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CompletedNCT00000643Updated Nov 2, 2021

Primary Prophylaxis of Cerebral Toxoplasmosis in HIV-Infected Patients

A Phase 2 interventional study of Pyrimethamine and Leucovorin calcium in Toxoplasmosis, Cerebral and HIV Infections, sponsored by National Institute of Allergy and Infectious Diseases (NIAID). Completed at 24 sites in United States. Open to participants aged 13 Years and older. Per ClinicalTrials.gov, last updated 2021-11-02.

Sponsored by National Institute of Allergy and Infectious Diseases (NIAID) · Phase 2, Interventional, and Prevention

Phase
Phase 2
Study type
Interventional
Enrollment
150
Ages
13 Years and older
Sex
All
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Study summary

To evaluate the effectiveness of pyrimethamine (given with leucovorin calcium versus placebo (an inactive substance) for the primary prophylaxis (prevention) of cerebral toxoplasmosis in HIV-infected patients.

Cerebral toxoplasmosis is one of the most frequently encountered opportunistic infections in the course of AIDS. The mortality (death) rate is estimated to be greater than 50 percent. Pyrimethamine is a drug that appears promising for the primary prevention of cerebral toxoplasmosis in HIV-infected patients.

Read the detailed description

Cerebral toxoplasmosis is one of the most frequently encountered opportunistic infections in the course of AIDS. The mortality (death) rate is estimated to be greater than 50 percent. Pyrimethamine is a drug that appears promising for the primary prevention of cerebral toxoplasmosis in HIV-infected patients.

AMENDED: 04-04-91 On the first day of therapy, a loading dose is given. After the first day, patients take pyrimethamine or placebo 3 times a week. Patients also take leucovorin calcium orally three times weekly. Enrollment occurs over approximately 12 months. All patients are followed on study until a common study close-out date and final analysis of the study. It is anticipated that this common close-out will occur when the mean duration of time on study therapy will be 3 years (approximately in January, 1994).

ORIGINAL design: On the first day of treatment, patients receive a loading dose of pyrimethamine or placebo, plus of leucovorin calcium. After the first day, patients take pyrimethamine or placebo three times a week. Patients also take folinic acid orally three times weekly. The mean duration of study participation is 3 years.

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Conditions studied

  • Toxoplasmosis, Cerebral
  • HIV Infections

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Keywords

  • Toxoplasmosis
  • Pyrimethamine
  • Leucovorin
  • Drug Evaluation
  • Acquired Immunodeficiency Syndrome
  • AIDS-Related Complex
  • Brain Diseases
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In context

Toxoplasmosis

36 studies on the registry are indexed under Toxoplasmosis; 9 are open to participants now.

This study's enrollment of 150 is above the median of 105 across 20 interventional studies indexed under Toxoplasmosis.

Browse Toxoplasmosis studies →

Lead sponsor

National Institute of Allergy and Infectious Diseases (NIAID) is the lead sponsor of 2,401 studies on the registry; 179 are open to participants now.

Of its 396 completed or terminated interventional studies of FDA-regulated products, 294 (74%) have results posted.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
13 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

Concurrent Medication:

Allowed:

  • Zidovudine (AZT), didanosine (ddI), dideoxycytidine (ddC), erythropoietin (Eprex), other agents granted Treatment IND or expanded access status.
  • Investigational triazoles.
  • Pentamidine for primary prophylaxis of Pneumocystis carinii pneumonia (PCP).

Patients with the following are excluded:

  • History of cerebral toxoplasmosis or toxoplasmosis infection in any other organ or tissue.
  • Focal neural abnormalities (except peripheral neuropathy) or mass lesions on a previous computerized tomography (CT) scan or magnetic resonance image (MRI), unless subsequent workup rules out toxoplasmosis, in which case abnormalities must have been stable for at least 2 months.
  • Known or suspected allergy or severe intolerance to study drugs.

Patients must have:

  • Positive toxoplasma serology.
  • HIV infection.
  • Willingness and ability to comply with the protocol and capability of giving written informed consent.

Exclusion criteria

Exclusion Criteria

Co-existing Condition:

Patients with the following conditions or symptoms are excluded:

  • Current diagnosis of cerebral toxoplasmosis or toxoplasmosis infection in any other organ or tissue.
  • Known or suspected allergy or severe intolerance to study drugs.

Concurrent Medication:

Excluded:

  • Anticoagulants. Other antifolates, sulfonamides, fansidar, macrolides, 5-fluorouracil, dapsone, or any other agent with known activity against Toxoplasma gondii.
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Study design

Phase
Phase 2
Primary purpose
Prevention
Masking
Double
Enrollment
150 participants

Interventions

  • DrugPyrimethamine
  • DrugLeucovorin calcium
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Study locations

