Resumen

El propósito de este estudio es evaluar la eficacia antiviral, la seguridad y la tolerabilidad de la terapia dual con 3TC y DTG como tratamiento inicial en pacientes naïve con HIV que presentan la mutación M184V documentada.

Descripción detallada

Este es un estudio piloto diseñado para evaluar la eficacia antiviral, la seguridad y la tolerabilidad de la terapia dual con 3TC y DTG como tratamiento inicial en sujetos naïve con HIV-1 de ≥18 años portadores de la mutación M184V. Esto será evaluado como la proporción de pacientes con carga viral plasmática (pVL) <50 copias/mL a la semana 48 mediante el análisis ITT-expuesto (FDA snapshot). Este estudio constará de un período de selección de hasta 42 días, un período de tratamiento de 48 semanas, seguido de un período de seguimiento (FU) posttratamiento de 4 semanas para documentar eventos adversos tardíos. El estudio incluirá 20 sujetos infectados con HIV-1 que cumplan todos los criterios de inclusión y no presenten ninguno de los criterios de exclusión para este estudio.

Elegibilidad

Edad mínima: 18 YearsSexo: ALL

Criterios de inclusión

≥18 years of age.
Documented HIV-1 infection defined as a positive rapid test or ELISA plus a plasma HIV-1 RNA ≥5,000 copies/mL or a reactive western blot.
Subject has voluntarily signed and dated an informed consent form, approved by an Institutional Review Board (IRB) / Independent Ethics Committee (IEC), after the nature of the study has been explained and the subject has had the opportunity to ask questions. The informed consent must be signed before any study-specific procedures are performed (see Appendix 4).
Naïve to ARV therapies (previous exposure to ARV drugs \< 10 days).
Documented M184V mutation associated with resistance to lamivudine in a previous genotypic test (last 3 months), or at screening.
HIV RNA at screening visit ≥5,000 copies/mL and \<≤100,000 copies/ml
CD4 ≥200 cells/mL
Subjects can comply with protocol requirements.
Subject agrees not to take any medication during the study, including over the counter medicines or herbal preparations, without the approval of the trial physician.
Subject's general medical condition, in the investigator's opinion, does not interfere with assessments and completion of the study.
The patient is a male or a female who is not breastfeeding or pregnant.
A female may be eligible to enter and participate in the study if she:
is of non-child-bearing potential either defined as post-menopausal (12 months of spontaneous amenorrhea and ≥ 45 years of age) or physically incapable of becoming pregnant with documented tubal ligation, hysterectomy or bilateral oophorectomy or,
is of child-bearing potential with a negative pregnancy test at both screening and day 1, and, agrees to use one of the highly effective methods of contraception to avoid pregnancy described in Appendix 3.

Criterios de exclusión

History or presence of allergy to the study drugs or their components or drugs of their class
Treatment with any of the following agents within 28 days of screening: radiation therapy; cytotoxic chemotherapeutic agents; any immunomodulators that alter immune responses or treatment with an HIV-1 immunotherapeutic vaccine within 90 days of screening or exposure to an experimental drug or experimental vaccine within either 28 days, 5 half-lives of the test agent, or twice the duration of the biological effect of the test agent, whichever is longer, prior to the first dose of investigational product
Any acute laboratory abnormality at screening, which, in the opinion of the Investigator, would preclude the subject's participation in the study of an investigational compound;
Alanine aminotransferase (ALT) \>5 times the upper limit of normal (ULN), or ALT ≥ 3xULN and bilirubin ≥ 1.5xULN (with \>35% direct bilirubin)
Creatinine clearance of \<50mL/min via Cockroft-Gault method
Subjects with moderate to severe hepatic impairment (Class B or greater) as determined by Child-Pugh classification
Patients will NOT be selected to be part of this study if they meet ANY of the following criteria:
Alcohol or drug use that might impact on adherence
Subjects positive for Hepatitis B at screening (+HBsAg), or anticipated need for Hepatitis C virus (HCV) therapy during the study
Women who are pregnant or breastfeeding, or women who plan to become pregnant in the next 2 years
interferon, interleukin-2, cytotoxic chemotherapy, Dofetilide (or pilsicainide) or immunosuppressors, antacid drugs containing Ca++ and or Mg++ at study entry
Grade 4 lab abnormalities
Primary HIV infection (indeterminate WB or previous negative HIV in the last 6 months
Opportunistic infection (CDC C category) or other disease and/or clinical condition that, in the investigator's opinion, would compromise the patient's safety or outcome of the study; including malignancy other than cutaneous Kaposi's sarcoma, basal cell carcinoma, or resected, non-invasive cutaneous squamous cell carcinoma, or cervical intraepithelial neoplasia
Subjects who in the investigator's judgment, poses a significant suicidality risk.

Dolutegravir-Lamivudine como Terapia Dual en Pacientes con HIV Naïve con Mutación M184V Documentada: Un Estudio Piloto

Resumen

Descripción detallada

Elegibilidad

Criterios de inclusión

Criterios de exclusión

Intervenciones

Dolutegravir plus lamivudine

Ubicaciones

Fundacion huesped

CAICI

Patrocinadores