The primary objective of this study is to evaluate the efficacy of tenofovir alafenamide (TAF) versus placebo, each administered with the existing, failing antiretroviral (ARV) regimen. There are 2 parts to this study: Part 1 and Part 2. Part 1 consists of 2 cohorts, starting with a sentinel cohort, in which participants will be enrolled to receive open-label TAF in addition to their current failing ARV regimen. This cohort will then be followed by a randomized, double-blind, cohort to compare the addition of TAF or placebo in HIV-1 positive adults who are failing their current ARV regimen. In Part 2, all participants who complete Part 1 of the study will discontinue their failing ARV regimen and TAF or placebo for a 14-day washout period. Following the washout period, all participants who received TAF in Part 1 and have a \> 0.5 log10 decline in HIV-1 RNA will receive elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide (E/C/F/TAF) single-tablet regimen (STR) plus atazanavir (ATV) once daily for 48 weeks. Participants who received TAF who have a ≤ 0.5 log10 decline in HIV-1 RNA will be discontinued from the study and will not be eligible to continue into Part 2 of the study. All participants who received placebo in Part 1 will be eligible to participate in Part 2 regardless of their viral load change. After completion of Part 2, all participants will be eligible to continue to receive E/C/F/TAF plus ATV in the extension phase until E/C/F/TAF becomes commercially available, or until Gilead Sciences terminates development of E/C/F/TAF in the applicable country.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
55
25 mg tablet administered orally once daily with food
Tablets to match TAF administered orally once daily with food
150/150/200/10 mg STR administered orally once daily with food
Participants will continue taking their current ARV regimen as prescribed in Part 1.
300 mg tablet administered orally once daily.
Midway Immunology and Research center
Ft. Pierce, Florida, United States
Triple O Research Institute, P.A.
West Palm Beach, Florida, United States
Rowan Tree Medical, P.A.
Wilton Manors, Florida, United States
Wake Forest University Health Sciences
Winston-Salem, North Carolina, United States
Penn Presbyterian Medical Center
Philadelphia, Pennsylvania, United States
Salvador B Gautier Hospital - Infectious Diseases Department
Santo Domingo, Dominican Republic
Instituto Dominicano de Estudio Virologicos - IDEV
Santo Domingo, Dominican Republic
Regional state budget health agency Krasnoyarsk Regional Center for Prevention and Control of AIDS
Krasnoyarsk, Russia
Center For Prevention and Treatment of AIDS and Infectious Diseases, Saint Petersburg
Saint Petersburg, Russia
The HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT)
Bangkok, Thailand
...and 5 more locations
Part 1: Percentage of Participants With Plasma HIV-1 RNA Decreases From Baseline Exceeding 0.5 log10 at Day 10
Time frame: Day 10
Part 1: Change From Baseline in Plasma log10 HIV-1 RNA (Copies/mL) at Day 10
Time frame: Baseline; Day 10
Part 2: Safety of E/C/F/TAF STR Plus ATV in Participants Who Switched From a Failing Regimen as Assessed by the Percentage of Participants Experiencing Grade 3 or 4 Laboratory Abnormalities Through Week 24
Time frame: Up to Week 24
Part 2: Safety of E/C/F/TAF STR Plus ATV in Participants Who Switched From a Failing Regimen as Assessed by the Percentage of Participants Experiencing Grade 3 or 4 Laboratory Abnormalities Through Week 48
Time frame: Up to Week 48
Part 2: Safety of E/C/F/TAF STR Plus ATV in Participants Who Switched From a Failing Regimen as Assessed by the Percentage of Participants Experiencing Any Treatment-Emergent Adverse Event Through Week 24
Time frame: Up to Week 24
Part 2: Safety of E/C/F/TAF STR Plus ATV in Participants Who Switched From a Failing Regimen as Assessed by the Percentage of Participants Experiencing Any Treatment-Emergent Adverse Event Through Week 48
Time frame: Up to Week 48
Part 2: Percentage of Participants With Plasma HIV-1 RNA < 50 Copies/mL as Defined by the FDA Snapshot Analysis at Week 24
The percentage of participants with HIV-1 RNA \< 50 copies/mL at Week 24 was analyzed using the snapshot algorithm, which defines a participant's virologic response status using only the viral load at the predefined time point within an allowed window of time, along with study drug discontinuation status.
Time frame: Week 24
Part 2: Percentage of Participants With Plasma HIV-1 RNA < 50 Copies/mL as Defined by the FDA Snapshot Analysis at Week 48
The percentage of participants with HIV-1 RNA \< 50 copies/mL at Week 48 was analyzed using the snapshot algorithm, which defines a participant's virologic response status using only the viral load at the predefined time point within an allowed window of time, along with study drug discontinuation status.
Time frame: Week 48
Part 2: Percentage of Participants With Plasma HIV-1 RNA < 400 Copies/mL as Defined by the FDA Snapshot Analysis at Week 24
The percentage of participants with HIV-1 RNA \< 400 copies/mL at Week 24 was analyzed using the snapshot algorithm, which defines a participant's virologic response status using only the viral load at the predefined time point within an allowed window of time, along with study drug discontinuation status.
Time frame: Week 24
Part 2: Percentage of Participants With Plasma HIV-1 RNA < 400 Copies/mL as Defined by the FDA Snapshot Analysis at Week 48
The percentage of participants with HIV-1 RNA \< 400 copies/mL at Week 48 was analyzed using the snapshot algorithm, which defines a participant's virologic response status using only the viral load at the predefined time point within an allowed window of time, along with study drug discontinuation status.
Time frame: Week 48
Part 2: Change From Baseline in Plasma log10 HIV-1 RNA (Copies/mL) at Week 24
Time frame: Baseline; Week 24
Part 2: Change From Baseline in Plasma log10 HIV-1 RNA (Copies/mL) at Week 48
Time frame: Baseline; Week 48
Part 2: Change From Baseline in CD4+ Cell Count at Week 24
Time frame: Baseline; Week 24
Part 2: Change From Baseline in CD4+ Cell Count at Week 48
Time frame: Baseline; Week 48
Part 2: Change From Baseline in CD4+ Percentage at Week 24
Time frame: Baseline; Week 24
Part 2: Change From Baseline in CD4+ Percentage at Week 48
Time frame: Baseline; Week 48
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