Instituto de Pesquisa Clinica Evandro Chagas CRS

ACTG A5424: Menopausal Hormone Therapy for Women Living with HIV (HoT)

Menopausal hormone therapy (MHT) is considered the most effective therapy for vasomotor symptoms (VMS; also known as hot flashes and night sweats), and the most appropriate choice to prevent bone loss during menopause. However, the safety and effectiveness of menopausal MHT has not specifically been studied in women living with HIV (WLWH).

“HoT” is a trial of MHT (transdermal estradiol with or without oral progesterone) versus placebo for WLWH in the late menopausal transition or early postmenopause with moderate to severe VMS. Study participants will record their VMS in a daily diary for 3 to 5 weeks. Those meeting VMS eligibility criteria will then be randomized to receive either study medication (MHT) or placebo and record their VMS in a daily diary for 12 weeks.

A5409: A Phase 2 Randomized, Adaptive, Dose-Ranging, Open-Label Trial of Novel Regimens for the Treatment of Pulmonary Tuberculosis (RAD-TB)

The standard of care (SOC) treatment of tuberculosis (TB) was developed over 40 years ago, and the treatment is long (6 months) and hard. In many settings, the medicine does not work well because people stop taking it or miss doses, which leads to TB returning. For some people, the SOC treatment can cause negative side effects.

This study will evaluate new medication regimens for the treatment of TB. This study is adaptive, which means, as new medication regimens are identified for the treatment of TB, some of them will be selected for testing in this study. Therefore, there may be different drug regimens being used as part of the study at different times.

A5388: A Double-Blind, Randomized, Placebo-Controlled Clinical Trial of Combination HIV-Specific Broadly Neutralizing Monoclonal Antibodies Combined with ART Initiation during Acute HIV Infection to Induce HIV Remission

Scientists are looking for ways to minimize the distribution of HIV-1 in the body, especially where anti-HIV medications (ART) are unable to reach. Starting ART as soon as possible following a diagnosis of Acute HIV Infection (AHI) has been shown to better preserve the immune system. Broadly neutralizing antibodies (bNAbs), when administered with ART, also have the potential to prevent the HIV virus from being able to reproduce.

This is a randomized, placebo-controlled research study that will enroll adults with recently diagnosed AHI. All participants will begin ART at entry and receive a single dose of two bNAbs (VRC07-523LS and PGT121.414.LS) or placebos. Everyone will be followed for about 1 year after starting ART, then stop ART for up to 2.5 years, then be followed for 1 year after restarting ART.

A5385: An Observational Post-Intervention Cohort Destination Protocol

This study is a two-step, non-interventional extension study for individuals participating in another interventional HIV cure trial (parent study) that includes an analytical treatment interruption (ATI) (stopping anti-HIV therapy [ART] while monitoring viral load). Participants will be individuals who achieved post-intervention control (PIC) (maintaining HIV suppression after treatment interruption) in their parent study.

Step 1 will consist of an extended ATI period in which PICs will be monitored for safety, viral, and immune outcomes. Time to viral rebound and restart of antiretroviral therapy (ART) will be measured. Participants will begin Step 2 if they meet ART restart criteria and will be monitored for safety, immune, and viral outcomes through 48 weeks after ART restart.

A5374: A Phase I/IIa Randomized, Placebo-Controlled Trial of Conserved-Mosaic T-cell Vaccine in a Regimen with Vesatolimod and Broadly Neutralizing Antibodies in Adults Initiated on Suppressive Antiretroviral Therapy during Acute HIV-1

Current antiretroviral therapy (ART) does not cure HIV. ART just holds the virus in check so it cannot multiply and destroy the immune system. When most people talk about a cure for HIV, they generally imagine a cure that would remove all virus from the body. However, many researchers are looking for a different approach, known as a functional cure, that would improve the immune system response to HIV so that it controls the virus and allows for longer periods during which a person with HIV could stop taking ART.

A5384: A Phase II, Randomized, Open-Label Trial of a Six-Month Regimen of High-Dose Rifampicin, High-Dose Isoniazid, Linezolid, and Pyrazinamide versus a Standard Nine-Month Regimen for the Treatment of Adults and Adolescents with Tuberculous Meningitis

Study Description

A5384 is a trial for people who have or might have tuberculous meningitis (TBM). TBM is an infectious disease that causes inflammation of the membranes that surround the brain and the spinal cord (meninges). TBM is caused by the bacterium Mycobacterium tuberculosis, which can be found elsewhere in the body, usually the lungs, but can travel via the bloodstream to the meninges, where the bacteria cause TBM.

This trial will compare a new experimental regimen of anti-TBM medicines taken over a 6-month time period with the current standard of care regimen of anti-TBM medicines taken over a 9-month time period.

A5321: Decay of HIV-1 Reservoirs in Participants on Long-Term Antiretroviral Therapy: The ACTG HIV Reservoirs Cohort (AHRC) Study

AHRC (pronounced “ARC”) is a study of differences and changes over time in HIV reservoirs (groups of HIV-infected cells that “hide” from anti-HIV medications). This study enrolls people into one of six groups, based on their different HIV treatment histories. The current version of this study is only enrolling for Group 6, which will include people who acquired or are suspected to have acquired HIV while taking long-acting cabotegravir (LA CAB) for pre-exposure prophylaxis (PrEP).