CSHHTVASIT: Comparative Study of Human Immunodeficiency Virus Negative Host Talaromyces Between Voriconazole and Amphotericin Sequential Itraconazole Therapy
Study Details
Study Description
Brief Summary
Through a multi-center large-sample non-randomized controlled study, the effect of voriconazole, amphotericin B sequential itraconazole therapy on Talaromyces in Human Immunodeficiency Virus(HIV)negative hosts were compared to clarify whether the two therapies were equivalent; A comprehensive efficacy evaluation system and standard treatment program was established to provide a basis for standardized treatment of Talaromyces in Human Immunodeficiency Virus negative hosts.The observational indicators included: 2-week all-cause mortality; 24-week all-cause mortality; clinical improvement time; level of decrease of fungus in the blood culture medium two weeks before treatment; recurrence; appearance of adverse drug reaction at the level 3 and above. Dynamically monitor the immune cells and factors like anti-Interferon-γ autoantibodies, Interferon-γ, Th1/Th2, and Th17/Treg in the HIV-negative Talaromyces host microenvironment, and observe the host's immune status and its change. 3. study the effect of absence of Interferon-γ and Interferon-γ Receptor (IFN-γR)on the activation and function of anti-Interferon-γ autoantibodies, Th1/Th2, and Th17/Treg by establishing a Talaromyces mouse model that knocks out the Interferon-γ and IFN-γR gene and a IFN-γ silenced cell model; Study the effect of anti-IFN-γ autoantibody on the activation and function of IFN-γ、Th1/Th2、Th17/Treg by increasing its titer in vitro and vivo; determine by which path the anti-IFN-γ autoantibody of HIV-negative host influences its immune regulation mechanism; finally, the intervention effect of IFN-γ on high titer anti-IFN-γ autoantibodies is studied, providing a new idea for immunotargeted therapy.
Condition or Disease | Intervention/Treatment | Phase |
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N/A |
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
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Experimental: HIV Negative Host talaromyces using Voriconazole Voriconazole On the first day, 6 mg/kg bid was given, and then 4 mg/kg bid was given intravenously for 6 days, and then oral voriconazole 200 mg bid was administered to maintain treatment for at least 6 months. |
Drug: Voriconazole
6mg/kg bid, was given on the first day, followed by intravenous 4mg/kg bid for 6 days, followed by oral Valconazole 200mg bid for at least 6 months.
Amphotericin B sequential itraconazole group (intravenous amphotericin, dose 0.7 - 1.0 mg / kg / d, 14 days, then changed oral itraconazole 200 mg bid for 10 weeks, after which 100 mg bid maintenance Until CD4+ T cells are greater than 100 cells/L for at least 6 months
Other Names:
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Experimental: HIV Negative talaromyces AMB Sequential Itraconazole Amphotericin B (AMB) sequential itraconazole group (intravenous amphotericin, dose 0.7 - 1.0 mg / kg / d, 14 days, then changed oral itraconazole 200 mg bid for 10 weeks, after which 100 mg bid maintenance Until cluster of differentiation 4 (CD4+ T) cells are greater than 100 cells/L for at least 6 months |
Drug: Voriconazole
6mg/kg bid, was given on the first day, followed by intravenous 4mg/kg bid for 6 days, followed by oral Valconazole 200mg bid for at least 6 months.
Amphotericin B sequential itraconazole group (intravenous amphotericin, dose 0.7 - 1.0 mg / kg / d, 14 days, then changed oral itraconazole 200 mg bid for 10 weeks, after which 100 mg bid maintenance Until CD4+ T cells are greater than 100 cells/L for at least 6 months
Other Names:
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Outcome Measures
Primary Outcome Measures
- Number of Participants with all-cause mortality [up to 2 weeks]
defined as the absolute risk of death from any cause during the first 2 weeks
- Number of Participants with all-cause mortality [up to 24 weeks]
defined as the absolute risk of death from any cause during 24 weeks
- Number of Participants with Clinical resolution of talaromyces [3 days]
Clinical resolution of talaromyces was defined as a temperature of less than 38°C (100°F) for 3 days, resolution of skin lesions, and tertile blood cultures. Early fungicidal activity was defined as the rate of decline in blood T. marneffei colony forming units (CFUs).
- Number of Participants with Early fungicidal activity [up to 2 weeks]
defined as the rate of decline in blood T. marneffei CFUs from sterical blood cultures obtained during the first 2 weeks.
- Number of Participants with Relapse of talaromyces [an average of 1 year]
defined as the recurrence of symptoms and a positive fungal culture from any sterile site that led to reinduction of therapy in patients who had achieved clinical resolution.
Eligibility Criteria
Criteria
Inclusion Criteria:
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HIV-negative adults (≥18 years of age) who diagnosis of talaromyces that was confirmed by either microscopy or culture
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Must be able to swallow tablets
Exclusion Criteria:
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Pregnancy, central nervous system involvement assessed either clinically or by analyses of cerebrospinal fluid
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An allergy to voriconazole, itraconazole or amphotericin
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The concomitant use of certain medications that interact with voriconazole, itraconazole or amphotericin
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An alanine aminotransferase or aspartate aminotransferase level of more than 400 U per liter
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An absolute neutrophil count of less than 500 per cubic millimeter
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A creatinine clearance of less than 30 ml per minute (calculated by the method of Cockcroft and Gault)
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a concurrent diagnosis of cryptococcal meningitis
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concurrent treatment with rifampicin
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previous treatment for talaromyces for more than 48 hours
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HIV positive who diagnosis of talaromyces.
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
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1 | Guangxi Medical University | Nanning | Guangxi | China | 530021 |
Sponsors and Collaborators
- Guangxi Medical University
- First Affiliated Hospital of Guangxi Medical University
- Second Affiliated Hospital of Guangzhou Medical University
- The Fourth People's Hospital of Nanning
- Guilin Medical College
- Nanning Second People's Hospital
Investigators
None specified.Study Documents (Full-Text)
None provided.More Information
Additional Information:
Publications
None provided.- TSM-AMB-VOR-2018