The overall aim of the BREATHER trial is to evaluate the role of Short-Cycle Therapy (SCT) in the management of HIV-infected young people who have responded well to antiretroviral therapy (ART) and to determine whether young people with chronic HIV infection undergoing Short-Cycle Therapy of five days on ART and two days off maintain the same level of viral load suppression as those on continuous therapy, over 48 weeks. To assess the advantages and disadvantages of the strategy, the incidence of toxicities, immunological control, resistance mutations, acceptability, quality of life and adherence to the randomised strategy will also be compared. Importantly, because of insufficient data on short-term viral load rebound after stopping ART in this population, the trial will incorporate an initial pilot phase in selected centres, to assess the safety of the SCT strategy by evaluating detailed HIV-1 RNA profiles of participants on the SCT strategy.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
160
May be taken as 600mg tablet, 200mg tablet or as part of a combination pill
St Jude Children's Research Hospital
Memphis, Tennessee, United States
INSERM
Villejuif, France
Universitätsklinikum Frankfurt
Frankfurt, Frankfurt Am Main, Germany
Our Lady's Children's Hospital
Dublin, Ireland
Program for HIV Prevention and Treatment (PHPT)/IRD 174
Changklan, Muang, Chiang Mai, Thailand
HIV-NAT Thai Red Cross AIDS Research Centre
Bangkok, Thailand
Joint Clinical Research Centre
Kampala, Uganda
Kiev City AIDS Center
Kiev, Vidpochynku 11, Ukraine
Birmingham Heartlands Hospital
Birmingham, United Kingdom
University Hospital Bristol
Bristol, United Kingdom
...and 8 more locations
HIV-1 RNA ≥50 copies/ml (confirmed on a separate sample within 1 week) at any of week 4, 12, 24, 36 or 48.
This outcome measure only considers HIV-1 RNA measurements at these time points due to the difference in viral load monitoring in the pilot phase and the main trial. However if a young person enrolled in the pilot phase has HIV-1 RNA ≥50 copies/ml at weeks 1, 2 or 3 (reproducible on the same sample) or at week 8 (confirmed on the same sample within 1 week), they will be considered as reaching the primary outcome at week 4 and 12 respectively
Time frame: 48 weeks
HIV-1 RNA <50 c/ml at 24 and 48 weeks
Time frame: 24 and 48 weeks
Number of HIV mutations present at week 4, 12, 24, 36 or 48 conferring resistance to drugs taken at randomisation or during the tria
Time frame: Weeks 4, 12, 24, 36, 48
Change in CD4 (absolute and percentage) from randomisation to 24 and 48 weeks
Time frame: 24 and 48 weeks
Change in ART (defined as any change from the ART regimen at randomisation)
Time frame: 48 weeks
Grade 3 or 4 clinical and laboratory adverse events
Time frame: 48 weeks
ART treatment modifying adverse events (all grades)
Time frame: 48 weeks
New CDC stage B or C diagnosis or death
Time frame: 48 weeks
Changes in fasting glucose, cholesterol, triglycerides, LDL, HDL and VLDL levels through 48 weeks
Time frame: 48 weeks
Adherence, acceptability, and quality of life over 48 weeks as assessed by patient completed questionnaires
Time frame: 48 weeks
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