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The aim of the trial is to evaluate in ANRS CO6 PRIMO cohort participants if the presence of the MHC B35 (53) Bw4TTC2 genotype favors the control of HIV infection (defined by a viral load (VL) less than 400 cp/mL) after discontinuation of antiretroviral therapy (ART) initiated during primary HIV infection.
The trial will be a pilot "proof of concept", one arm, multicenter, nested in the ANRS CO6 PRIMO Cohort, in which the intervention is treatment interruption (of at least 6 months).
It is planned to include between 20 and 50 participants.
The ANRS 175 RHIVIERA 01 trial will focus on people who were initiated early and have a particular genotypic profile associated with HIV remission.
The study proposes to test an intervention consisting in a ART-treatment interruption (of at least 6 months) in ANRS CO6 PRIMO cohort participants carrying the MHC B35/53Bw4TTC2 genotype and well controlled on cART.
The study aims to enrol 20-30 participants in 30 French clinical sites. Participants will be enrolled after checking eligibility criteria and will interrupt ART immediatly after inclusion.
Control of HIV-Infection, defined by a viral load less than 400 cp/mL, will be evaluated after 24 weeks of interruption.
Study duration will vary by participant, depending on the time of ART interruption and the time to viral rebound. Participants will be followed maximum 48 weeks on ATI. If there is a viral rebound justifying the resumption of ART, participant will be followed 24 weeks maximum after resumption. The maximum duration of the study will be 48+24 = 72 weeks.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Patients treated early and carrying the MHC B35/53Bw4TTC2 Genotype | Experimental | Patients included in the ANRS CO6 PRIMO cohort, treated early and carrying the MHC B35/53Bw4TTC2 Genotype |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Analytical Treatment Interruption (ATI) | Other | Analytical Interruption of Treatment for 24-48 weeks ART resumption and follow-up for 24 weeks if the participant meets at least one ART resumption criteria |
| Measure | Description | Time Frame |
|---|---|---|
| Proportion of subjects with a Plasma HIV-1 RNA (viral load,VL) below 400 copies/mL at 6 months after Treatment interruption (Week 24). | Proportion of subjects with a Plasma HIV-1 RNA below 400 copies/mL on subjects included at 6 months after Treatment interruption. | Six months after treatment interruption (Week 24). |
| Measure | Description | Time Frame |
|---|---|---|
| The acceptation rate of the trial by eligible patients | Percentage of patients who accept to participate on patients pré-screened and eligible | At inclusion (Day 0) |
| Proportion of patients with a plasma VL < 50 copies/ml at 3 and 6 months following Analytic Treatment Interruption (ATI) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Vincent MEIFFREDY | Contact | 00 33 1 45 59 52 06 | vincent.meiffredy@inserm.fr | |
| Nicolas LETURQUE | Contact | 00 33 1 45 59 51 93 | nicolas.leturque@inserm.fr |
| Name | Affiliation | Role |
|---|---|---|
| Cécile GOUJARD | Hôpital Bicêtre, Service de médecine interne et d'immunologie clinique | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Centre Hospitalier du Pays d'Aix | Recruiting | Aix-en-Provence | 13616 | France |
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The trial will be a pilot "proof of concept", one arm, multicenter, nested in the ANRS CO6 PRIMO Cohort, in which the intervention is treatment interruption (of at least 6 months).
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Proportion of patients with a plasma VL < 50 copies/ml at 3 and 6 months following ATI |
| At 3 months (week 12) and 6 months (week 24) following ATI |
| Evolution of number of CD4 T cells count during ATI and after ART resumption | Measurement of CD4 T cells count at Screening, Day 0, Week 2, Week 4, Week 6, Week 8, Week 12, Week 16, Week 20, Week 24, Week 36, Week 48, Day 0 ART resumption, Week 4 resumption, Week 12 resumption, Week 24 resumption | During all ATI period (from Day 0 to Day 0 ART resumption - maximum 48 weeks) and during ART resumption period (maximum 24 Weeks) |
| Evolution of CD4 to CD8 ratio during ATI and after ART resumption | Measurement of CD4 to CD8 at Screening, Day 0, Week 2, Week 4, Week 6, Week 8, Week 12, Week 16, Week 20, Week 24, Week 36, Week 48, Day 0 ART resumption, Week 4 resumption, Week 12 resumption, Week 24 resumption | During all ATI period (from Day 0 to Day 0 ART resumption - maximum 48 weeks) and during ART resumption period (maximum 24 Weeks) |
| Evolution of total and integrated HIV DNA and cell-associated HIV RNA transcripts | Quantification of total HIV-DNA and integrated HIV-DNA by ultrasensitive techniques (ultrasensitive real-time PCR and Alu PCR) Quantification of intracellular HIV-RNA transcripts by ultrasensitive technique (ultrasensitive qPCR gag). | During ATI period (At Day 0, Week 4, Week 12, Week 24) and during ART resumption period (at Day 0 Resumption, and Week 24 ART Resumption) |
| Evolution of HIV markers in sperm (on 25 participants) | Quantification of HIV DNA on semen cells (ultrasensitive technique) and quantification of HIV RNA on seminal fluid (ultrasensitive technique) | During ATI period (At Day 0, Week 4, Week 12, Week 24) and at Day 0 ART resumption |
| Evolution of the levels of inflammation markers during ATI | Physiological parameters levels will be studied (Luminex and Simoa technology): IFNα, TGFβ, IL-7, IL-12, IL-15, IL-18, IP-10, DPPIV, ARNr 16S, I-FABP, citrulline, sCD14, sCD163 | During ATI period (up to week 24 ATI) and at Day 0 ART resumption |
