Genetics and HIV-1 Protease Inhibitors



Status:Completed
Conditions:HIV / AIDS
Therapuetic Areas:Immunology / Infectious Diseases
Healthy:No
Age Range:18 - 55
Updated:4/21/2016
Start Date:September 2006
End Date:June 2008

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Genetic-determinants of Protease Inhibitor Pharmacology

This study evaluated the blood levels of atazanavir according to a genetic makeup for CYP3A5
(cytochrome P450 3A5, an enzyme that metabolizes atazanavir). The hypothesis was that people
with a slow-metabolizing genotype would have higher blood levels of atazanavir compared to
people with the normal metabolizing genotype.


Inclusion Criteria:

- Age 18 to 55 years

- Negative HIV screening antibody test

- CYP3A5 expressor status, race, and sex fit an enrollment opening.

Exclusion Criteria:

- Pregnant or breast-feeding

- Medical history of hepatitis B or C, autoimmune disease, active malignancy, kidney
disease including nephrolithiasis

- Organ dysfunction manifested by liver transaminases or serum creatinine >1.25 times
the upper limit of normal, or any comprehensive metabolic test (except asymptomatic
unconjugated hyperbilirubinemia), blood count, or lipid value > Grade I according to
Division of AIDS (DAIDS) adverse drug event grading system (appendix).

- Medical history of arrhythmias (including atrial fibrillation, atrioventricular
block, and/or pacemaker)

- Any QT interval abnormalities or other congenital arrhythmia syndromes on ECG or any
ECG abnormality that in the opinion of the investigators would preclude entry into
the study.

- Medical history of any serious heart condition including congestive heart failure,
myopathies, coronary artery disease, or unexplained syncope.

- Medical history of bleeding disorders (i.e., hemophilia)

- Hyperlipidemia

- Any prescription, herbal, recreational, or over-the-counter medication
contraindicated with ritonavir or atazanavir including,
substrates/inhibitors/inducers of CYP3A/P-gp, cardio-active medication, or
medications that alter the acid in the stomach. The study investigators will review
each concurrent medication on a case-by-case basis.

- Inability to refrain from grapefruit or grapefruit juice during the study.

- Investigational drugs within the last 30 days.

- Active alcohol / recreational drug abuse, or inability to give informed consent.

- A body mass index below 18.5 or above 34.
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