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A Phase II, Double-Blind, Randomized Study to Determine the Effect of Adding Delayed Versus Immediate Hydroxyurea to a Genotypic Based, ddI-Containing, Three-Drug Antiretroviral Regimen on the Recovery of Total CD4+ T-Cell Counts and Suppression of Plasma Viral Load in Advanced HIV-1 Infected Subjects Failing a First or Second Triple Combination Therapy


Phase 2
13 Years
N/A
Not Enrolling
Both
HIV Infections

Thank you

Trial Information

A Phase II, Double-Blind, Randomized Study to Determine the Effect of Adding Delayed Versus Immediate Hydroxyurea to a Genotypic Based, ddI-Containing, Three-Drug Antiretroviral Regimen on the Recovery of Total CD4+ T-Cell Counts and Suppression of Plasma Viral Load in Advanced HIV-1 Infected Subjects Failing a First or Second Triple Combination Therapy


Increasing frequency of treatment failures on potent antiretroviral therapy has accelerated
the need for new classes of agents. Hydroxyurea, an agent broadly used for its
antineoplastic properties, has been shown to inhibit HIV-1 in vitro and in vivo when
combined with the nucleoside analogue reverse transcriptase inhibitor didanosine (ddI).
There is an urgent need to prospectively test the safety, tolerability, and efficacy of
hydroxyurea in late-stage, treatment-experienced patients.

Patients undergo genotypic analysis after registration to Step 1. Genotypic antiretroviral
resistance test (GART) along with a patient's antiretroviral drug history will be used to
select an optimal antiretroviral drug regimen (non-study drugs) for each patient. Patients
willing to initiate the GART-based regimen are randomized at Week 5 into Step 2. They are
stratified, first by level of ddI resistance, then within each strata by CD4+ T cell count,
and then assigned to 1 of 3 treatment arms to start all study drugs (ddI and hydroxyurea)
and non-study antiretroviral drugs on the day of randomization. Patients in Arm A receive
ddI and hydroxyurea placebo; Arm B, ddI and hydroxyurea placebo that is replaced by
hydroxyurea after 8 weeks; and Arm C, ddI and hydroxyurea. Patients receive treatment for 48
weeks. Patients are checked regularly for immunologic, virologic, and metabolic parameters.
Patients may elect to participate in substudy A5070s, which explores the effects of study
treatment on T cell populations and other immunologic evaluations.

Inclusion Criteria


Inclusion Criteria

Patients may be eligible for this study if they:

- Are at least 13 years old.

- Have the signed consent of parent/guardian if under 18 years of age.

- Are HIV-positive.

- Have failed 1 or 2 anti-HIV drug combination therapies which had at least 3 anti-HIV
drugs each.

- Have been on stable, triple anti-HIV drug therapy for at least 16 weeks prior to
study entry.

- Have a CD4 count under 300 cells/mm3 within 45 days prior to study entry.

- Agree not to become pregnant or make anyone else pregnant while on study drugs and
for 60 days after stopping drugs.

- Agree to use 2 methods of birth control while on study drugs and for 60 days after
stopping study drugs.

- Have a negative pregnancy test within 14 days prior to study entry.

Exclusion Criteria

Patients will not be eligible for this study if they:

- Received treatment for a serious infection or illness that was completed less than 2
weeks prior to study entry or, if they are still receiving treatment, he/she must
have been clinically stable for at least 14 days prior to study entry.

- Are pregnant or breast-feeding.

- Are using any drugs that affect the immune system, other than those specified by the
study.

- Received an immunization within 30 days prior to study entry.

- Have had pancreatitis.

- Have severe neuropathy (a condition affecting the nervous system).

- Received granulocyte colony-stimulating factor (G-CSF) or granulocyte-macrophage
colony-stimulating factor (GM-CSF) within 14 days prior to study entry.

- Abuse alcohol or drugs.

- Have any medical condition that would make the patient unable to complete the study.

- Have used hydroxyurea within 24 weeks prior to study entry.

- Had hepatitis within 60 days of study entry.

Type of Study:

Interventional

Study Design:

Endpoint Classification: Safety Study, Masking: Double-Blind, Primary Purpose: Treatment

Principal Investigator

David Asmuth

Investigator Role:

Study Chair

Authority:

United States: Federal Government

Study ID:

A5069

NCT ID:

NCT00008866

Start Date:

Completion Date:

Related Keywords:

  • HIV Infections
  • HIV-1
  • Didanosine
  • Drug Therapy, Combination
  • Drug Administration Schedule
  • CD4-Positive T-Lymphocytes
  • Hydroxyurea
  • RNA, Viral
  • Genotype
  • Reverse Transcriptase Inhibitors
  • Anti-HIV Agents
  • Viral Load
  • HIV Infections
  • Acquired Immunodeficiency Syndrome

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