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Ensayos clínicos

Ensayos clínicos

Comparación de dos formas de administrar el tratamiento contra el VIH (Estudio SMART)

Patrocinador(es) del estudio: National Institute of Allergy and Infectious Diseases (NIAID)
Números de identificación: NCT00027352, CPCRA 065
  • Concluido

Propósito del estudio

El propósito de este estudio es comparar dos formas de usar medicamentos antirretrovirales para así ayudar a los proveedores de la salud y los pacientes a determinar cómo usar mejor a través de los años los tratamientos contra el VIH. Muchos proveedores de la salud tratan ahora a los pacientes con medicamentos diariamente para mantener la concentración del VIH en la sangre (carga viral) lo más baja posible. Este método ayuda a aquellos pacientes cuyo recuento de células CD4 está por debajo de 200 a 250 células/mm3 a vivir más tiempo sin padecer de enfermedades graves. Aún no se sabe si esta es la mejor forma de tratar a pacientes con un recuento más alto de células CD4. Existe información que sugiere que los pacientes infectados por el VIH pueden esperar para usar medicamentos contra este virus mientras que sus recuentos de células CD4 sean superiores a 250 células/mm3. Como este estudio se llevará a cabo por vario años, proveerá información sobre las ventajas y desventajas a largo plazo de estas dos estrategias de tratamiento.

Afección:
Infecciones por el VIH

Detalles del estudio

La implementación de las pautas del tratamiento antirretroviral (ART), que hace énfasis en la supresión máxima y duradera de la carga viral para la mayoría de las personas infectadas por el VIH, ha dado como resultado una disminución considerable en las tasas de morbilidad y mortalidad. Sin embargo, muchos pacientes asintomáticos no corren un riesgo inmediato de enfermedades oportunistas graves, la eficacia del tratamiento antirretroviral disminuye con el tiempo debido a la resistencia al medicamento contra el VIH y hay toxicidad del tratamiento a corto y largo plazo. Esto motiva a la comparación de dos estrategias: Una que mantiene los tratamientos difiriendo su uso mientras que el riesgo de enfermedad oportunista es bajo y otra cuya finalidad es la supresión virológica continua, independientemente del riesgo de enfermedad. En este ensayo grande, a largo plazo, los pacientes serán asignados al azar ya sea al grupo de conservación del medicamento (DC) o al grupo de supresión viral (VS). Los pacientes se inscribirán durante un periodo de 3 años y se les hará seguimiento por un promedio de 7.5 años. El grupo DC suprimirá o pospondrá el tratamiento antirretroviral (ART) hasta que el recuento de células CD4 llegue a por debajo de 250 células/mm3, en ese momento recibirán tratamiento para aumentar el recuento de CD4 a por encima de 350 células/mm3, seguido de tratamiento antirretroviral episódico basado en el recuento de células CD4. El grupo VS usará el tratamiento antirretroviral para mantener la carga viral tan baja como sea posible, independientemente del recuento de células CD4. Los pacientes asistirán a consulta médica en los meses 1, 2, 4, 6, 8, 10 y 12 y luego cada cuatro meses para visitas de recolección de datos. Todos los tratamientos antirretrovirales estarán disponibles, incluso los inmunomoduladores y las pruebas de resistencia pueden usarse para los pacientes en los dos grupos de tratamiento. A ciertas submuestras de pacientes inscritos en el estudio se les hará seguimiento con una recolección de datos más intensa para ver el resultado secundario relacionado al costo y utilización de la atención médica, calidad de vida, riesgos de comportamiento para la transmisión del VIH y complicaciones metabólicas del tratamiento.

Criterios de inclusión

    Los pacientes podrán participar en el estudio si:
    • Han comprobado que tienen infección por el VIH.
    • Tienen un recuento de células CD4 superior a 350 células/mm3 durante los 45 días anteriores al ingreso al estudio.
    • Están dispuestos a empezar, cambiar o suspender el tratamiento antirretroviral.
    • Se comprometen a usar métodos eficaces de control de la natalidad.
    • Tienen buena salud al momento del ingreso al estudio.
    • Están disponibles para participar en el estudio por lo menos por 6 meses.
    • Pueden, según la opinión del investigador, cumplir con el protocolo.

Criterios de exclusión

    Los pacientes no podrán participar en el estudio si:
    • Actualmente participan en el estudio CPCRA FIRST, MDR-HIV o NvR u otro estudio que no es coherente con uno de los grupos de tratamiento en este estudio.
    • Están embarazadas o dando de pecho.

