HIV Clinical Trial
Official title:
Kaohsiung Medical University Chung-Ho Memorial Hospital Tropical Medicine Center
Although combination antiretroviral therapy (cART) can significantly reduce morbidity and mortality, it still fails to eradicate HIV. Given the difficulty for eradication of HIV, functional cure is more likely to achieve the goal. In recent breakthrough scientific reports, there already existed several examples of HIV-infected cases achieving the status of functional cure only through early administration of cART in newborns or early infected cases. From Taiwan centers for disease control (CDC) reports and our clinical experiences, more and more young men got HIV infection and the most important finding is the investigators can find some of them are newly infected, let's say, within six months.
This study targets on this newly HIV- infected cohort and urging them to receive cART in
order to achieve the possible status of HIV function cure. After 3~5 years period of
treatment, cART will be discontinued after laboratory evaluation and functional cure is
anticipated. These patients can achieve good life quality. In addition to elimination of the
risk for HIV transmission, the cART expense of the government can be reduced on the large
scale. The core of this study aims at setting up a precise and standard laboratory
methodology for detecting the newly infected cases and predicting the time to stop cART. Once
these assay methods are well established, they can be widely applied to assess the previous
cases with long term cART for the prediction of the appropriate time to stop cART.
Thru the conventional HIV tests (within the sero-conversion stage), the detection rate of
early infection is only 5-10 %. Therefore it is very desperately important to develop more
tools for the diagnosis of early infection.
In addition to the standard method for detecting HIV infection, the investigators will use
the HIV p24 Ag test and detuned Enzyme-linked Immunoblotting assay (EIA) assay for detecting
early infection. For naïve patients, the investigators will also check the resistance testing
for antiretroviral drugs in order to adjust and choose the susceptible cART for the patients.
During the cART period, the investigators will follow up these patients for checking quantity
of HIV RNA and proviral DNA (HIV DNA) from Peripheral blood mononuclear cell (PBMCs) in their
blood. After three to five years of cART, if their HIV RNA is not detected and HIV DNA is
very low, the investigators will draw the blood from the patients to isolate the Cluster of
Differentiation 4 (CD4) receptors + T cells and co-cultivated with PBMCs from the healthy
cohorts to evaluate the existence of HIV infectivity or not in the cART treated cases. If
there is no infectivity, the investigators will stop cART. After stopping cART, the
investigators will follow up these cases every six months till at least two years to check
their HIV antibody, HIV RNA and HIV DNA from PBMCs to observe whether HIV recurrence occurs
to them.
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