ClinicalTrials.gg
CompletedNCT02159027Updated Aug 30, 2021

Maraviroc and NeuroAIDS Pathogenesis

A Phase 2/3 interventional study of Maraviroc and Placebo in AIDS Dementia Complex, sponsored by University of Hawaii. Completed at 2 sites in 2 countries. Open to participants aged 18 Years to 70 Years. Per ClinicalTrials.gov, last updated 2021-08-30.

Sponsored by University of Hawaii · Phase 2/3, Interventional, and Treatment

Phase
Phase 2/3
Study type
Interventional
Enrollment
48
Allocation
Randomized
Ages
18 Years to 70 Years
Sex
All
01

Study summary

Maraviroc is an antiretroviral medication that may help in improving mental function in HIV infected patients with mental problems by decreasing inflammatory tendencies. We will test this in a clinical trial of 42 HIV infected individuals with some mild to moderate mental problems who are already on HIV medications and doing well. We will add Maraviroc or a sugar pill to their HIV medications and see if mental function improves over 48 weeks. This study will be conducted at 2 sites in Hawaii and Puerto Rico.

Read the detailed description

We hypothesize that maraviroc (MVC) will lead to improved cognition as assessed by improvement in neuropsychological (NP) performance. We hypothesize that MVC therapy leads to (1) decrease in HIV infection of monocytes (MO), particularly of CD16-expressing MO and (2) phenotypic and functional secretory changes suggestive of decrease in MO immune activation, and that these changes will lead to less HIV infected activated MO trafficking to the CNS, less CNS inflammation and neuronal damage, and ultimately improved cognition. We will test this in a 48 week trial in 42 HIV infected individuals on suppressive antiretroviral therapy (ART) with mild to moderate cognitive dysfunction. These individuals will be randomized to intensify their ART in double-blind fashion to MVC vs placebo. The primary endpoint will be change in NPZglobal. Magnetic resonance spectroscopy (MRS)/magnetic resonance spectroscopic imaging (MRSI) will be conducted to assess potential alterations in inflammatory and neuronal brain chemicals.

02

Conditions studied

  • AIDS Dementia Complex

Keywords

  • Human Immunodeficiency Virus
  • AIDS Dementia Complex
03

In context

AIDS Dementia Complex

41 studies on the registry are indexed under AIDS Dementia Complex; 2 are open to participants now.

This study's enrollment of 48 is close to the median of 50 across 31 interventional studies indexed under AIDS Dementia Complex.

Browse AIDS Dementia Complex studies →

Lead sponsor

University of Hawaii is the lead sponsor of 97 studies on the registry; 21 are open to participants now.

Of its 8 completed or terminated interventional studies of FDA-regulated products, 4 (50%) have results posted.

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

04

Who can participate

Ages eligible
18 Years to 70 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Documentation of -1 infection by an FDA approved test at any time prior to study entry.
  • Receipt of ARV medication uninterrupted for > 1 year leading up to the screening period; brief interruptions for toxicity purposes will be evaluated on a case by case basis and may be allowed
  • Screening plasma HIV RNA \< 50 copies/ml within 3 months of entry
  • Willingness for both males and females of to utilize 2 effective methods (2 separate forms, one of which must be an effective barrier method), be non-heterosexually active or have a an exclusive vasectomized partner from screening throughout the duration of the study treatment and for 30 days following the last dose of study drugs.
  • Age between 18 to 70 years.
  • Ability and willingness to provide written Mild to moderate cognitive impairment with global neuropsychological (NP) test (NPZglobal) score of \< -0.5 OR a neurocognitive abnormality (\< -0.5) in at least one cognitive domain known to be typically affected by HIV

Exclusion criteria

Exclusion Criteria:

