This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. This is a phase II randomized double-blind trial of the safety and efficacy of an orally-administered CCR5 inhibitor, a new class of antiretroviral drugs. Individuals on a failing HIV antiretroviral regimen containing ritonavir will have the inhibitor added for 14 days to assess its antiviral potency and safety. Comparisons will be made with regimens containing placebo, 5, 10, and 15 mg doses. The individuals will then have a new antiretroviral backbone added to the therapy. Pharmacokinetics will be done. This 'long-term' phase of the study will continue for 46 weeks. Animal data suggests that prolonged QT and seizures are possible at higher doses. Data obtained thus far have not substantiated this in humans and the doses used. The protocol addresses these possible toxicities. There is also concern that inhibiting R5 viruses that use CCR5 will result in the selection of CXCR4 viruses that don't use the CCR5 receptor. This will also be monitored.
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