Centros de estudio/contactos

Georgia

    Absolute Care Clinic, Atlanta, Georgia, 30308, United States

    AID Atlanta/Morehouse Med School Ryan White Cl, Atlanta, Georgia, 30308, United States

California

    AIDS Healthcare Foundation, Los Angeles, California, 90015, United States

    AIDS Medical Center, International Medical Center, Tokyo, California, 162-8655, Japan

Illinois

    AIDS Research Alliance - Chicago, Chicago, Illinois, 60657, United States

Georgia

    AIDS Research Consortium of Atlanta (ARCA) Central, Atlanta, Georgia, 30308, United States

    Alfred Hosp, Prahan, Georgia, 30308, Australia

    Ambulatorio de Imunodeficiencias Secundarias/Der30, Sao Paulo, Georgia, 01246-900, Brazil

    Bamrasnaradura Institute, Nonthaburi 11000, Georgia, 01246-900, Thailand

    Barts and The London, NHS Trust, London, Georgia, EC1A 7BE, United Kingdom

New York

    Bronx Veterans Affairs Medical Center, Bronx, New York, 10468, United States

    Bronx-Lebanon Hosp Ctr, Bronx, New York, 10453, United States

    Burwood Street General Pratice, Burwood Nsw, New York, 2134, Australia

    C.H.U. Fort-de-France, Fort-de-france, New York, 97261, Martinique

    CAICI, Rosario, New York, 97261, Argentina

    Cassiano Antonio de Moraes University Hospital, Boqueirao-Santos, New York, 11045-904, Brazil

Florida

    Center for Prevention and Treatment of Infections, Pensacola, Florida, 32504, United States

    Central Middlesex Hospital, London, Florida, NW10 7NS, United Kingdom

Quebec

    Centre hospitalier de l'universite Laval (CHUL), Sainte-Foy, Quebec, F1V 4G2, Canada

    Centre Hospitalier de Luxembourg, Barble, Quebec, L-1210, Luxembourg

    Centre Hospitalier Universitaire, Chu-grenoble, Quebec, L-1210, France

    Centre Hospitalier Universitaire Sart-Tilman, Liege, Quebec, 4000, Belgium

    Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Quebec, 1011, Switzerland

    Centro de Pesquisa Clinical do Hospital Guilherme, Boqueirao-Santos, Quebec, 11045-904, Brazil

    Centro de Referencia e Treinamento DST/AIDS, San Paulo, Quebec, 04121-000, Brazil

    Chelsea and Westminster Hospital, London, Quebec, SW10 9NH, United Kingdom

    Christchurch Hosp, Christchurch, Quebec, SW10 9NH, New Zealand

Delaware

    Christiana Care Health Services HIV Program George, Wilmington, Delaware, 19801, United States

    CHU de la Region Annecienne, Annecy, Delaware, 74011, France

    Clinica Malattie Infettive, Pavia, Delaware, 27100, Italy

Quebec

    Clinique Medicale L'actuel, Montreal, Quebec, H2L 4P9, Canada

Georgia

    Cobb-Douglas County Infectious Disease Clinic, Atlanta, Georgia, 30308, United States

California

    Community Consortium / UCSF, San Francisco, California, 94110, United States

Massachusetts

    Community Research Initiative/ProACT, Springfield, Massachusetts, 01107, United States

    Community Research Initiatives of New England, Boston, Massachusetts, 02215, United States

    Community Research Initiatives/ProACT, Boston, Massachusetts, 02215, United States

    Consorcio Hospital General Universitario de Valencia, Valencia, Massachusetts, 46014, Spain

Illinois

    Cook County Hosp, Chicago, Illinois, 606576156, United States

New Jersey

    Cooper Hospital Early Intervention Program, Camden, New Jersey, 08103, United States

Virginia

    Cross Over Clinic / Div of Infectious Diseases, Richmond, Virginia, 232980049, United States

Georgia

    Dekalb County Health Dept Infectious Disease, Atlanta, Georgia, 30308, United States

Colorado

    Denver CPCRA / Denver Public Hlth, Denver, Colorado, 802044507, United States

    Dept. of Infection and Tropical Medicine - Royal Hallamshire Hospital, Sheffield, Colorado, S10 2JF, United Kingdom