  • Currently receiving or having used a CCR5 antagonist as part of an antiretroviral regimen within 6 months of study entry
  • Plasma RNA > 100 copies/ml at any time within 6 months of study entry
  • History of HIV-2
  • Diagnosis of cirrhosis
  • Active or inadequately treated tuberculosis (TB) infection, or inadequate treatment for a positive purified protein derivative (PPD) test. Adequate treatment is defined as meeting the current recommendations of the Centers of Disease Control and Prevention (CDC), National Institutes of Health (NIH) and the HIV Medicine Association of the Infectious Diseases Society of America (IDSA) guidelines33 or other CDC recommendations if the patient was treated before the current recommendations or before coinfection with HIV.
  • Uncontrolled seizure disorder
  • Current or history of past malignancies excluding basal cell CA and Kaposi's sarcoma restricted to the skin, unless subject considered cured.
  • Any immunomodulator, HIV vaccine, any other vaccine, or therapy within 30 days of study entry.
  • Requirement for acute therapy for any AIDS-defining illness or other serious medical illnesses (in the opinion of the site investigator) within 14 days prior to entry.
  • Chronic illnesses including hematologic, pulmonary, and diseases and endocrinopathies, except for stable controlled diabetes or cardiovascular disease in the view of the investigator and stable testosterone or thyroid medication use
  • Known to MVC or its
  • Anticipated need for specific prescription medications. Unwillingness to stop from eating grapefruit or using St. John's wort.
  • Chronic use of over-the-counter (OTC) medications unless approved by Study Investigator
  • \< 9.0; \< 500/μL; count \< 40,000/μL; (SGOT) and ALT (SGPT) > 5x ; Lipase > 2.0 x ULN
  • Estimated \< 30 cc/min using Cockcroft and Gault method
  • Abnormal unless determined by the Investigator to be not .
  • Presence of any condition that would interfere with the absorption, distribution, metabolism, or excretion of the drug
  • Current illicit substance or alcohol use or abuse which, in the judgment of the Investigator, will interfere with the patient's ability to comply with the protocol requirements
  • Pregnancy or breast-feeding, intent to become pregnant during the study
  • Patients, who, in the opinion of the Investigator, are unable to comply with the dosing schedule and protocol evaluation or for whom the study may not be advisable
  • Any factor that precludes MRI scan including presence of metal or exposure to metal work (e.g. metal grinder/worker) and claustrophobia
  • Any CNS pathology which, in the judgment of the investigator, will interfere with the ability to assess study change in MRSI
  • Learning disability, history of head injury with prolonged loss of consciousness or cognitive sequelae, history of opportunistic infection of the brain or other non-HIV etiologies that, in the judgment of the investigator, can explain the subjects's mild to moderate cognitive performance.
  • Serum B12 or folate below the lower limits of normal
  • Abnormal TSH, except when free T4 is within normal limits
  • History of untreated or inadequately treated positive RPR
Terms in these criteria, in plain language(17)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

Autoimmune disease

A condition in which the immune system attacks the body’s own tissues, such as rheumatoid arthritis, lupus, psoriasis, type 1 diabetes or inflammatory bowel disease.

Immunotherapy studies often leave out active autoimmune disease, and some name exceptions, such as thyroid disease on replacement hormone. Check the exceptions this study lists.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Excipients

The other ingredients in a medicine besides the active drug, such as fillers, colours or preservatives.

Hemoglobin (Hb)

The protein in red blood cells that carries oxygen. A low level is anaemia, which can cause tiredness and breathlessness. Measured in g/dL or g/L (9 g/dL is 90 g/L).

Absolute neutrophil count (ANC)

The number of neutrophils, white blood cells that help fight infection, in a given amount of blood. Too few raises the risk of infection.

It is a count, not a percentage of the white cells. Limits are written in units that mean the same: ≥ 1.5 × 10⁹/L is ≥ 1,500 per mm³ (µL). Each lab has its own reference range.

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

Creatinine clearance (CrCl)

How quickly the kidneys clear creatinine, a waste product, from the blood. A study may estimate it from a blood test with age, weight and sex (often by the Cockcroft–Gault formula), or measure it using blood and urine collected over a set time. Given in mL/min; higher is better.

