A Randomized, Double-Blind, Three-Arm Study Comparing Combination to Monthly Alternating Nucleoside Therapy for the Treatment of Advanced HIV Disease (CD4 <= 50/mm3) With a Prior History of Nucleoside Therapy
Data Collection
Blood-Borne Infections+13
+ Urogenital Diseases
+ Genital Diseases
Treatment Study
Summary
Combining two nucleoside drugs has the theoretical advantage of optimal protection against the evolution of resistant strains of HIV. However, one major problem with combination nucleoside therapy in patients with advanced disease is the increased toxicity resulting from such therapy. One approach to minimize toxicity while perhaps retaining some of the benefits of combination therapy is to alternate the two drugs. Patients are randomized to one of three treatment arms: AZT plus ddI, AZT plus ddC, and AZT alone alternating monthly with ddI. Half of the patients receiving AZT alternating monthly with ddI will start with AZT, while the other half will start with ddI. Treatment continues until death or termination of the study. Patients are followed every 4 weeks. The study will include a subset of patients for whom virologic, pharmacokinetic, and macroneurologic assessments will be made.
Protocol
This section provides details of the study plan, including how the study is designed and what the study is measuring.654 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 13 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: Required: * PCP prophylaxis. Allowed: * Erythropoietin. * Prophylaxis for MAI or fungal infections. * Antibiotics. * Over-the-counter, alternative, or regularly prescribed drugs. * Steroids, if for \< 21 days. Concurrent Treatment: Allowed: * Radiation therapy for cutaneous Kaposi's sarcoma. Patients must have: * HIV infection. * CD4 count \<= 50 cells/mm3. * Prior nucleoside monotherapy for at least 6 months. * Life expectancy of at least 6 months. Prior Medication: Required: * Nucleoside monotherapy for at least 6 months. Active alcohol or drug abuse. Exclusion Criteria Co-existing Condition: Patients with the following symptoms or conditions are excluded: * Severe peripheral neuropathy. * Psychological or emotional problems sufficient to prevent study compliance. Concurrent Medication: Excluded: * Systemic chemotherapy for malignancy. * Acute or induction therapy for opportunistic infection. Patients with the following prior conditions are excluded: * History of acute or chronic pancreatitis. * Grade 3 or greater toxicity to AZT, ddI, or ddC on two or more occasions. Prior Medication: Excluded: * Non-study nucleosides or biologic response modifiers within 7 days prior to study entry. * Acute therapy for opportunistic process within 14 days prior to study entry. * Acute systemic therapy for other medical conditions 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 37 locations
Memorial Sloan-Kettering Cancer Ctr.
New York, United StatesUniv. of Rochester ACTG CRS
Rochester, United StatesUnc Aids Crs
Chapel Hill, United States