A Study to Evaluate the Short-Term Clinical and Virologic Significance of Zidovudine Resistance
Zidovudine
+ Didanosine
Blood-Borne Infections+14
+ Urogenital Diseases
+ Genital Diseases
Treatment Study
Summary
High-grade resistance to AZT has been detected in HIV isolates from approximately 25 percent of individuals with AIDS who received AZT for at least 1 year. To elucidate the clinical significance of in vitro AZT resistance, it is necessary to distinguish between clinical failure caused by AZT resistance and clinical decompensation caused by other factors. One hundred-twenty patients who have been receiving AZT for at least 1 year are randomized to 1) continue with AZT, 2) switch to treatment with didanosine at 1 of 2 doses, or 3) receive both AZT and ddI. Treatment is given for 16 weeks, with a possible extension to 32 weeks. Patients are followed at weeks 2, 4, 8, 12, and 16. For analysis purposes only, patients are stratified according to degree of susceptibility of HIV isolates to AZT.
Protocol
This section provides details of the study plan, including how the study is designed and what the study is measuring.120 patients to be enrolled
Total number of participants that the clinical trial aims to recruit.Treatment Study
Eligibility
Researchers look for people who fit a certain description, called eligibility criteria: person's general health condition or prior treatments.Any sex
Biological sex of participants that are eligible to enroll.Over 12 Years
Range of ages for which participants are eligible to join.Healthy volunteers not allowed
If individuals who are healthy and do not have the condition being studied can participate.Conditions
Pathology
Criteria
Inclusion Criteria Concurrent Medication: Allowed: Chemoprophylaxis against Pneumocystis carinii pneumonia (PCP), Mycobacterium tuberculosis, or Herpes simplex virus, or against other opportunistic infections as indicated. Corticosteroids for no longer than 21 days (only as part of PCP therapy). Erythropoietin and G-CSF. Patients must have: Documented HIV-seropositivity. CD4 count 100 - 300 cells/mm3. Prior continuous AZT dose = or > 300 mg/day for 1 year or longer. Prior Medication: Required: AZT for at least 1 year prior to study entry. Exclusion Criteria Co-existing Condition: Patients with the following symptoms and conditions are excluded: Medical contraindication or is considered noncompliant in the opinion of the investigator. Peripheral neuropathy = or > grade 2. Concurrent Medication: Excluded: Anti-HIV agents other than study drugs. Biologic response modifiers (other than erythropoietin or G-CSF). Systemic cytotoxic chemotherapy. Regularly prescribed medications (such as antipyretics, analgesics, allergy medications) that are associated with an increased risk of pancreatitis, peripheral neuropathy, or bone marrow suppression. Concurrent Treatment: Excluded: Radiation therapy. Patients with the following prior conditions are excluded: History of acute or chronic pancreatitis, gout, or uric acid nephropathy. Prior Medication: Excluded: Other antiretrovirals besides AZT. ddI or ddC for more than 30 days within the past year or any time within 3 months prior to study entry. Acute therapy for an infection or other medical illness within 14 days prior to study entry.
Study Centers
These are the hospitals, clinics, or research facilities where the trial is being conducted. You can find the location closest to you and its status.This study has 18 locations
Univ of Alabama at Birmingham
Birmingham, United StatesOpen Univ of Alabama at Birmingham in Google MapsSan Francisco Gen Hosp
San Francisco, United StatesSanta Clara Valley Med Ctr / AIDS Community Rsch Consortium
San Jose, United StatesSan Mateo AIDS Program / Stanford Univ
Stanford, United States