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Integrase Inhibitor (MK-0518) Viral Decay

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00520897
Recruitment Status : Completed
First Posted : August 27, 2007
Last Update Posted : June 5, 2012
National Institutes of Health (NIH)
Information provided by (Responsible Party):
Canadian Immunodeficiency Research Collaborative

Brief Summary:
The eradication of HIV by antiretroviral therapy has thus far been elusive. It has been consistently demonstrated that a pool of latently infected, resting CD4+ T cells persists in the majority of HIV-infected individuals receiving antiretroviral therapy in whom plasma viremia has been successfully suppressed for prolonged periods of time; this pool has emerged as the major obstacle in achieving the eradication of HIV. We believe that MK-0518 can further the decay and suppression of HIV-1 in patients who have been virologically suppressed for a prolonged period of time on effective cART (≥ 4 years).

Condition or disease Intervention/treatment Phase
HIV Infections Drug: Raltegravir (MK0518) Drug: Placebo Procedure: Leukopheresis Procedure: Sigmoid Biopsy Phase 2

Detailed Description:
The trial is a prospective, double-blind, randomized, placebo-controlled study with two phases: phase I to 48 weeks and phase II to 96 weeks with the primary analysis at 48 weeks. HIV-infected individuals who are taking their first standard cART regimen for at least four years with complete viral suppression. Upon enrollment, he/she will be randomized to one of two arms: the MK-0518 arm or the control arm. As each participant reaches week 48, he/she will be unblinded and those in the MK-0518 arm will continue taking MK-0518. Based on the results of an interim analysis, the control arm will be rolled over to receive MK-0518 for 48 weeks. After the screening, baseline visits and week 4 safety visit, follow-up visits will occur every 8 weeks for both arms.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 24 participants
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Triple (Participant, Care Provider, Investigator)
Primary Purpose: Treatment
Official Title: Effect of Integrase Inhibitor (MK-0518) on Decay of Low Level Viral Replication in HIV Reservoirs in Infected Individuals Who Initiated Conventional Antiretroviral Therapy During the Chronic Phase of Infection
Study Start Date : April 2007
Actual Primary Completion Date : February 2009
Actual Study Completion Date : November 2011

Resource links provided by the National Library of Medicine

Arm Intervention/treatment
Experimental: MK0518 + cART
Raltegravir + standard of care combined antiretroviral therapy
Drug: Raltegravir (MK0518)
400mg BID; 48 weeks

Procedure: Leukopheresis
pack of cells as per protocol

Procedure: Sigmoid Biopsy
gut samples as per protocol

Placebo Comparator: Placebo + cART
Placebo + standard of care combined antiretroviral therapy
Drug: Placebo
400mg QD

Procedure: Leukopheresis
pack of cells as per protocol

Procedure: Sigmoid Biopsy
gut samples as per protocol

Primary Outcome Measures :
  1. change of proviral HIV-1 DNA in total CD4+ T cells from baseline to week 48 [ Time Frame: 48 weeks ]
    evaluate the change of proviral HIV-1 DNA in total CD4+ T cells from baseline to week 48 in participants randomized to the raltegravir arm (400mg raltegravir) for 48 weeks in addition to their current standard combination antiretroviral regimen versus the control arm, who remained on their current standard combination antiretroviral regimen.

Secondary Outcome Measures :
  1. evaluated the effect of raltegravir intensification on blood CD4+ T cell populations [ Time Frame: 48 & 96 weeks ]
    evaluated the effect of raltegravir intensification on blood CD4+ T cell populations. In addition, after treatment-intensification in both groups at week 48, a post-hoc follow-up of all participants was conducted up to week 96 to examine if raltegravir intensification had any long-term effects on proviral HIV DNA and CD4+ T cell populations in the blood and gut.

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 65 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  1. Participant must be HIV-1 infected
  2. Participant must be 18 years old
  3. Participant must be taking first standard cART with 2-3 NRTIs and 1-2 PIs or an NNRTI for at least four years (first cART regimen may include changes due to toxicity but not due to virologic failure).
  4. Participant must have a VL < 50 copies/ml (using the standard available methods of detection) during the entire time on standard cART except for initial fall of VL and a maximum of two non-consecutive blips of < 100 copies/ml that the study investigator deems to be not clinically significant
  5. Female participant must agree to use two methods of birth control or abstinence during the period of the study
  6. Participant has to have signed full informed consent

Exclusion Criteria:

  1. Participant who would have difficulty participating in a trial due to non-adherence or substance abuse
  2. Participant who has taken mono or dual antiretroviral therapy in the past
  3. Participant who has had a VL > 50 copies/ml on any antiretroviral regimen
  4. Participant with any of the following abnormal laboratory test results in screening:

    • Hemoglobin < 100 g/L
    • Neutrophil count < 750 cells/L
    • Platelet count < 50,000 cells/L
    • AST or ALT > 5X the upper limit of normal
    • Creatinine > 250 mol/L
  5. Participant with a malignancy
  6. Participant with other significant underlying disease (non-HIV) that might impinge upon disease progression or death
  7. Participant with an active AIDS-defining illness in the past six months
  8. Participant who is pregnant

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00520897

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Canada, Ontario
Maple Leaf Medical Clinic
Toronto, Ontario, Canada, M5B 1L6
Sponsors and Collaborators
Canadian Immunodeficiency Research Collaborative
National Institutes of Health (NIH)
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Principal Investigator: Mona Loutfy, MD Women's College Hospital
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Responsible Party: Canadian Immunodeficiency Research Collaborative Identifier: NCT00520897    
Other Study ID Numbers: 038-00
First Posted: August 27, 2007    Key Record Dates
Last Update Posted: June 5, 2012
Last Verified: June 2012
Keywords provided by Canadian Immunodeficiency Research Collaborative:
chronic HIV infection
Human Immunodeficiency Virus
Treatment Experienced
Additional relevant MeSH terms:
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HIV Infections
Lentivirus Infections
Retroviridae Infections
RNA Virus Infections
Virus Diseases
Sexually Transmitted Diseases, Viral
Sexually Transmitted Diseases
Immunologic Deficiency Syndromes
Immune System Diseases
Raltegravir Potassium
Anti-HIV Agents
Anti-Retroviral Agents
Antiviral Agents
Anti-Infective Agents
HIV Integrase Inhibitors
Integrase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action