Acyclovir to Treat Patients Co-infected With HIV and Herpes Viruses in Uganda

• Status: Completed
• Trial end date: 2010-11-01
• Target enrollment: 0
• Participant gender: All

Summary

This study will determine whether acyclovir, a medicine used to treat herpes simplex virus 2 (HSV-2), can slow down the progression (worsening) of HIV disease in people with both HIV and HSV-2 infections. HSV-2 increases the amount of HIV virus in the blood of infected people and may make HIV progress faster. The study will evaluate:

"Whether people who take acyclovir can avoid antiretroviral treatment until later in their lives

"Whether people who take acyclovir get fewer genital ulcers

"How well people are able to take acyclovir and any side effects they experience from it

"Differences in the amount of HIV virus in the blood of patients who are and are not taking acyclovir, and how HIV/AIDS is different in these patients.

People 18 years of age and older living in the Rakai district of Uganda who are infected with both HIV (early stage disease) and HSV-2 may be eligible for this study. Participants are randomly assigned to take the study drug, acyclovir, or a placebo (look-alike pill with no active ingredient) daily for 2 years. During this time, they visit the clinic once a month for a routine physical examination. Patients who develop genital ulcers or complications of HIV are treated for the problem, and patients whose HIV disease progresses, requiring them to begin antiretroviral therapy, are treated accordingly.

• Phase: Phase 2
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: National Institute of Allergy and Infectious Diseases (NIAID)
• Collaborators: Johns Hopkins University; Translational Genomics Research Institute; University of Washington
• Treatments: Acyclovir

Criteria

• INCLUSION CRITERIA:

1. Documentation of HIV-1 infection, by either two positive ELISAs or two discrepant ELISAs with a confirmatory positive Western Blot

2. Documentation of prior HSV-2 infection by Focus Kalon ELISA

3. Absolute CD4+ T-cell count of greater than or equal to 300 and less than or equal to 400 cells/microliter within 30 days prior to randomization

4. All participants must be receiving Cotrimoxazole prophylaxis as part of standard care unless contraindicated

5. Age at least 18 years and above

6. Laboratory values (within 30 days prior to randomization)

1. Aspartate transaminase (AST) no more than five times the upper limit of normal (ULN)

2. Total bilirubin no more than 2 times ULN

3. Creatinine no more than 2.0 mg/dL

4. Platelet count at least 50 000/microliter

5. Hemoglobin at least 8g/dL

7. Written informed consent

EXCLUSION CRITERIA:

1. Concurrent malignancy or any other disease state requiring cytotoxic chemotherapy

2. Symptomatic for significant HIV-related illnesses (WHO stage III or IV), such as opportunistic infections and malignancies other than mucocutaneous Kaposi's sarcoma. A history of AIDS defining opportunistic infections other than mucocutaneous Kaposi's sarcoma or candida or treated tuberculosis

3. Active HSV-2 disease as suggested by painful genital ulcer disease at time of screening or enrollment

4. Current use of antiretroviral medications or Preventing Mother-to-Child Transmission (PMTCT) use of antiretrovirals within the previous 6 months

5. Significant cardiac, pulmonary, kidney, rheumatologic, gastrointestinal, or CNS disease as detectable on routine medical history, physical examination, or screening laboratory studies.

6. Psychiatric illness that, in the opinion of the PI, might interfere with the study compliance.

7. Active substance abuse or history of prior substance abuse that may interfere with protocol compliance or patient safety.

8. CD4+ count less than 300 or more than 400 cells/microliter.