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CompletedNCT01694017Updated Nov 24, 2014

Economic, Clinical and Quality of Life Assessment in Patients on Antiretroviral Therapy

A Phase 4 interventional study of Tenofovir and Zidovudine in HIV, sponsored by Tufts University. Completed at 1 site in India. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2014-11-24.

Sponsored by Tufts University · Phase 4, Interventional, and Treatment

Phase
Phase 4
Study type
Interventional
Enrollment
68
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

The purpose of this study is to compare clinical, economical and quality of life (QOL) outcomes in patients living with HIV on zidovudine/stavudine regimen and tenofovir regimen. This study will be an unblinded randomized trial. The first step will be empirical data collection for one year for calculating the incremental cost effectiveness ratio (ICER). The second step will be to perform a simulation model for calculating long term ICER.

Read the detailed description

The drug regimen for treatment of HIV at the free ART centers in India includes stavudine/zidovudine and lamivudine with nevirapine. Approximately 20-30% of the patients on this regimen experience drug toxicity within the first six months of treatment.

The tenofovir based regimen is one of the least toxic regimens with less than 5% of patients experiencing toxicity. Tenofovir based regimen is not considered as the first choice for ART in the Indian governmental program, because it is more expensive than the other drug regimens, in spite of better clinical outcomes in resource limited settings. The cost of treatment with stavudine/zidovudine is presumed to be less expensive and is the preferred first line treatment, but we believe that although the direct cost to the government is less, patients on zidovudine/stavudine regimen have to spend more money for additional hospital visits and admissions, laboratory investigations and other medications due to ART induced toxicity.

There are no published data including economic, clinical and quality of life outcomes to compare the two regimens from India. Hence, this unblinded randomized pragmatic comparative effectiveness study will seek to identify the best treatment for HIV patients based on the incremental cost effectiveness ratio (ICER), quality of life (QOL) and clinical outcomes.

The clinical outcomes include viral suppression, change in the CD4 and proportion of patients with toxicity and opportunistic infections. Direct costs for the treatment will be calculated. The QOL scores will be estimated and compared between the regimens using questionnaires. QOL scores and direct cost will be used as utilities for calculating ICER.

02

Conditions studied

  • HIV

Keywords

  • HIV,treatment,cost effectiveness,drug toxicity,QOL,costs
03

In context

Lead sponsor

Tufts University is the lead sponsor of 225 studies on the registry; 24 are open to participants now.

Of its 10 completed or terminated interventional studies of FDA-regulated products, 7 (70%) have results posted.

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

04

Who can participate

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

Inclusion criteria

  • All treatment naïve patients above 18 years confirmed with the diagnosis of HIV
  • Eligible for initiation of cART based on the National Aids Control Organization of India
  • Consenting for participation and follow-up for one year.

Exclusion criteria

Exclusion Criteria:

  • All patients requiring hospitalization at the time of initiation of treatment
  • Patients with opportunistic infections including tuberculosis
  • Patients with co-morbidities like diabetes or neurological impairments
  • Pregnant and breast feeding women and children less than 18 years will be excluded
  • All patients living outside the catchment area of CMC and not willing for regular follow-up will be excluded
  • Patients with a creatinine clearance less than 50 mL/min will be excluded.
  • Patients receiving other co-medications with possible interaction with tenofovir, like antifungal (voriconazole), ergot derivatives (dihydroergotamine, ergonovine, ergotamine, and methylergonovine), benzodiazepines (midazolam, triazolam), calcium channel blocker (bepridil), GI motility agent (cisapride), neuroleptic (pimozide) and St.John's wort will be excluded.
  • Patients with hemoglobin less than 8 gm/dl
  • Patients started on tenofovir regimen by the treating physician at the time of enrollment will be excluded
05

Study design

Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
68 participants (actual)

Study arms

  • Active comparator
    Zidovudine

    zidovudine 300 mg + lamivudine 150 mg + nevirapine 200 mg , once daily, for a year

    Drug: Zidovudine

  • Active comparator
    Tenofovir

    tenofovir 300 mg+ emtricitabine 200 mg + efavirenz 600 mg, once daily, for one year

    Drug: Tenofovir

Interventions

  • DrugTenofovir

    tenofovir 300 mg+ emtricitabine 200 mg + efavirenz 600 mg, once daily, for one year

    Also known as: Atripla, Vonavir

  • DrugZidovudine

    zidovudine 300 mg + lamivudine 150 mg + nevirapine 200 mg , once daily, for a year

    Also known as: Lazid-N, Duovir-N, Zidolam-N

06

What researchers measure

Primary outcomes

  1. Viral suppression

    Time frame: End of follow-up : end of 12th Month

  2. Change in CD4 levels

    Time frame: End of Months 6 and 12

  3. Drug related toxicity

    Time frame: Months : 1,2,3,4,5,6,7,8,9,10,11,12

  4. opportunistic infections

    Time frame: Months: 1,2,3,4,5,6,7,8,9,10,11,12

  5. Direct costs

    Time frame: Months: 1,2,3,4,5,6,7,8,9,10,11,12

  6. Quality of life

    Time frame: Month 1 and end of months 4,8 and 12

07

Study locations

1 site
  • Christian Medical College
    Vellore, Tamilnadu 632004, India
08

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Nov 24, 2014, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT01694017
Lead sponsor
Tufts University
Collaborators
Christian Medical College, Vellore, India
Responsible party
Christine A. Wanke (Professor of Medicine and Public Health and Community Medicine, Tufts University) — Principal investigator
First posted
Sep 26, 2012
Start date
Nov 2012
Primary completion
Aug 2014
Completion
Aug 2014
Last update
Nov 24, 2014

Study contacts

Christine C Wanke, MD
study chair · Tufts University
Sowmyanarayanan V Thuppal, MD
principal investigator · Tufts University

Oversight

Data monitoring committee
Yes
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Nov 2014. You cannot join it, but the record below documents what was studied.

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