ECG (electrocardiogram)

A recording of the heart’s electrical activity, taken with stickers on the chest, arms and legs. It takes a few minutes and does not hurt.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

05

Study design

Phase
Phase 2 / Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Triple (Participant, Care provider, Investigator)
Enrollment
48 participants (actual)

Study arms

  • Placebo comparator
    placebo

    placebo identical in appearance to maraviroc 150 and 300 mg tablets will be added to each subjects antiretroviral regimen at doses as recommended by the package insert

    Drug: Placebo

  • Experimental
    maraviroc

    Maraviroc Tablets are available as 150 mg and 300 mg tablets. Each subject will add maraviroc to their current antiretroviral regimen with dosage based on recommendations as per maraviroc package insert

    Drug: Maraviroc

Interventions

  • Maraviroc administered twice daily, dosage based on concomitant medication being taken.

    Also known as: Selzentry

  • DrugPlacebo

    Maraviroc placebo administered twice daily, dosage based on concomitant medication being taken.

06

What researchers measure

Primary outcomes

  1. Change in Neuropsychological Performance

    Change in global neuro-psychological Z scores and change in various neuro-psychological Z subdomains will be assessed

    Time frame: 48 weeks

Secondary outcomes

  1. Changes in monocyte subsets and function

    Change in monocyte subsets based on CD14 and CD16 expression by flow cytometry; Change in inflammatory and neurotoxic mediators (sCD14, TNFalpha, sCD163 and neopterin

    Time frame: 48 weeks

  2. Change in HIV DNA content within MO subsets

    Change in HIV DNA content specifically within each MO subsets

    Time frame: 48 weeks

  3. Change in brain metabolites by magnetic resonance spectroscopy

    Change in neuronal and inflammatory brain metabolites globally within brain and in select brain regions

    Time frame: 48 weeks

07

Study locations

2 sites
  • Clint Spencer Clinic, Hawaii Center for AIDS, University of Hawaii
    Honolulu, Hawaii 96813, United States
  • Puerto Rico Clinical and Translational Research Consortium
    San Juan, 00936, Puerto Rico
08

References and documents

Publications

  • Ndhlovu LC, Umaki T, Chew GM, Chow DC, Agsalda M, Kallianpur KJ, Paul R, Zhang G, Ho E, Hanks N, Nakamoto B, Shiramizu BT, Shikuma CM. Treatment intensification with maraviroc (CCR5 antagonist) leads to declines in CD16-expressing monocytes in cART-suppressed chronic HIV-infected subjects and is associated with improvements in neurocognitive test performance: implications for HIV-associated neurocognitive disease (HAND). J Neurovirol. 2014 Dec;20(6):571-82. doi: 10.1007/s13365-014-0279-x. Epub 2014 Sep 17. PubMed 25227930 ↗
09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Ran from Jun 2015 to primary completion in Feb 2019, 44 months.

How these figures are worked out, and which studies are left out of them.

Registered
Jun 5, 2014
First posted
Jun 9, 2014
StartActual
Jun 2015
Primary completionActual
Feb 2019
CompletionActual
Feb 2019
Last update
Aug 30, 2021
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Aug 30, 2021, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT02159027
Lead sponsor
University of Hawaii
Collaborators
ViiV Healthcare, University of Puerto Rico
Responsible party
Sponsor
First posted
Jun 9, 2014
Start date
Jun 2015
Primary completion
Feb 2019
Completion
Feb 2019
Last update
Aug 30, 2021

Study contacts

Cecilia M. Shikuma, M.D.
principal investigator · University of Hawaii

Oversight

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

Not currently enrolling

This study is completed, as verified in Aug 2021. You cannot join it, but the record below documents what was studied.

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Studies of the drug tested here: Maraviroc

Start the discussion