• Opportunistic infection or surgical procedure within the past 60 days,

• Myocardial infarction within the last 30 days,

• Renal disease (CKD Stages 3-5), and

• Unstable liver disease.

Related Conditions & MeSH terms

• HIV Infections

Locations

Country	Name	City	State
United States	University of California, Davis	Sacramento	California

Sponsors (2)

Lead Sponsor	Collaborator
University of California, Davis	California HIV/AIDS Research Program

Country where clinical trial is conducted

United States,