Michigan

    Detroit Community Health Connection, Detroit, Michigan, 48201, United States

    Detroit Receiving, Detroit, Michigan, 48201, United States

British Columbia

    Downtown Infectious Disease Clinic, Vancouver, British Columbia, V6Z 2C7, Canada

Georgia

    Dr. Dennis Melton (Private Practice), Atlanta, Georgia, 30308, United States

    Dr. Melanie Thompson and Dr. Annette Bernard (Private Practice), Atlanta, Georgia, 30308, United States

    Dr. Richard Hudson (Private Practice), Atlanta, Georgia, 30308, United States

California

    Dr. Shawn Hassler, San Francisco, California, 94110, United States

Colorado

    Drs. Lichtenstein & Greenberg, Denver, Colorado, 80204-4507, United States

California

    East Bay AIDS Ctr, San Francisco, California, 94110, United States

Pennsylvania

    Einstein Medical Center, Philadelphia, Pennsylvania, 19140, United States

    Essex County Hospital, Essex, Pennsylvania, CO3 3NB, United Kingdom

District of Columbia

    George Washington Univ, Washington, District of Columbia, 20422, United States

New York

    Grant Houses Health Ctr, New York, New York, 10037, United States

Ontario

    Hamilton Health Science Centre-McMaster, Hamilton, Ontario, L8N 3Z5, Canada

    Hawthorn House, Birmingham Heartlands NHS Trust, Birmingham, Ontario, B9 5SS, United Kingdom

Michigan

    Henry Ford Hosp, Detroit, Michigan, 48202, United States

New York

    HHC MMC Unit #1, New York, New York, 10037, United States

    HHC Outpatient Clinics, New York, New York, 10037, United States

Ontario

    HIV Care Program, Windsor Regional Hospital, Windsor, Ontario, N8W 1E3, Canada

Idaho

    HIV Services Clinic/Family Practice Medical Center, Boise, Idaho, 83704, United States

    Homerton University Hospital NHS Foundation Trust, London, Idaho, E9 6SR, United Kingdom

    Hopital de la Ville, La Chaux-de-Fonds, Idaho, 2300, Switzerland

    Hopital Louis Mourier, Colombes, Idaho, 2300, France

    Hopital Pellegrin, Bordeaux, Idaho, 33076, France

    Hopital Pitie Salpetriere, Paris, Idaho, 75651, France

    Hopital Saint-Louis, Paris, Idaho, 75010, France

    Hopital Sainte-Marguerite, Marseille, Idaho, 13009, France

    Hospital Central, Mendoza, Idaho, 13009, Argentina

    Hospital de Clinicas de Porto Alegre, Porto Alegre-RS Cep, Idaho, 90035, Brazil

    Hospital de Clinicas Jose de San Martin, Buenos Aires, Idaho, 90035, Argentina

    Hospital de Infecciosas F.J. Muniz, Buenos Aires, Idaho, 90035, Argentina

    Hospital de la Santa Creu i Sant Pau, Barcelona, Idaho, E08025, Spain

    Hospital dos Servidores do Estado, Rio de Janeiro, Idaho, 20221-903, Brazil

RJ

    Hospital Escola Sao Francisco de Asis, Rio de Janeiro, RJ, 20210.030, Brazil

    Hospital Gn'l de Agudos JM Ramos Mejia, Buenos Aires, RJ, 20210.030, Argentina

    Hospital Gn'l de Agudos T. Alvarez, Buenos Aires, RJ, 20210.030, Argentina

    Hospital Interzonall de San Juan de Dios, La Plata, RJ, 20210.030, Argentina

    Hospital Italiano de Buenos Aires, Buenos Aires, RJ, 20210.030, Argentina

    Hospital Mutua de Terrassa, Terrassa, RJ, 08221, Spain

    Hospital Nacional Edgardo Rebagliati Martins, Lima, RJ, 11, Peru

    Hospital Nacional Guillermo Almenara Irigoyen, Lima, RJ, 13, Peru

RS

    Hospital Nossa Senhora da Conceicao, Porto Alegre, RS, 91350-200, Brazil

    Hospital Rawson, Cordoba, RS, 91350-200, Argentina

    Hospital U. Virgen del Rocio, Sevilla, RS, 41013, Spain

    Hospital Universitario de La Princesa, Madrid, RS, E-28006, Spain

    Hospital Universitario Principe de Asturias, Madrid, RS, E-28805, Spain

    Hospital Universitario Professor Edgard Santos, Salvador-BA, RS, 110-160, Brazil

Texas

    Houston Veterans Administration Med Ctr, Houston, Texas, 77030, United States

    I.R.C.C.S."L.Spallanzani", Rome, Texas, 00149, Italy

Virginia

    Infectious Disease Associates of Virginia, Lynchburg, Virginia, 24501, United States

