Impact of Cotrimoxazole Prophylaxis for HIV-Infected Adults on Antifolate

Status Completed

Clinical Trial Summary

At least three studies in sub-Saharan Africa have demonstrated a decrease in morbidity or mortality among HIV-infected adults who took daily cotrimoxazole (trimethoprim sulfamethoxazole) [CTX] prophylaxis. Because of the demonstrated beneficial effect, high tolerability and low cost of CTX, the United Nations Programme on HIV/AIDS (UNAIDS) recommends that HIV-infected persons with symptomatic HIV or depressed CD4 counts receive daily CTX. The effect of this recommendation on subsequent development of antimicrobial resistance to antifolates among important pathogens needs to be evaluated. The investigators measured the change in the prevalence of markers of antifolate resistance among P. falciparum, and the change in the prevalence of CTX resistance among S. pneumoniae, and E. coli in HIV-infected individuals receiving CTX daily prophylaxis. In addition, the investigators measured the change in the prevalence of naso-pharyngeal or oro-pharyngeal carriage of CTX resistant S. pneumoniae among children living in households where an HIV-infected adult was receiving CTX daily prophylaxis.

Clinical Trial Description

We conducted this study in Kisumu, Kenya where HIV prevalence is high and malaria is highly endemic. HIV infected and uninfected adults were assigned to receive daily CTX if CD4 cell count was <350, or daily multivitamin if CD4 cell count was >= 350 or if the client was HIV negative. All clients were then followed for a total of 6 months. At specified scheduled and sick visits, clients received a physical exam, blood smears, nasopharyngeal swabs and stool samples or rectal swabs. Samples collected at baseline and during follow-up were used to measure the change in CTX resistance among P. falciparum parasites, pneumococcus isolates, and commensal E. coli. ;

Study Design

Allocation: Non-Randomized, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Educational/Counseling/Training

Related Conditions & MeSH terms

Clinical Trial Details

NCT number	NCT00137657
Study type	Interventional
Source	Centers for Disease Control and Prevention
Contact
Status	Completed
Phase	Phase 4
Start date	February 2002
Completion date	November 2003

View Details

See also
Status	Clinical Trial	Phase
Recruiting	`NCT06162897` - Case Management Dyad	N/A
Completed	`NCT03999411` - Smartphone Intervention for Smoking Cessation and Improving Adherence to Treatment Among HIV Patients	Phase 4
Completed	`NCT02528773` - Efficacy of ART to Interrupt HIV Transmission Networks
Recruiting	`NCT05454839` - Preferences for Services in a Patient's First Six Months on Antiretroviral Therapy for HIV in South Africa
Recruiting	`NCT05322629` - Stepped Care to Optimize PrEP Effectiveness in Pregnant and Postpartum Women	N/A
Completed	`NCT02579135` - Reducing HIV Risk Among Adolescents: Evaluating Project HEART	N/A
Active, not recruiting	`NCT01790373` - Evaluating a Youth-Focused Economic Empowerment Approach to HIV Treatment Adherence	N/A
Not yet recruiting	`NCT06044792` - The Influence of Primary HIV-1 Drug Resistance Mutations on Immune Reconstruction in PLWH
Completed	`NCT04039217` - Antiretroviral Therapy (ART) Persistence in Different Body Compartments in HIV Negative MSM	Phase 4
Active, not recruiting	`NCT04519970` - Clinical Opportunities and Management to Exploit Biktarvy as Asynchronous Connection Key (COMEBACK)	N/A
Completed	`NCT04124536` - Combination Partner HIV Testing Strategies for HIV-positive and HIV-negative Pregnant Women	N/A
Recruiting	`NCT05599581` - Tu'Washindi RCT: Adolescent Girls in Kenya Taking Control of Their Health	N/A
Active, not recruiting	`NCT04588883` - Strengthening Families Living With HIV in Kenya	N/A
Completed	`NCT02758093` - Speed of Processing Training in Adults With HIV	N/A
Completed	`NCT02500446` - Dolutegravir Impact on Residual Replication	Phase 4
Completed	`NCT03805451` - Life Steps for PrEP for Youth	N/A
Active, not recruiting	`NCT03902431` - Translating the ABCS Into HIV Care	N/A
Completed	`NCT00729391` - Women-Focused HIV Prevention in the Western Cape	Phase 2/Phase 3
Recruiting	`NCT05736588` - Elimisha HPV (Human Papillomavirus)	N/A
Recruiting	`NCT03589040` - Darunavir and Rilpivirine Interactions With Etonogestrel Contraceptive Implant	Phase 2

Clinical trials are conducted in a series of steps, called phases - each phase is designed to answer a separate research question.

Phase 1: Researchers test a new drug or treatment in a small group of people for the first time to evaluate its safety, determine a safe dosage range, and identify side effects.
Phase 2: The drug or treatment is given to a larger group of people to see if it is effective and to further evaluate its safety.
Phase 3: The drug or treatment is given to large groups of people to confirm its effectiveness, monitor side effects, compare it to commonly used treatments, and collect information that will allow the drug or treatment to be used safely.
Phase 4: Studies are done after the drug or treatment has been marketed to gather information on the drug's effect in various populations and any side effects associated with long-term use.

Impact of Cotrimoxazole Prophylaxis for HIV-Infected Adults on Antifolate Resistance

Clinical Trial Summary

Clinical Trial Description

Study Design

Related Conditions & MeSH terms