24 sites
  • Stanford CRS
    Palo Alto, California 94304, United States
  • Harbor-UCLA Med. Ctr. CRS
    Torrance, California 90502, United States
  • Univ. of Miami AIDS CRS
    Miami, Florida 33136, United States
  • Northwestern University CRS
    Chicago, Illinois 60611, United States
  • Rush Univ. Med. Ctr. ACTG CRS
    Chicago, Illinois 60611, United States
  • Indiana Univ. School of Medicine, Infectious Disease Research Clinic
    Indianapolis, Indiana 46202, United States
  • Tulane Med. Ctr. - Charity Hosp. of New Orleans, ACTU
    New Orleans, Louisiana, United States
  • Johns Hopkins Adult AIDS CRS
    Baltimore, Maryland 21287, United States
  • Bmc Actg Crs
    Boston, Massachusetts 02118, United States
  • University of Minnesota, ACTU
    Minneapolis, Minnesota 55455, United States
  • St. Louis ConnectCare, Infectious Diseases Clinic
    Saint Louis, Missouri, United States
  • Washington U CRS
    Saint Louis, Missouri, United States
  • NJ Med. School CRS
    Newark, New Jersey 07103, United States
  • SUNY - Buffalo, Erie County Medical Ctr.
    Buffalo, New York 14215, United States
  • Beth Israel Med. Ctr. (Mt. Sinai)
    New York, New York 10003, United States
  • NY Univ. HIV/AIDS CRS
    New York, New York 10016, United States
  • Cornell University A2201
    New York, New York 10021, United States
  • Memorial Sloan-Kettering Cancer Ctr.
    New York, New York 10021, United States
  • Univ. of Rochester ACTG CRS
    Rochester, New York 14642, United States
  • Unc Aids Crs
    Chapel Hill, North Carolina 27599, United States
  • Duke Univ. Med. Ctr. Adult CRS
    Durham, North Carolina 27710, United States
  • Univ. of Cincinnati CRS
    Cincinnati, Ohio 45267, United States
  • Case CRS
    Cleveland, Ohio 44106, United States
  • Pitt CRS
    Pittsburgh, Pennsylvania 15213, United States
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References and documents

Publications

  • Rousseau F, Pueyo S, Morlat P, Hafner R, Chene G, Leport C, Luft BJ, Miro J, Aubertin J, Salamon R, Vilde JL. Increased risk of toxoplasmic encephalitis in human immunodeficiency virus-infected patients with pyrimethamine-related rash. ANRS 005-ACTG 154 Trial Group. Agence Nationale de Recherche sur le SIDA (ANRS-INSERM) and the NIAID-AIDS Clinical Trials Group. Clin Infect Dis. 1997 Mar;24(3):396-402. doi: 10.1093/clinids/24.3.396. PubMed 9114191 ↗
  • Leport C, Chene G, Farinotti R, Ecobichon J-L, Petavin G, Sagardoy G, Morlat P, Hafner R, Luft B, Salamon R, Vilde J-L. Determination of pyrimethamine serum levels in a primary prophylaxis trial for toxoplasmic encephalitis. Conf Retroviruses Opportunistic Infect. 1996 Jan 28-Feb 1;3rd:159
  • Leport C, Chene G, Morlat P, Luft BJ, Rousseau F, Pueyo S, Hafner R, Miro J, Aubertin J, Salamon R, Vilde JL. Pyrimethamine for primary prophylaxis of toxoplasmic encephalitis in patients with human immunodeficiency virus infection: a double-blind, randomized trial. ANRS 005-ACTG 154 Group Members. Agence Nationale de Recherche sur le SIDA. AIDS Clinical Trial Group. J Infect Dis. 1996 Jan;173(1):91-7. doi: 10.1093/infdis/173.1.91. PubMed 8537688 ↗
  • Pueyo S, Salmi LR, Chene G, Leport C, Morlat P, Dequae L, Gregoire V, Hafner R, Vilde JL, Luft BJ, Aubertin J, Salamon R. Survival after AIDS-defining events in patients with < 200 lymphocytes CD4+ x 10(6)/L who are toxoplasmosis antibody positive. ANRS 005/ACTG 154 Trial Group. J Acquir Immune Defic Syndr Hum Retrovirol. 1997 Apr 15;14(5):459-64. doi: 10.1097/00042560-199704150-00010. PubMed 9170421 ↗
  • Derouin F, Leport C, Pueyo S, Morlat P, Letrillart B, Chene G, Ecobichon JL, Luft B, Aubertin J, Hafner R, Vilde JL, Salamon R. Predictive value of Toxoplasma gondii antibody titres on the occurrence of toxoplasmic encephalitis in HIV-infected patients. ANRS 005/ACTG 154 Trial Group. AIDS. 1996 Nov;10(13):1521-7. doi: 10.1097/00002030-199611000-00010. PubMed 8931787 ↗
  • Chene G, Morlat P, Hafner R, Aboulker JP, Luft B, Dormont J, Vilde JL, Salamon R. Intent-to-treat versus on treatment analysis: how to interpret the results of a clinical trial? Experience from ANRS 005/ACTG 154 study. Natl Conf Hum Retroviruses Relat Infect (1st). 1993 Dec 12-16:100
  • Chene G, Morlat P, Leport C, Hafner R, Dequae L, Charreau I, Aboulker JP, Luft B, Aubertin J, Vilde JL, Salamon R. Intention-to-treat vs. on-treatment analyses of clinical trial data: experience from a study of pyrimethamine in the primary prophylaxis of toxoplasmosis in HIV-infected patients. ANRS 005/ACTG 154 Trial Group. Control Clin Trials. 1998 Jun;19(3):233-48. doi: 10.1016/s0197-2456(97)00145-1. PubMed 9620807 ↗
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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Nov 2, 2021, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT00000643
Lead sponsor
National Institute of Allergy and Infectious Diseases (NIAID)
Responsible party
Sponsor
First posted
Aug 31, 2001
Completion
May 1994
Last update
Nov 2, 2021

Study contacts

BJ Luft
study chair
JL Vilde
study chair
View the source record on ClinicalTrials.gov ↗

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