    Institute of Tropical Medicine, Antwerp, Virginia, 2000, Belgium

    Instituto A. Z. de Pesquisa e Ensino, Curitiba, Virginia, 80430-040, Puerto Rico

S.p. Cep

    Instituto de Infectologia Emilio Ribas, Sao Paulo, S.p. Cep, 01246, Brazil

    Instituto de Malattie Infettive e Tropicali, Brescia, S.p. Cep, I-25125, Italy

    International Medical Center of Japan, Tokyo, S.p. Cep, 162-8655, Japan

New York

    Jacobi Medical Center, New York, New York, 10037, United States

New Jersey

    Jeffrey Bomser Clinic / NJCR, Newark, New Jersey, 07103, United States

    Jersey Shore Med Ctr, Neptune, New Jersey, 07753, United States

    Johann Wolfgang Goethe University Hospital, Frankfort, New Jersey, 60590, Germany

England

    John Radcliffe Hospital, Oxford, England, OX3 9DU, United Kingdom

California

    Kaiser Permanente-Fremont/Hayward Medical Centers, Fremont, California, 94538, United States

Illinois

    Klein and Slotten Associates / AIDS Research Alliance, Chicago, Illinois, 606576156, United States

    Klinik fur Dermatologie, Venerologie, Allergologie, Essen, Illinois, 45122, Germany

    Klinikum der Ruprecht-Karis-Universitat (U. Hospital), Heidelberg, Illinois, D-69115, Germany

Kansas

    KU Medical School-Wichita, Midtown Clinic, Wichita, Kansas, 37214-3199, United States

    KU Medical School-Wichita, MPA, Wichita, Kansas, 37214-3199, United States

Illinois

    Lakeshore Infectious Disease Associates, Chicago, Illinois, 606576156, United States

California

    Lawrence Goldyn, MD, San Francisco, California, 94110, United States

Oregon

    Legacy Clinic NE, Portland, Oregon, 97209-2534, United States

New York

    Lenox Avenue Health Ctr, New York, New York, 10037, United States

    Lincoln Medical & Mental Health Center, New York, New York, 10037, United States

    Lithuanian AIDS center, Vilnius, New York, 03011, Lithuania

California

    Los Angeles Gay and Lesbian Community Service Ctr, Los Angeles, California, 90028, United States

Louisiana

    Louisiana Comm AIDS Rsch Prog / Tulane Univ Med, New Orleans, Louisiana, 70112, United States

    Malattie Infettive Busto, Busto Arsizio (va), Louisiana, 21052, Italy

Minnesota

    Mayo Clinic/CORNET, Rochester, Minnesota, 55905, United States

Michigan

    McAuley Health Center, Grand Rapids, Michigan, 49503, United States

Colorado

    McDowell Healthcare Center, Denver, Colorado, 80204, United States

Virginia

    McGuire VA / Division of Infectious Diseases, Richmond, Virginia, 232980049, United States

    MCV ID Clinic, Richmond, Virginia, 23298, United States

    MediCorp, Infectious Disease Associates, Richmond, Virginia, 23298, United States

New York

    Metropolitan Hospital Center, New York, New York, 10039, United States

Florida

    Miami Veterans Affairs Med Ctr, Miami, Florida, 33125, United States

Michigan

    Michigan State University Infectious Diseases Clinic, Lansing, Michigan, 48910, United States

Quebec

    Montreal Chest Institute/Royal Victoria Hospital, Montreal, Quebec, H2X 2P4, Canada

Texas

    Montrose Clinic, Houston, Texas, 77006, United States

Michigan

    Mt. Clemens General Hospital, Detroit, Michigan, 48202, United States

    National Centre in HIV Epidemiology and Clinical Research, Sydney, Michigan, 48202, Australia

New Jersey

    New Jersey Community Research Initiative, Newark, New Jersey, 07103, United States

