Early ART to Limit Infection and Establishment of Reservoir



Status:Recruiting
Conditions:Infectious Disease, HIV / AIDS
Therapuetic Areas:Immunology / Infectious Diseases
Healthy:No
Age Range:18 - Any
Updated:10/19/2018
Start Date:January 2017
End Date:June 30, 2020

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Effect of Antiretroviral Treatment Initiated During Acute HIV-1 Infection on Measures of HIV-1 Persistence and on HIV-1-Specific Immune Responses

The study is being done to:

- start ART early in those recently or acutely infected with HIV-1

- see how starting ART as soon as the infection is found affects the amount of HIV-1 in
blood and how well the body fights the HIV-1 infection

- look at the amount of HIV-1 DNA (genetic material for HIV-1) seen in CD4+ T-cells
(infection-fighting cells in blood) after 48 weeks of ART

- see how early treatment for HIV affects the numbers of HIV-1 infection fighting cells
(CD4+ and CD8+ T-cells) in blood


Inclusion Criteria:

- Appropriate documentation from medical records of diagnosis of acute HIV-1 infection
(AHI) within 7 days prior to enrollment, that includes one of the following:

1. A detectable HIV-1 RNA within 28 days prior to study entry AND a non-reactive
HIV-1 antibody within 7 days prior to entry OR

2. A detectable HIV-1 RNA or a reactive HIV-1 antibody within 28 days prior to study
entry AND a negative/indeterminate WB or negative/indeterminate Geenius
HIV-1/HIV-2 Supplemental Assay within 7 days prior to entry OR

3. A documented non-reactive HIV-1 antibody or negative HIV-1 RNA within 90 days
prior to study entry AND a documented reactive HIV-1 antibody or positive WB that
is negative for p31 band or a positive Geenius HIV-1/HIV-2 Supplemental Assay
that is negative for p31 band within 7 days prior to entry OR

4. ARCHITECT or GSCOMBO S/CO ≥10 within 7 days prior to entry AND a non-reactive
HIV-1 antibody within 7 days prior to entry OR

5. ARCHITECT or GSCOMBO S/CO ≥1 within 7 days prior to entry AND a non-reactive
HIV-1 antibody within 7 days prior to entry AND a known prior S/CO <0.5 within 90
days prior to entry OR

6. ARCHITECT or GSCOMBO S/CO >0.5 but <10 within 7 days prior to entry AND a
non-reactive HIV-1 antibody within 7 days prior to entry AND detectable HIV-1 RNA
within 7 days prior to entry

NOTE A: HIV-1 RNA result must be reported from an FDA-approved or CE-marked assay.

NOTE B: Since characterization of Fiebig stage using samples at the time of ART initiation
will be performed with results known within 12 weeks based on standardized, centralized
testing, an estimated Fiebig group at enrollment based on inclusion criteria as shown in
the table above will provide additional real-time monitoring for accruals into each study
group. The protocol team will notify the sites if some criteria may no longer be used
because accrual is completed in certain Fiebig groups.

NOTE C: Specimens for the testing specified above may be collected on the day of study
entry provided the testing result is available prior to enrollment.

- Ability and willingness of candidate to provide written informed consent.

- Ability and willingness to initiate ART at enrollment.

- Ability and willingness to participate in scheduled study visits for up to 72 weeks.

- Female candidates of reproductive potential who are not pregnant at the time of
enrollment and who will receive the study-provided EVG/COBI/FTC/TAF and must agree not
to participate in the conception process (ie, active attempt to become pregnant, in
vitro fertilization), and if participating in sexual activity that could lead to
pregnancy, the female candidate must agree to use at least one reliable form of
contraceptive while receiving study-provided treatment.

Female candidates are considered to be of reproductive potential if any of the following
conditions apply:

- Candidate has experienced menarche.

- Candidate has not undergone bilateral tubal ligation, bilateral oophorectomy, or
hysterectomy.

- Candidate has not experienced menopause, defined as lack of menstruation within the
preceding 12 months.

Acceptable contraceptive methods include:

- Condoms (male or female) with or without a spermicidal agent

- Diaphragm or cervical cap with spermicide

- Intrauterine device

- Hormonal contraceptive

Female candidates who are not of reproductive potential or whose male partner(s) has
documented azoospermia are not required to use contraceptives. Any statement of
self-reported sterility or that of her partner must be entered in the source documents.

NOTE: Acceptable documentation of lack of reproductive potential is oral or written
documentation from the individual.

Female candidates who are prescribed a non-study-provided ARV regimen should discuss the
safety of that regimen during conception and pregnancy with the prescribing physician. Such
individuals should follow medical guidance regarding any potential need for contraception
while using the non-study-provided ARV regimen.

