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Trial registered on ANZCTR
Registration number
ACTRN12610001097033
Ethics application status
Approved
Date submitted
4/02/2010
Date registered
15/12/2010
Date last updated
6/07/2012
Type of registration
Prospectively registered
Titles & IDs
Public title
A randomised, double-blind, placebo-controlled, clinical trial to compare the safety and efficacy of reduced dose efavirenz (EFV) with standard dose EFV plus two nucleotide reverse transcriptase inhibitors (N(t)RTI) in antiretroviral-naïve Human Immunodeficiency virus (HIV)-infected individuals over 96 weeks.
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Scientific title
A randomised, double-blind, placebo-controlled, clinical trial to compare the safety and efficacy of reduced dose efavirenz (EFV) with standard dose EFV plus two nucleotide reverse transcriptase inhibitors (N(t)RTI) in antiretroviral-naïve Human Immunodeficiency virus (HIV)-infected individuals over 96 weeks.
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Secondary ID [1]
253295
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Encore1
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Universal Trial Number (UTN)
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Trial acronym
Encore1
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
HIV infection
252037
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Condition category
Condition code
Infection
252227
252227
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0
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Acquired immune deficiency syndrome (AIDS / HIV)
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
400mg Efavirenz plus 300 mg tenofovir and 200mg emtricitabine for 1 year once daily for each oral tablets
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Intervention code [1]
241434
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Treatment: Drugs
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Comparator / control treatment
600mg Efavirenz plus 300 mg tenofovir and 200mg emtricitabine for 1 year once daily oral tablets
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Control group
Dose comparison
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Outcomes
Primary outcome [1]
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To compare between treatment groups the proportions of patients with HIV Ribonucleic acid (RNA) <200 copies/mL 96 weeks after randomisation by blood assay
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Assessment method [1]
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Timepoint [1]
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2 years after randomisation
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Secondary outcome [1]
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Proportion of patients at 48 weeks with plasma HIV RNA <400 copies/mL and <50 copies/mL through blood assay
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Assessment method [1]
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Timepoint [1]
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2 years after randomisation
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Secondary outcome [2]
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Change from baseline in white blood T cell count/microlitre by blood assay.
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Assessment method [2]
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Timepoint [2]
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2 years after randomisation
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Secondary outcome [3]
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Rate of opportunistic disease or death by statistical analysis
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Assessment method [3]
268639
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Timepoint [3]
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2 years after randomisation
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Secondary outcome [4]
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Cahnge from baseline in fasted lipids (cholesterol, good and bad fats) by fasting blood analysis.
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Assessment method [4]
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Timepoint [4]
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2 years after randomisation
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Secondary outcome [5]
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Change from baseline in selected body biochemicals such as sodium, potassium, calcium etc.
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Assessment method [5]
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Timepoint [5]
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2 years after randomisation
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Secondary outcome [6]
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self reported adherence to randomised study medications by questionnaires
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Assessment method [6]
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Timepoint [6]
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2 years after randomisation
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Secondary outcome [7]
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Change from baseline health status scores by questionnaires
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Assessment method [7]
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Timepoint [7]
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2 years after randomisation
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Secondary outcome [8]
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Patterns of genotypic viral resistance from medications
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Assessment method [8]
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Timepoint [8]
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2 years after randomisation
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Secondary outcome [9]
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Steady state efavirenz concentrations measured by plasma and dried blood spot sample analysis
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Assessment method [9]
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Timepoint [9]
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2 years after randomisation
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Secondary outcome [10]
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Relationship between dried blood spot and plasma samples when measuring viral load and efavirenz concentrations
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Assessment method [10]
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Timepoint [10]
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2 years after randomisation
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Eligibility
Key inclusion criteria
*HIV-1 positive by licensed diagnostic test
*aged >16 years of age (or minimum age as determined by local regulations or as legal requirements dictate)
*50 < CD4 <350 cells/microlitres or previous aquired immune deficiency syndrome-defining illness
*HIV RNA greater than or equal to 1000 copies/mL
*no prior exposure to antiretrovirals (including short course antiretrovirals for preventing mother to child transmission)
*calculated creatinine clearance (CLCr) must be greater than or equal to 50 mL/min (Cockcroft-Gault formula)
*provision of written informed consent.
