The Safety and Effectiveness of Injections of Human Recombinant Interferon-gamma in Patients With AIDS Who Have Taken Zidovudine
Study Details
Study Description
Brief Summary
To find out which of four doses of (recombinant) human interferon gamma (IFN-G) is most effective in stimulating the white blood cells (monocytes) to fight infection and to see if treatment with IFN-G can strengthen the ability of AIDS patients to control infections. This study will also determine how long after a single injection of IFN-G white blood cells remain stimulated.
AIDS is a disease that progressively destroys that aspect of the body's defense called the immune system. It is particularly harmful to a class of cells called helper T-lymphocytes. The specific opportunistic infections and malignancies associated with AIDS have been treated with therapies that are often poorly tolerated by the patients and are associated with dose-limiting toxicities. The principal focus of AIDS therapy research at present is to control the underlying retroviral infection and to restore immune function with recombinant lymphokines, adoptive immunotherapy, and/or lymphocyte transplants. These treatments include zidovudine (AZT), which has been shown to control the HIV infection, and IFN-G, a lymphokine which activates tumor-destroying and germ-killing functions. Studies are needed to find the dose by which IFN-G works best.
Condition or Disease | Intervention/Treatment | Phase |
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Phase 1 |
Detailed Description
AIDS is a disease that progressively destroys that aspect of the body's defense called the immune system. It is particularly harmful to a class of cells called helper T-lymphocytes. The specific opportunistic infections and malignancies associated with AIDS have been treated with therapies that are often poorly tolerated by the patients and are associated with dose-limiting toxicities. The principal focus of AIDS therapy research at present is to control the underlying retroviral infection and to restore immune function with recombinant lymphokines, adoptive immunotherapy, and/or lymphocyte transplants. These treatments include zidovudine (AZT), which has been shown to control the HIV infection, and IFN-G, a lymphokine which activates tumor-destroying and germ-killing functions. Studies are needed to find the dose by which IFN-G works best.
Patients, who may participate in all three parts of the study, are maintained on a stable dose of AZT. In part A (optimal dose), five AIDS patients who have had an AIDS related opportunistic infection receive 4 once-weekly increasing doses of IFN-G. Monocyte antimicrobial activity is examined in test tube studies before and after each injection of IFN-G. In part B, five patients receive the optimal dose of IFN-G established in part A. Patients enrolled from part A have completed at least 2 weeks of part A before enrolling in part B. Antimicrobial activity is examined 1, 2, and 3 days after a single injection of the optimal dose of IFN-G (determined in part A). In part C (safety and tolerance of combined treatment of IFN-G and AZT), patients are treated with IFN-G for 4 weeks using the optimal dose and administration schedule derived from parts A and B.
Study Design
Outcome Measures
Primary Outcome Measures
Eligibility Criteria
Criteria
Inclusion Criteria
Concurrent Medication:
Allowed:
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Prophylactic antibiotics.
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Tylenol (650 mg orally every 6 hours as needed for temperature > 38.5 degrees C).
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Meperidine (25 - 50 mg intravenously, once, for severe rigors if systolic blood pressure is > 90 mmHg).
Patients must meet criteria for AIDS classification (CDC) category IV C-1.
- Patients must have had one or more prior opportunistic infections identified in surveillance definition of AIDS. Patients whose AIDS-defining illness is Kaposi's sarcoma are also eligible if they have previously had one of the secondary infectious diseases identified in category C-1.
Prior Medication:
Required:
- Patients must have been receiving zidovudine (AZT) on a stable dosage regimen for at least 8 weeks immediately preceding entry into study.
Exclusion Criteria
Co-existing Condition:
Patients with the following are excluded:
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Clinically significant cardiac (= or > class II, New York Heart Association) or peripheral vascular disease that requires treatment.
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Presence of an active opportunistic infection that requires treatment.
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Hemorrhagic diathesis or active bleeding disorder.
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Clinically apparent vascular disease.
Concurrent Medication:
Excluded:
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Medications required for treatment of active cardiac disease.
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Ongoing therapy with anticoagulants or thrombolytic agents.
Patients with the following are excluded:
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Clinically significant cardiac (= or > class II, New York Heart Association) or peripheral vascular disease that requires treatment.
-
Presence of an active opportunistic infection that requires treatment.
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Hemorrhagic diathesis or active bleeding disorder.
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Clinically apparent vascular disease.
Prior Medication:
Excluded within 4 weeks of study entry:
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Antiviral chemotherapy other than zidovudine.
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Excluded within 12 weeks of study entry:
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Immunosuppressive or cytotoxic therapy.
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
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1 | Cornell University A2201 | New York | New York | United States | 10021 |
Sponsors and Collaborators
- National Institute of Allergy and Infectious Diseases (NIAID)
Investigators
- Study Chair: HW Murray,
Study Documents (Full-Text)
None provided.More Information
Publications
- ACTG 072
- 11046