NOTE: Pregnant and breastfeeding women may enroll in the study provided that they meet the
eligibility requirements and have access to non-study-provided ARV regimens.

Exclusion Criteria:

- Positive HIV-1 antibody test ≥90 days prior to study entry.

- Active drug or alcohol use or dependence that, in the opinion of the site
investigator, would interfere with adherence to study requirements.

- Any acute, chronic, or recent and clinically significant medical condition that, in
the opinion of the site investigator, would interfere with adherence to study
requirements or jeopardize the safety or rights of the participant.

- Receipt of an investigational study agent within 28 days prior to enrollment

- Chronic or recurrent use of medications that modify host immune response, eg, oral or
parenteral steroids, cancer chemotherapy.

- AHI diagnosis within 60 days after receiving any investigational ARV or HIV-1 vaccine
or immune prophylaxis for HIV-1 infection.

- Use of ARVs for pre- or post-exposure prophylaxis within 60 days prior to the
diagnosis of AHI.

NOTE: The rationale for this exclusion is to minimize the impact of therapy on the primary
endpoint.
We found this trial at
27
sites
Greensboro, North Carolina 27401
Principal Investigator: Cornelius Van Dam, MD
Phone: 336-832-7888
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Atlanta, Georgia 30308
Principal Investigator: Carlos del Rio, MD
Phone: 404-616-6313
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Atlanta, GA
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Aurora, Colorado 80045
Principal Investigator: Thomas B Campbell, MD
Phone: 303-724-5931
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Aurora, CO
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Birmingham, Alabama 35294
Principal Investigator: Edgar Overton, MD
Phone: 205-996-2373
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Birmingham, AL
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Boston, Massachusetts 02114
Principal Investigator: Rajesh T. Gandhi, MD
Phone: 1-617-724-0072
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Boston, MA
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Boston, Massachusetts 02115
Principal Investigator: Paul E. Sax, MD
Phone: 617-732-5635
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Boston, MA
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3201 Orange Chapel Clover Garden Road
Chapel Hill, North Carolina 27516
Principal Investigator: David A. Wohl, MD
Phone: 919-966-6712
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Chapel Hill, NC
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Chicago, Illinois 60611
Principal Investigator: Babafemi Taiwo, MBBS, MD
Phone: 312-695-5012
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Chicago, IL
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Chicago, Illinois 60612
Principal Investigator: Beverly E Sha, MD
Phone: 312-942-4810
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Chicago, IL
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Cincinnati, Ohio 45267
Principal Investigator: Carl Fichtenbaum, MD
Phone: 513-584-6383
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Cincinnati, OH
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Columbus, Ohio 43210
Principal Investigator: Susan Koletar, MD
Phone: 614-293-5856
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Dallas, Texas 75208
Principal Investigator: Roger Bedimo, MD, MS
Phone: 972-807-7370
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Houston, Texas 77030
Principal Investigator: Roberto C. Arduino, MD
Phone: 713-500-6718
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Los Angeles, California 90095
Principal Investigator: Raphael Landovitz, MD
Phone: 310-557-3798
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Los Angeles, CA
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New York, New York 10010
Principal Investigator: Timothy Wilkin, MD, MPH
Phone: 212-746-4177
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New York, New York 10011
Principal Investigator: Marshall J. Glesby, MD
Phone: 212-746-4393
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New York, New York 10032
Principal Investigator: Magdalena Sobieszczyk, MD, MPH
Phone: 212-305-3178
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Newark, New Jersey 07103
Principal Investigator: Shobha Swaminathan, MD
Phone: 973-973-3811
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Philadelphia, Pennsylvania 19104
Principal Investigator: Pablo Tebas, MD
Phone: 215-349-8092
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Pittsburgh, Pennsylvania 15213
Principal Investigator: Sharon Riddler, MD, MPH
Phone: 412-383-1675
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596 Avenida Francisco Trein
Porto Alegre, RS 90430
Principal Investigator: Breno Regal Santos, MD
Phone: 55 51 3361 2911
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Providence, Rhode Island 02906
Principal Investigator: Karen T. Tashim, MD
Phone: 401-793-4971
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Providence, RI
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Saint Louis, Missouri 63110
Principal Investigator: David Clifford, MD
Phone: 314-454-0058
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Saint Louis, MO
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San Diego, California 92103
Principal Investigator: Constance Benson, MD
Phone: 619-543-8080
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Seattle, Washington 98104
Principal Investigator: Ann Collier, MD
Phone: 206-744-8886
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Torrance, California 90502
Principal Investigator: Eric S. Daar, MD
Phone: 310-222-3848
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Washington, District of Columbia 20005
Principal Investigator: W. David Hardy, MD
Phone: 202-797-3589
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