| Proportion of patients who resumed treatment during the first 6 months of ATI, according to the reasons for resuming | Percentage of resumption, according to the reasons listed in the protocol, before the evaluation of the primary outcome | At week 24 |
| Pharmacological dosages of antiretrovirals performed during the ATI from frozen samples | Pharmacological dosages of antiretrovirals performed during the ATI at Week 2 and Week 24 of ATI | At Week 2 and Week 24 of ATI |
| Proportion of patients reporting at each visit to use condoms | Document the emphasis being placed on the impact of access to information on prevention behaviors and the quality of sexual life. | From date of inclusion to the last follow-up visit, up to 72 weeks (average of 1 year). |
| Proportion of patients reporting at each visit to have proposed PrEP at their partners | Document the emphasis being placed on the impact of access to information on prevention behaviors and the quality of sexual life. | From date of inclusion to the last follow-up visit, up to 72 weeks (average of 1 year). |
| Proportion of patients satisfied with their participation at the end of the trial | Through statistical analyses of some self-administered questionnaires items (Likert). On a Likert scale, a person selects one option among several that reflects how much they agree with a statement. The scale generally consists of five or seven balanced responses that people can choose from. | Questionnaire at the end of the study (Week 48 ou Week 24 resumption). Questionnaire at screening (in case of refusal to participate) |
| Evolution of the level of the quality of life between inclusion and the end of the trial | Through statistical analyses of some self-administered questionnaires items ( SF12.v2 scale for quality of life). The 12-item Short-Form Health Survey is a widely used, generic patient-reported measure of health status that provides summary scores of physical and mental health. Scores range from 0 to 100, with higher scores indicating better physical and mental health functioning. | Questionnaire at Day 0, at Week 24 (or resumption of ART) and at the end of the study (Week 48 ou Week 24 resumption). Questionnaire at screening (in case of refusal to participate) |
| Evolution of the global satisfaction with sexual life between inclusion and the end of the trial | Through statistical analyses of some self-administered questionnaires items (Likert). On a Likert scale, a person selects one option among several that reflects how much they agree with a statement. The scale generally consists of five or seven balanced responses that people can choose from. | Questionnaire at Day 0, at Week 24 (or resumption of ART) and at the end of the study (Week 48 ou Week 24 resumption). Questionnaire at screening (in case of refusal to participate) |
| Hôtel Dieu | Withdrawn | Angers | 49033 | France |
| Hôpital Avicenne | Active, not recruiting | Bobigny | 93000 | France |
| Hôpital Saint-André | Active, not recruiting | Bordeaux | 33075 | France |
| Hôpital PELLEGRIN | Withdrawn | Bordeaux | 33076 | France |
| Hôpital de la Côte de Nacre | Withdrawn | Caen | 14033 | France |
| Hôpital Gabriel Montpied | Active, not recruiting | Clermont-Ferrand | 63000 | France |
| Hôpital Le Bocage | Recruiting | Dijon | 21034 | France |
|
| Hôpital Pierre Zobda-Quitman | Active, not recruiting | Fort de France | 97261 | France |
| Hôpital Raymond Poincaré | Recruiting | Garches | 92380 | France |
|
| CHD Vendée | Withdrawn | La Roche-sur-Yon | 85925 | France |
| Hôpital de Bicêtre | Active, not recruiting | Le Kremlin-Bicêtre | 94275 | France |
| Hôpital de la Croix Rousse | Withdrawn | Lyon | 69317 | France |
| Hôpital Edouard HERRIOT | Active, not recruiting | Lyon | 69437 | France |
| Hôpital Sainte Marguerite | Active, not recruiting | Marseille | 13274 | France |
| Hôpital Gui de Chauliac | Active, not recruiting | Montpellier | 34295 | France |
| Hôtel Dieu | Recruiting | Nantes | 44035 | France |
|
| Hôpital Carémeau | Recruiting | Nîmes | 30029 | France |
|
| Hôtel Dieu | Withdrawn | Paris | 75004 | France |
| La Pitié Salpêtrière | Withdrawn | Paris | 75013 | France |
| Institut Pasteur | Withdrawn | Paris | 75015 | France |
| Hôpital de l'Hôtel-Dieu | Recruiting | Paris | 75181 | France |
|
| Hôpital Lariboisière | Withdrawn | Paris | 75475 | France |
| Hôpital Saint-Louis | Recruiting | Paris | 75475 | France |
|
| Hôpital Tenon | Withdrawn | Paris | 75970 | France |
| Hôpitaux Universitaires de Strasbourg | Active, not recruiting | Strasbourg | 67091 | France |
| Hôpital de Purpan | Recruiting | Toulouse | 31059 | France |
|
| Hôpital Gustave Dron | Recruiting | Tourcoing | 59027 | France |
|
| Hôpital Bretonneau | Active, not recruiting | Tours | 37044 | France |
| CHI Villeneuve Saint Georges | Active, not recruiting | Villeneuve-Saint-Georges | 94195 | France |
| ID | Term |
|---|---|
| D015658 | HIV Infections |
| ID | Term |
|---|---|
| D000086982 | Blood-Borne Infections |
| D003141 | Communicable Diseases |
| D007239 | Infections |
| D015229 | Sexually Transmitted Diseases, Viral |
| D012749 | Sexually Transmitted Diseases |
| D016180 | Lentivirus Infections |
| D012192 | Retroviridae Infections |
| D012327 | RNA Virus Infections |
| D014777 | Virus Diseases |
| D000091662 | Genital Diseases |
| D000091642 | Urogenital Diseases |
| D007153 | Immunologic Deficiency Syndromes |
| D007154 | Immune System Diseases |
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