    Newcastle General Hospital, Newcastle, New Jersey, NE4 6BE, United Kingdom

    NJCRI, Newark, New Jersey, 07103, United States

Illinois

    Northside Family Medicine, Chicago, Illinois, 60657, United States

    Northwestern Memorial Physicians, Chicago, Illinois, 60657, United States

    Ospedale Regionale di Lugano, Lugano, Illinois, 6903, Switzerland

Louisiana

    Our Lady of the Lake Regional Med Ctr, New Orleans, Louisiana, 701122699, United States

    Pasteur Suite, Ealing Hospital, Middlesex, Louisiana, UB1 3HW, United Kingdom

Pennsylvania

    Penn Community Infectious Diseases, Philadelphia, Pennsylvania, 19107, United States

Virginia

    Petersburg Health Care Alliance, Richmond, Virginia, 23298, United States

Pennsylvania

    Philadelphia FIGHT, Philadelphia, Pennsylvania, 19107, United States

    Poliklinik fur Infektiologie, Bern, Pennsylvania, 3010, Switzerland

New York

    Polo Grounds Health Care Ctr, New York, New York, 10037, United States

Victoria

    Prahran Market Clinic, South Yarra, Victoria, 10037, Australia

Michigan

    Providence Hosp- Newland Med Assoc. Inc., Detroit, Michigan, 48202, United States

Nova Scotia

    Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, NS B3H 1V7, Canada

    Ramathibodi Hospital, Tel Aviv, Nova Scotia, 64239, Israel

New Jersey

    Raritan Bay Med Ctr, Newark, New Jersey, 071032842, United States

Quebec

    Recherche Clinique Centre Medical Halles de Saint-, Ste-Foy, Quebec, G1V 4P9, Canada

South Australia

    Royal Adelaide Hospital, Adelaide, South Australia, G1V 4P9, Australia

    Royal Free Hospital, London, South Australia, NW3 2QG, United Kingdom

    Royal Perth Hosp, Perth, South Australia, NW3 2QG, Australia

    Royal Prince Alfred Hospital, Prahan, South Australia, NW3 2QG, Australia

    Royal Victoria Hospital, Belfast, South Australia, BT12 6BA, United Kingdom

    S.S. Giovanni e Paolo Hospital, Venice, South Australia, BT12 6BA, Italy

New Jersey

    Saint Michael's Med Ctr, Newark, New Jersey, 071032842, United States

Oregon

    Salem Hospital, Portland, Oregon, 97209-2534, United States

    Sanpatong Hospital, Chiang Mai, Oregon, 50120, Thailand

    Servizio Regionale di Immunologia Clinica e Tipizz, Torrette Di Ancona, Oregon, 71-60020, Italy

    SOCDU Malattie Infettive Ospedale Civile Asti, Asti, Oregon, 14100, Italy

New Jersey

    South Jersey Infectious Disease, Somers Poinnt, New Jersey, 08244, United States

Virginia

    South Richmond Health Ctr, Richmond, Virginia, 23298, United States

Texas

    South Texas Veterans Health Care System, San Antonio, Texas, 78229, United States

Illinois

    Southern Illinois University (SIU) School of Medicine, Springfield, Illinois, 62702, United States

    Southmead Hospital, Bristol, Illinois, BS10 5NB, United Kingdom

    St. George's Hospital, London, Illinois, SW17 ORE, United Kingdom

    St. Helier Hospital, Carshalton, Illinois, SM5, 1AA, United Kingdom

    St. Helier Hospital, Carshalton, Surrey, Illinois, SM5, 1AA, United Kingdom

    St. James Hospital, Dublin 8, Illinois, SM5, 1AA, Ireland

Ontario

    St. Joseph's Health Care Centre of London, London, Ontario, N5Y 3H6, Canada

    St. Josephs Hospital, London, Ontario, N5Y 3H6, Canada

    St. Mary's Hospital, London, Ontario, W1 2NY, United Kingdom

    St. Thomas' Hospital, London, Ontario, SE1 7EH, United Kingdom

New York

    SUNY Downstate Med Ctr, Brooklyn, New York, 11023, United States

    Syndenham Neighborhood Family Care Ctr, New York, New York, 10037, United States

    T1 Coleridge Unit, North Middlesex Hospital, London, New York, SE5 9RS, United Kingdom

Pennsylvania

    Temple Univ School of Medicine, Philadelphia, Pennsylvania, 19140, United States

    The Caldecot Centre, Kings College Hospital NHS Tr, London, Pennsylvania, SE5 9RS, United Kingdom

