A Randomized Phase II Study of Two Doses of Interferon Alfa-2a (IFN Alfa-2a) in Combination With Zidovudine (AZT) and Dideoxycytidine (ddC) Versus AZT and ddC Only in Patients With HIV Infection and Less Than 400 CD4 Cells/mm3

Study Overview
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Brief Summary
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To determine the safety and efficacy of two doses of interferon alfa-2a ( IFN alfa-2a ) in combination with zidovudine ( AZT )/zalcitabine ( ddC ) versus AZT/ddC only in patients with HIV infection and CD4 count < 400 cells/mm3. AZT and ddC inhibit HIV by acting as reverse transcriptase chain terminators, while IFN alfa-2a inhibits translation of viral proteins. Combining agents that act at different sites of viral replication may improve HIV inhibition and produce more effective and sustained anti-HIV effects.

Detailed Description
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AZT and ddC inhibit HIV by acting as reverse transcriptase chain terminators, while IFN alfa-2a inhibits translation of viral proteins. Combining agents that act at different sites of viral replication may improve HIV inhibition and produce more effective and sustained anti-HIV effects. Patients are randomly assigned to one of three treatment arms to receive AZT/ddC alone or combined with one of two doses of IFN alfa-2a. Treatment continues for up to 12 months after enrollment of the last patient. Patients are followed at 2, 4, and 8 weeks and every 8 weeks thereafter. Mean duration of follow-up is expected to be 13 months.

Official Title
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A Randomized Phase II Study of Two Doses of Interferon Alfa-2a (IFN Alfa-2a) in Combination With Zidovudine (AZT) and Dideoxycytidine (ddC) Versus AZT and ddC Only in Patients With HIV Infection and Less Than 400 CD4 Cells/mm3

Conditions
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HIV Infections

Intervention / Treatment
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* Drug: Interferon alfa-2a
* Drug: Zidovudine
* Drug: Zalcitabine


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria Concurrent Medication: Allowed: Isoniazid for < grade 2 peripheral neuropathy (if patient is also taking 50 mg/day pyridoxine). Phenytoin for < grade 2 peripheral neuropathy. A 21-day course of adjuvant systemic corticosteroid therapy for moderate to severe Pneumocystis carinii pneumonia (PCP). Chemoprophylaxis for PCP, candidiasis, herpes simplex infection (up to 1 g acyclovir daily), and Mycobacterium tuberculosis. Patients must have: HIV infection. CD4 count < 400 cells/mm3 within 30 days prior to study entry. NOTE: Minimal Kaposi's sarcoma is allowed. Exclusion Criteria Co-existing Condition: Patients with the following symptoms and conditions are excluded: Active opportunistic infection requiring acute therapy. Need for maintenance therapy for cytomegalovirus infection, toxoplasmic encephalitis, or mycobacterial infection. Malignancy (other than minimal Kaposi's sarcoma) requiring therapy. Grade 2 or worse peripheral neuropathy. Concurrent Medication: Excluded: Other antiretroviral drugs, biologic response modifiers, cytotoxic chemotherapy, or investigational drugs (unless approved by the protocol chairs). Recombinant erythropoietin, G-CSF, or GM-CSF. Drugs that cause peripheral neuropathy, e.g., gold, hydralazine, nitrofurantoin, vincristine, cisplatin, disulfiram, and diethyldithiocarbamate (unless approved by the protocol chairs). Concurrent Treatment: Excluded: Radiation therapy (unless approved by the protocol chairs). Patients with the following prior conditions are excluded: History of intolerance to AZT at 600 mg/day or less. Unexplained temperature of 38.5 degrees C persisting for 14 days or longer. Unexplained, chronic diarrhea defined as 3 or more stools per day persisting for 14 days or longer. Prior Medication: Excluded: Acute therapy for opportunistic infection within 14 days prior to study entry. Prior ddC, ddI, or IFN alfa-2a. Active substance abuse.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment


Arms and Interventions

| Intervention/Treatment |
| --- |
|Drug: Interferon alfa-2a|nan|
|Drug: Zidovudine|nan|
|Drug: Zalcitabine|nan|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Zalcitabine, Acquired Immunodeficiency Syndrome, AIDS-Related Complex, Zidovudine, Interferon-alpha