A Phase I Evaluation of the Safety and Toxicity of Zidovudine and Didanosine in Combination in HIV-Infected or Exposed Infants and a Phase II Study of the Effect of Didanosine vs. Combination Therapy With Zidovudine and Didanosine on HIV-1 RNA in Infants With HIV Infection
Zidovudine
+ Didanosine
Blood-Borne Infections+14
+ Urogenital Diseases
+ Genital Diseases
Treatment Study
Summary
Early treatment of HIV-infected infants with antiretroviral agents may prevent the early and rapid decline of CD4 count and immunologic function. Combination therapy may be preferred over monotherapy, since resistance to a single agent can develop rapidly. Currently, there is little information on ddI monotherapy in young infants less than 90 days and no information on the use of combination therapy in this population. In Part A, a cohort of patients younger than 28 days (was less than 120 days; amended 6/20/95) of age receives open-label ddI monotherapy for 1 week before initiation of AZT/ddI combination therapy. After pharmacokinetic data are obtained, an additional cohort of patients receives ddI at a higher dose. An age-adjusted dose for ddI is determined for use in Part B. (NOTE: As of 2/13/95, Part A has completed accrued for infants 29 to 120 days of age.) Part B patients less than 90 days of age (was less than 180 days of age; amended 6/20/95) are randomized, on a double-blind basis, to receive ddI or AZT/ddI. All patients continue treatment until 12 months after the last patient on Part B is enrolled. PER AMENDMENT 4/8/97: Part A of this protocol is closed with accrual objectives met. Part B of the study will remain open for patient accrual until 6/2/97. Part B is designed as a 2-arm, randomized, double-blind study to assess safety, toxicity and tolerability as well as anti-HIV activity of ddI or AZT/ddI.
Protocol
This section provides details of the study plan, including how the study is designed and what the study is measuring.180 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.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: Recommended: PCP prophylaxis. Allowed: Acetaminophen if not on a continual basis. NOTE: Drugs that are metabolized by hepatic glucuronidation or that are associated with occurrence of pancreatitis are allowed but should be used with caution. Patients must have at least one of the following: Documented HIV infection. Been born to an HIV-infected woman and receiving AZT. PER AMENDMENT 4/8/97: Number 2 above no longer required with closure of Part A of study. Patients must have signed, informed consent of parent or legal guardian. PER 6/20/95 AMENDMENT, patients in Part A must be less than 28 days of age and those in Part B must be less than 90 days of age. PER 7/7/94 AMENDMENT, patients in Part A were less than 120 days of age and those in Part B were less than 180 days of age. NOTE: All patients must have been more than 34 weeks gestation at birth. Prior Medication: Allowed: Prior vaccine therapy. Exclusion Criteria Co-existing Condition: Patients with the following symptoms or conditions are excluded: Pancreatitis. Clinically unstable condition. Current participation on a vaccine trial or, for Part A, a perinatal trial if of indeterminate infection status. Concurrent Medication: Excluded: Vaccine therapy. Patients with the following prior condition are excluded: Pancreatitis at any time since birth. Prior Medication: Excluded in Part B patients only: More than 90 days of prior antiretroviral or immunomodulator therapy, exclusive of therapy received in utero.
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 47 locations
Univ of Alabama at Birmingham Schl of Med / Pediatrics
Birmingham, United StatesOpen Univ of Alabama at Birmingham Schl of Med / Pediatrics in Google MapsUCSD Med Ctr / Pediatrics / Clinical Sciences
La Jolla, United StatesLong Beach Memorial (Pediatric)
Long Beach, United StatesLos Angeles County - USC Med Ctr
Los Angeles, United States