Victoria

    The Centre Clinic, South Yarra, Victoria, SE5 9RS, Australia

Ontario

    The HAVEN Program, HRSRH, Sudbury, Ontario, P3E 5J1, Canada

    The James Cook University Hospital, Middlesbrough, Ontario, TS4 3BW, United Kingdom

    The Mortimer Market Center, London, Ontario, WC1E 6AU, United Kingdom

Oregon

    The Research & Education Group / Multomah Cnty Hlth Dept, Portland, Oregon, 972105311, United States

    The Research & Education Group / The R & E Grp Office, Portland, Oregon, 972105311, United States

    The Research & Education Grp / Oregon Hlth Sci Univ, Portland, Oregon, 972105311, United States

    The Research and Education Group, Portland, Oregon, 97210, United States

    The Rsch & Ed Grp / Legacy Cln at Good Samaritan, Portland, Oregon, 972105311, United States

    The Rsch & Ed Grp / Providence Portland Med Ctr, Portland, Oregon, 972105311, United States

District of Columbia

    Timothy A Price, Washington, District of Columbia, 204220001, United States

Florida

    Treasure Coast Infectious Disease Consultants, Vero Beach, Florida, 32960, United States

Ontario

    Tronto General Hospital, Toronto, Ontario, M5G 2N2, Canada

    U.O. Malattie Infettive, H.S.Maria Annunziata, Antella-Firenze, Ontario, 50011, Italy

    Ulleval Hospital, Oslo, Ontario, N-0407, Norway

    Unidade de Pesquisa Clinica, San Paulo, Ontario, 13083-970, Brazil

Oklahoma

    Univ of Oklahoma Health Sciences, Oklahoma City, Oklahoma, 73104, United States

Texas

    Univ TX Health Science Ctr, Houston, Texas, 77030, United States

    Universidade Federal De Sao Paulo-Hospital Sao Paulo, Sao Paulo, Texas, 04040-002, Brazil

    Universita degli Studi di Modena e Reggio Emilia, Modena, Texas, 41100, Italy

    University Clinical Research Center, Houston, Texas, 77030, United States

Quebec

    University de Sherbrooke, Fleurimont, Quebec, JIH 5N4, Canada

    University Hospital Basel, Basel Ch, Quebec, 4031, Switzerland

    University Hospital Zurich, Zurich Ch-, Quebec, 8091, Germany

Illinois

    University of Chicago, Chicago, Illinois, 60657, United States

    University of Illinois at Chicago, Chicago, Illinois, 606576156, United States

Michigan

    University of Michigan Health System, Ann Arbor, Michigan, 48100-0378, United States

Louisiana

    University of Mississippi Medical Center, New Orleans, Louisiana, 70112-2699, United States

    University of Turin, Torino, Louisiana, 10149, Italy

    University of Vienna Medical School, AKH, Vienna, Louisiana, A-1090, Austria

Wisconsin

    University Of Wisconsin Hospital and Clinics/CORNET, HIV Care Program, Madison, Wisconsin, 53792, United States

Virginia

    Vernon J. Harris East End Community Health Care Ct, Richmond, Virginia, 23298, United States

Connecticut

    Veterans Administration Medical Center, New Haven, Connecticut, 06510, United States

    Victoria General Hospital, Q.E. II Health Sciences, Halifax, Connecticut, 06510, United Kingdom

North Carolina

    Wake Forest Univ Health Sciences, Winston-Salem, North Carolina, 27157-1042, United States

District of Columbia

    Washington Reg AIDS Prog / Dept of Infect Dis, Washington, District of Columbia, 20422, United States

    Watford Sexual Health Center;Watford General Hosp, Watford Wd, District of Columbia, 18 0HB, United Kingdom

Michigan

    Wayne State Univ / Medical College of Ohio at Toledo, Detroit, Michigan, 48201, United States

    Wellington Hosp, Wellington, Michigan, 48201, New Zealand

    West-Tallinn Central Hospital, Tallinn, Michigan, 10617, Estonia

Colorado

    Western Infectious Disease Consultants, Denver, Colorado, 80204-4507, United States

Michigan

    William Beaumont Hospital/CORNET, Royal Oak, Michigan, 48073, United States

    Wroclaw University School of Medicine, Koszarowa Str. 5, Michigan, 48073, Poland

Connecticut

    Yale U / New Haven Med Ctr / AIDS Clinical Trials Unit, New Haven, Connecticut, 065102483, United States

Actualizado: 12 de noviembre del 2004

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