Establish and Characterize an Acute HIV Infection Cohort in a High Risk Population
Study Details
Study Description
Brief Summary
To describe clinical, immunological, and virological characteristics of persons with acute HIV infection
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To describe demographics and behavioral risk factors for those identified with acute HIV infection
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To describe neurocognitive function and neuroimaging findings in acute HIV infection as well as describe immune response, HIV-1 genotypes and sequences in the cerebrospinal fluid.
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To describe the number and characteristics of sexual contacts
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To describe the willingness of acute HIV-infected subjects to allow the tracking of their sexual contacts for voluntary HIV counseling and testing (VCT)
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To describe immune response, HIV-1 genotypes and sequences in the genital compartment
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To describe T cell depletion in the gut mucosa in acute HIV infection and describe the changes in gut T cell during follow up
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To archive samples for future investigations including determination of viral evolution, and cell-mediated and humoral immune responses in peripheral blood and mucosal compartments
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
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Detailed Description
This study will establish an acute infection cohort which is predominantly non-subtype B. Description of the early events in HIV infection is critical to HIV vaccine development and understanding HIV-1 immunopathogenesis. The ability to establish this cohort and identify individuals with acute HIV-1 infection would provide the basis for future hypothesis-driven proposals.
Subjects will be recruited at the TRCARC. Subjects seeking VCT will be asked to provide contact information. Blood samples, either plasma or whole blood collected on filter paper (dried blood spots, or DBS) will be screened for acute HIV infection by pooled or individual NAT if non-reactive after screening by an EIA capable of detecting both HIV antibody and antigen (4th generation or sensitive EIA). Additionally, 4th generation reactive samples will be screened with a non-IgM sensitive EIA capable of detecting HIV antibody only (less sensitive EIA) within 1-2 days of sample collection. Those who are found to have acute HIV infection will be asked to enroll in the cohort study. These acute HIV-infected participants will be followed prospectively at week 0, day 2, 3, 5, 7, 10 then weeks 2, 4, 8, 12, 16, 20, 24, then every 12 weeks until the end of the study (maximum of 192 weeks of follow up). Subjects will receive blood testing for CD4, HIV RNA, ALT, creatinine and lipids, and urinalysis. Subjects will be asked to complete a questionnaire on HIV risk behavior. Archiving of plasma and PBMC for future immunologic and virologic testing will be performed. Optional study procedures include 1) collection of genital secretions 2) collection of cerebrospinal fluid 3) brain MRI/MRS without gadolinium 4) sampling of gut-associated lymphoid tissue by colon biopsy 5) genetic testing 6) tracking of and offering VCT to sexual contacts of acute HIV-infected subjects. Subjects are encouraged to be hospitalized for the first 3-7 days for post-procedural observation and for ease of follow up.
Study Design
Outcome Measures
Primary Outcome Measures
- Number of HIV and non-HIV related clinical events [It will take approximately 72 months to complete the study. The screening and enrollment is 48 months.]
Secondary Outcome Measures
- demographics and behavioral risk factors for those identified with acute HIV infection [approximately 72 months to complete the study. The screening and enrollment is 48 months]
- neurocognitive function and neuroimaging findings in acute HIV infection as well as describe immune response, HIV-1 genotypes and sequences in the cerebrospinal fluid [approximately 72 months to complete the study. The screening and enrollment is 48 months]
- number and characteristics of sexual contacts [approximately 72 months to complete the study. The screening and enrollment is 48 months]
- the willingness of acute HIV-infected subjects to allow the tracking of their sexual contacts for voluntary HIV counseling and testing (VCT) [approximately 72 months to complete the study. The screening and enrollment is 48 months]
- immune response, HIV-1 genotypes and sequences in the genital compartment [approximately 72 months to complete the study. The screening and enrollment is 48 months]
- T cell depletion in the gut mucosa in acute HIV infection and describe the changes in gut T cells during follow up [approximately 72 months to complete the study. The screening and enrollment is 48 months]
Eligibility Criteria
Criteria
Inclusion Criteria:
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Age >18 years old
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Have protocol-defined acute HIV-1 infection (Tested 4th generation HIV EIA negative and NAT positive or tested 4th generation HIV EIA positive, negative by less sensitive EIA and NAT positive)
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Understand the study and sign informed consent form. Persons who cannot read will have the consent form read to them by a study staff and they can give informed consent by using thumb print.
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Availability for follow-up for the planned study duration
Exclusion Criteria:
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Persons who have a history of a medical or psychiatric disorder by investigator's interview and physical examination according to standard practices, that in the judgment of the investigator(s), would interfere with or serve as a contraindication to adherence to the study protocol or ability to give informed consent.
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Female participants who are pregnant at the time of screening
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Thai Red Cross AIDS Research Centre | Bangkok | Thailand | 10330 |
Sponsors and Collaborators
- South East Asia Research Collaboration with Hawaii
- Armed Forces Research Institute of Medical Sciences, Thailand
- Thai Red Cross AIDS Research Centre
- Yale University
- National Institute of Allergy and Infectious Diseases (NIAID)
- University of California, San Francisco
- National Institutes of Health (NIH)
- Johns Hopkins University
- University of Missouri-Columbia
Investigators
- Study Chair: Jintanat Ananworanich, MD, US Military HIV Research Program
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- SEARCH010/ RV 254