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Completed

NCT Number: NCT03041012

Early Administration of Romidepsin and 3BNC117 in Treatment-naïve HIV Patients Starting ART

To evaluate the effect of early viral reactivation by latency reversing agents (LRA) and/or administration of potent broadly neutralizing antibodies (bNAb) on the size of the latent HIV-1 reservoir in treatment naïve HIV-1 patients initiating antiretroviral therapy (ART)

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Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 2

Primary location

Department of Infectious Diseases, Aalborg, Denmark

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About this study

The study will be conducted among ART naïve HIV-1-infected patients.

Subjects will continue ART while receiving LRA romidepsin and/or bNAb 3BNC117.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Documented HIV-1 infection
  • CD4+ T cell count >200/µL on last visit prior to study entry
  • ART naïve
  • Able to give informed consent

Exclusion criteria

  • Any significant acute medical illness (not including primary HIV infection) in the past 8 weeks
  • Any evidence of an active AIDS-defining opportunistic infection
  • Active alcohol or substance use that, in the Investigator's opinion, will prevent adequate compliance with study therapy
  • The following laboratory values at screening, but the values can be repeated within the screening period, but test results must be available before baseline (day 0) and checked for eligibility:
  • Hepatic transaminases (AST or ALT) ≥3 x upper limit of normal (ULN)
  • Serum total bilirubin ≥3 ULN
  • Estimated glomerular filtration rate (eGFR) ≤60 mL/min (based on serum creatinine or other appropriate validated markers)
  • Platelet count ≤100 x10^9/L
  • Absolute neutrophil count ≤1x10^9/L
  • Serum potassium, magnesium, phosphorus outside ≥1.5 ULN/LLN
  • Total calcium (corrected for serum albumin) or ionized calcium ≥1.5 ULN/LLN
  • Hepatitis B or C infection as indicated by the presence of hepatitis B surface antigen (HBsAg) or hepatitis C virus RNA (HCV-RNA) in blood
  • ECG at screening that shows QTc >450 ms when calculated using the Fridericia formula from either lead V3 or V4 [86]
  • Use of:
  • Warfarin or warfarin-derivatives
  • HDACi
  • An agent definitely or possibly associated with effects on QT intervals within 2 weeks of screening
  • Drugs that induce or inhibit CYP3A4 or P-gp
  • History of:
  • Clinically significant cardiac disease, symptomatic or asymptomatic arrhythmias, syncopal episodes, or additional risk factors for Torsades de pointes (e.g. heart failure)
  • Malignancy or transplantation, including skin cancers or Kaposi sarcoma
  • Diabetes mellitus
  • Receipt of strong immunosuppressive or systemic chemotherapeutic agents within 28 days prior to study entry
  • Known resistance to >2 classes of ART
  • Known hypersensitivity to the components of romidepsin, 3BNC117 or their analogues
  • Women who are pregnant or breastfeeding, or with a positive pregnancy test during screening or Women of Child Bearing Potential (WOCBP) who are unwilling or unable to use an acceptable method of non-estrogen containing contraceptions (according to the Danish Medicines Agency guidelines) to avoid pregnancy for the 3 week study period and 4 weeks after study treatment or until undetectable plasma HIV-1 RNA using standard assays
  • Males or females who are unwilling or unable to use barrier contraception during sexual intercourse for the 3-week study period, and 4 weeks after study treatment or until undetectable plasma HIV-1 RNA using standard assays

Treatment and study plan

Romidepsin

Drug

5mg/m2 romidepsin will be administered IV on days 10, 17, and 24 after initiating ART

Other names: Istodax

3BNC117

Drug

30 mg/kg 3BNC117 will be administered IV on day 7 and 21 after initiating ART

Other names: Broadly neutralizing antibody

Antiretrovirals

Drug

Combination antiretroviral therapy

Other names: ART

Primary outcomes

  1. Plasma HIV RNA kinetics

    Time frame: 3 months

    Time to undetectable (<20 c/mL)

  2. Quantification of the size of the proviral HIV reservoir

    Time frame: 1 year

    Copies of total HIV-1 DNA per 10⁶ CD4+ T cells as measured by digital droplet PCR

  3. Time to viral rebound during ATI

    Time frame: 12 weeks

    Days from stopping ART to plasma HIV RNA >5,000 on two consecutive measurements

Secondary outcomes

  1. Incidence of treatment emerging events (Safety and tolerability)

    Time frame: 1 year

    Frequence and severity of adverse events (AE), adverse reactions (AR), serious adverse events (SAE), serious adverse reactions (SAR) and suspected unexpected serious adverse reactions (SUSAR).

  2. Quantification of the intact proviral DNA

    Time frame: 1 year

    Intact HIV-1 DNA in CD4+ T cells (copies per million cells) as measured by dd-PCR.

  3. Quantification of HIV mRNA and/or p24 positive cells

    Time frame: 30 days from study entry

    Frequency of mRNA/p24 postive per 1 million CD4+ T cells by FISH-flow

  4. Immune reconstitution

    Time frame: 1 year

    Absolute CD4+ and CD8+ T cell count

  5. Analytic treatment interruption (ATI) study

    Time frame: 64 weeks

    Time to first plasma HIV RNA >5000 c/mL

  6. Impact of pre-ART virus sensitivity to 3BNC117 on ATI outcomes

    Time frame: Baseline and at viral rebound

    3BNC117 sensitivity determined by PhenoSense and/or HIV env sequencing

  7. T cell mediated HIV specific immunity

    Time frame: First of 365 days

    T cell immunity as determined by the HIV AIM assay

Other outcomes

  1. Plasma cytokine and immune activation biomarker levels

    Time frame: 1 year

    Soluble IL-6, sCD14, sCD163

Sponsors and collaborators

Lead sponsor

Aarhus University Hospital

Other

Collaborators

  • Aalborg University Hospital
  • Hammersmith Hospitals NHS Trust
  • Herning Hospital
  • Hvidovre University Hospital
  • Odense University Hospital
  • Rigshospitalet, Denmark
  • St Mary's Hospital, London

Registry information

Official study title

Early Administration of Latency Reversing Therapy and Broadly Neutralizing Antibodies to Limit the Establishment of the HIV-1 Reservoir During Initiation of Antiretroviral Treatment - a Randomized Controlled Trial

Acronym: eCLEAR

Important dates

Study start
2017
Primary completion
2021
Study completion
2022
First posted
Feb 2, 2017
Registry last updated
Apr 18, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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