Our Unit continues to be a top performing site in the Adult Clinical Trial Network (ACTG). The National Institute of Health (NIH) funds the research conducted through the ACTG. Clinical Trials conducted through the ACTG include, drug resistant HIV trials, Kaposi Sarcoma and Cervical CA studies, drug sensitive and drug resistant Tuberculosis trials, treatment of Hepatitis C, treatment of cognitive impairment in HIV and the reduction of cardiovascular risk in HIV positive individuals on antiretroviral treatment.
Several abstracts from trials conducted at CHRU were presented at the Conference on Retroviruses and Opportunistic Infections (CROI) 2019.
The A5288 study provided third-line ARV treatment for patients failing second-line treatment. The primary results were presented last year. However, a couple of secondary analysis abstracts were presented at CROI 2019.
The Hepatitis C trial is offering treatment that can potentially cure Hepatitis C. These treatments are currently not available in South Africa.
Under the TB agenda the A5338 study that focused on the potential concern for the timing of DPMA injections among women treated for HIV and TB. DPMA is an important form of contraception used by women in resource -limited settings; not much is known about its interaction with rifampicin-based TB treatment. This study provided the first answers regarding the drug-drug interactions between DPMA and Rifampicin based TB treatment in women that are on Efavirenz based ARV’s.
The global results of the STREAM 1 study were released in October 2018 and illustrated that that the comparison between a longer and shorter treatment regimen were non-inferior to each other. The significance of this results is beneficial to standard of care treatment for patients who suffer from MDR TB. The results affirm the World Health Organisation’s recommendation of a shorter treatment regimen. We participated in the global STREAM 2 study but in 2018 recruitment at all South African sites stopped after the national guidelines implemented Bedaquiline as the preferred standard of care treatment, which was also one of the STREAM 2 study drugs.
The CHRU continues to grow its TB Projects through, amongst others, its collaboration with the Ludwig Maximilian University of Munich on the TB Sequel project, which views the long-term impact of TB on the lungs and lung function.
Members of our staff continue to be involved in several committees within the ACTG Network; this gives them the opportunity to contribute to the development of new protocols. CHRU has also contributed to several publications in the past year.