Role of PLA2G1B During HIV Infection (PREDIACC)
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|ClinicalTrials.gov Identifier: NCT04208711|
Recruitment Status : Active, not recruiting
First Posted : December 23, 2019
Last Update Posted : December 23, 2019
|Condition or disease||Intervention/treatment||Phase|
|HIV Infections||Other: biological sample||Not Applicable|
Antiretroviral therapy in HIV-infected patients has progressed significantly over the past two decades.
Viral replication in patients who are complicit in their treatment regimen is greatly reduced below detection limits (quantification) by current and approved laboratory tests. However, the persistence of residual (plasma) replication of the virus creates an inflammatory state associated with certain pathologies, accelerated aging and premature mortality. If treatment is discontinued for any reason, viral replication resumes within a few weeks in almost all patients.
Alternative infections of inflammatory pathways in HIV can also play a critical role in the inflammatory process suppressed by treatment. Members of the phospholipase A2 family can hydrolyze phospholipid molecules at the sn-2 position, making it a question about lipid moieties. One of the members, the phospholipase A2 group1B (PLA2G1B), is found in the plasma of HIV-infected patients who are not receiving antiretroviral therapy. Ex vivo, this enzyme is able to induce a purified CD4 lymphocyte energy from donors, as well as by inducing the lack of response to IL-7 (interleukin-7). In the long term, loss of response to IL-7 induces CD4 lymphopenia. Therefore, PLA2G1B must play an important role in the mechanism leading to HIV-infected patients becoming immunodeficient.
At the clinical level, we found that PLA2G1B activity increases in all HIV-infected patients and decreases after ARV treatment. On the other hand, for patients who are able to eliminate the HIV virus on therapy but whose immunological response remains low, PLA2G1B activity remains high. More interestingly, in "HIV Elite Controller" patients, PLA2G1B activity is not found in their plasma. Overall, there is a correlation between the different clinical groups (viremic not on therapy, ARV and virus removal with robust CD4+ T-cell response, virus removal with suboptimal CD4+ T-cell response and "HIV Elite Controller") and the activity level of PLA2G1B in their plasma.
The purpose of this study, more generally, is to study the role of PLA2G1B in CD4 lymphocytes and to analyze the reversion of its effects in the immunopathogenicity of HIV infection.
In the main study, 15 patients will be included. The analysis of the first 7 patients will in addition meet the objectives of the study, to determine the test that will allow the follow-up of the 8 other patients after ARV treatment. The participation of the 7 patients in the study is limited to 1 (one) day.
In the sub-study, the last 8 patients following their inclusion in the main study will enter a follow-up phase of 12 months after they are put on ARV treatment. The total duration of participation for the 8 patients will be 13 months.
The main study is carried out by taking 50 mL of total blood and in the sub-study, 30mL of blood sample will be taken during the follow-up visit (at M1, M3, M6, M9 and 12 Months) after ARV treatment.
|Study Type :||Interventional (Clinical Trial)|
|Estimated Enrollment :||15 participants|
|Intervention Model:||Single Group Assignment|
|Masking:||None (Open Label)|
|Primary Purpose:||Basic Science|
|Official Title:||Study of the Role of PLA2G1B in the Immunopathogenicity by Action on CD4 T Cells During HIV Infection|
|Actual Study Start Date :||March 1, 2019|
|Estimated Primary Completion Date :||March 2021|
|Estimated Study Completion Date :||March 2021|
positive HIV patient not treated by ARV yet
Before starting HIV treatment, 15 patients will be included in the study and 50mL of whole blood will be taken. After treatment initiation 8 of the 15 patients will entered in the follow-up phase for 1 year (5 followup visit, M1, M3, M6, M9, M12) and 30mL of whole blood will be taken at each visit.
The duration of the study for the 7 other patients will be 1 day.
Other: biological sample
whole blood sample
- immunological : [ Time Frame: up to 1 year ]
The assessment of the change in the proportion of lymphocytes at 1, 3, 6, 9 and 12 months as compared to Day 1:
- CD4 with membranes abnormalities above normal,
- CD4 with major membrane abnormalities,
- CD4 with signal transduction abnormalities,
- CD4 reversing one of these abnormalities spontaneously or after treatment with neutralizing monoclonal antibody (mAb) 2B2
- immunological [ Time Frame: up to 1 year ]
The assessment of the change at 1, 3, 6, 9 and 12 months as compared to Day 1 of:
- number of CD4/mm3 of blood, number of CD8/mm3 of blood, CD4 / CD8 ratio, viral load (copies of HIV RNA/mL of blood), viral DNA (copies of HIV DNA/mL of blood)
- number of CD4/mm3 secreting IFN gamma (Interferon gamma), TNF (Tumor necrosis factor) and IL-2 (Interleukin-2) (in % of IFN - TNFa - IL-2+ / CD4)
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 ClinicalTrials.gov identifier (NCT number): NCT04208711
|CIC 1417 Cochin Pasteur, hôpital Cochin|
|Paris, France, 75014|
|Principal Investigator:||Odile LAUNAY, MD, PHD||CIC 1417 Clinical Center Investigation - Cochin Hospital, AP-HP|