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Minimum age
16
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
*the following laboratory values:
*absolute neutrophil count (ANC) <500 cells/microlitre
*hemoglobin <7.0 g/dL
*platelet count <50,000 cells/microlitre
*alanine aminotransferase and/or aspartate aminotransferase >5 x upper limit of normal
*pregnant women or nursing mothers
*active opportunistic or malignant disease not under adequate control
*use of immunomodulators within 30 days prior to screening
*use of any prohibited medications
*current alcohol or illicit substance use that might adversely affect study participation.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
If the participant agreed to participate in the study they will be randomised to receive truvada with either the standard or reduced dose of efavirenz. Which of the two regimens they will receive will be chosen at random by a computer and the doctor has no influence on the treatment chosen for them. Participants will have an equal (1:1) chance of receiving either regimen. This is a double-blind study so neither participant nor the doctor will be aware of which treatment participants are receiving.
Participants will be told which treatment they were given as soon as the final study results are released.
participants are required to attend the clinic on 11 occasions and have one telephone interview over the 96 weeks of the study.
allocation will be done by the study statisticial who will program this to the computer.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Which of the two regimens participants will receive will be chosen at random by a computer. It will generate a three letter code (usually first letter of the first name and two letters of the last name) and a 5 randomisation number.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 3
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Active, not recruiting
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Date of first participant enrolment
Anticipated
24/08/2011
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
630
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Recruitment outside Australia
Country [1]
2273
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Argentina
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State/province [1]
2273
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Country [2]
2274
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Chile
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State/province [2]
2274
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Country [3]
2275
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China
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State/province [3]
2275
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Country [4]
2276
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Germany
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State/province [4]
2276
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Country [5]
2277
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Hong Kong
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State/province [5]
2277
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Country [6]
2278
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India
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State/province [6]
2278
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Country [7]
2279
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Israel
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State/province [7]
2279
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Country [8]
2280
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Malaysia
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State/province [8]
2280
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Country [9]
2281
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Mexico
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State/province [9]
2281
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Country [10]
2282
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Nigeria
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State/province [10]
2282
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Country [11]
2283
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Singapore
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State/province [11]
2283
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Country [12]
2284
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South Africa
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State/province [12]
2284
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Country [13]
2285
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Taiwan, Province Of China
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State/province [13]
2285
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Country [14]
2286
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Thailand
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State/province [14]
2286
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Country [15]
2287
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United Kingdom
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State/province [15]
2287
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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University of New South Wales
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Address [1]
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UNSW Sydney NSW 2052
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Country [1]
256467
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Australia
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Primary sponsor type
Government body
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Name
National Centre for HIV Epidemiology and Clinical Research
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Address
45 beach street, Coogee. New South Wales 2034
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Country
Australia
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Secondary sponsor category [1]
255777
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None
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Name [1]
255777
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Address [1]
255777
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Country [1]
255777
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
258520
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St Vincent's Hospital Human Research Ethics Committee
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Ethics committee address [1]
258520
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Level 6, de Lacy Building St Vincents Hospital 390 Victoria Street, Darlinghurst NSW 2010
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Ethics committee country [1]
258520
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Australia
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Date submitted for ethics approval [1]
258520
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01/03/2010
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Approval date [1]
258520
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05/05/2010
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Ethics approval number [1]
258520
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10/056
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Summary
Brief summary
The recommended dosage for some drugs currently used to treat HIV infection is highly effective but clinical data suggests that the doses could be reduced without compromising their effectiveness. Lower drug doses could have fewer side effects and could be tolerated better, making it easier for people to take and stay on their anti-HIV medication. Dose reduction would also make the drugs cheaper; this would allow more people to be treated and free up money for other important work in the fight against HIV such as education and prevention programs. Two different regimens containing either the standard dose or a reduced dose of efavirenz will be compared: I. efavirenz 600mg + truvada (tenofovir and emtricitabine) II. efavirenz 400mg + truvada (tenofovir and emtricitabine) Tenofovir, emtricitabine and efavirenz are all licensed as individual drugs for the treatment of HIV disease in many countries around the world. Efavirenz is only licensed at the standard dose of 600mg. Emtricitabine and tenofovir are provided as a fixed dose combination that is not currently licensed in every country involved in this study. A fixed dose combination means that the two drugs are incorporated into one pill.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Dr. Rebekah Puls
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Address
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45 Beach Street, Coogee, New South Wales, Australia, 2034
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Country
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Australia
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Phone
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+612 9385 0900
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Fax
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+612 9385 0910
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Email
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[email protected]
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Contact person for scientific queries
Name
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Dr. Mark Boyd
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Address
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45 Beach Street, Coogee, New South Wales, Australia, 2034
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Country
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Australia
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Phone
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+612 9385 0900
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Fax
4578
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+612 9385 0910
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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