We hypothesize that using a potent antiretroviral such as Enfuvirtide during the induction phase of HAART therapy will lead to faster clearance of virus and infected cells, and lower number of minority variant HIV-1 strains.
This is an 48 week Phase 4, open label, randomized, prospective, pilot proof of concept study to evaluate the use of Enfuvirtide in an induction/maintenance treatment model. Patients meeting inclusion criteria will be stratified into two groups according to HIV-1 RNA viral loads (less than 300,000 copies/ml and greater than 300,000 copies/ml). Thereafter, patients will be block randomized (the size of each block will be two patients) into one of two treatment arms. All patients will receive Efavirenz 600mg once a day, Lamivudine 300 mg once a day, and Tenofovir 300mg once a day. After randomization, one half of the patients will receive no additional treatment, while the other half will receive Enfuvirtide 90mg sq BID until the viral load is \<50 x 2 consecutive visits or 12 weeks (whichever comes first).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
2
subcutaneously twice a day
Efavirenz -600mg once daily, lamivudine- 300mg once daily, and tenofovir 300mg once daily
University of Maryland, Institute of Human Virology
Baltimore, Maryland, United States
Time to viral suppression below 50c/ml.
The study is 48 weeks long and the time to viraL suppression will vary depending on the subject. Or there is the possibility that they do not supress
Time frame: Individual
Log viral copy/ml decrease over time during phase 1 and phase 2.
Time frame: Over the 48 week study period
Development of clinical mutations.
Time frame: Over the 48 week study period
Development of sub-clinical mutations (minority variants)
Time frame: Over the 48 week study period
Viral suppression (below 50c/ml) at 24 and 48 weeks.
Time frame: At 24 and 48 weeks
Time to loss of viral response. Loss of viral response defined as:
Time frame: Over the 48 week study period
Less then 2.0 log decrease in viral load at week 8.
Time frame: Week 8
Inability to achieve Viral load <50c/ml by week 12.
Time frame: Week 12
Viral load >50c/ml on 2 consecutive measurements taken 2 weeks apart after viral
Time frame: Over the 48 week study period
suppression <50c/ml has occurred
Time frame: Over the 48 week study period
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Rate and quantity of HIV-1 proviral DNA decay.
Time frame: Over the 48 week study period
Safety and tolerability.
Time frame: Over the 48 week study period