The CAMbodian Early vs. Late Introduction of Antiretrovirals (CAMELIA) clinical trial reached an important milestone on May 28, 2009, when the 661st and final patient entered the study. The trial, the first international study to take place in Cambodia, is testing whether starting severely immunodeficient AIDS patients who have tuberculosis (TB) on antiretroviral medication (AIDS drugs) either two weeks or two months after beginning their TB treatment results in better survival and fewer side effects. With enrollment completed, the researchers expect to have the answer by the spring of 2010.
CAMELIA represents a unique international collaboration between US, French, and Cambodian clinicians and scientists. The results will have major impact on the treatment of TB and AIDS co-infection not only in Cambodia but also internationally, particularly in impoverished regions of the world where the two diseases are epidemic.
The study, which formally began in 2006, involves five hospitals, two in the in the capital city of Phnom Penh and one each in rural Svay Rieng, Siem Riep and Takeo provinces. It is funded as part of a five year, $2.5 million dollar grant originally awarded to the CHC in 2003 from the United States National Institutes of Health (NIH), through its Comprehensive International Program for Research on AIDS (CIPRA). The French Agence Nationale de Recherches sur le Sida et les Hepatides Virales (ANRS) is co-sponsoring the study, and other partners include the Cambodian National AIDS and TB Programs, and Medicins Sans Frontiers-Belgium.
Beyond providing much-needed information to steer effective treatment, CAMELIA's collateral benefits include the improvement of the treatment, research and teaching infrastructure for TB and HIV in Cambodia. A major bonus of the study is the training of staff and the enhancement of care that patients are receiving, whether or not they are part of the study. In addition, the transformation of run-down, under equipped hospitals into modern research centers will allow Cambodian doctors and patients to participate fully in the testing of new therapies and vaccines for HIV and TB as they are developed. Finally, nested in CAMELIA are a series of basic research studies that are giving researchers new understanding of the complex immunological response to treatment in HIV and TB co-infected patients, knowledge that will help to develop the next generation of therapies.
Even before its conclusion, CAMELIA has achieved three major goals of the CHC: the delivery of first-rate care, the development of new operational approaches with global impact, and the merging of clinical and basic research to pave the way for future treatments.