Safety and Efficacy of Darunavir/Cobicistat/Emtricitabine/GS-7340 Single Tablet Regimen Versus Cobicistat-boosted Darunavir Plus Emtricitabine/Tenofovir Disoproxil Fumarate Fixed Dose Combination in HIV-1 Infected, Antiretroviral Treatment Naive Adults

• Percentage of subjects with HIV-1 RNA < 50 copies/mL at Week 48 [ Time Frame: 48 Weeks ] [ Designated as safety issue: No ]
  The percentage of subjects with HIV-1 RNA < 50 copies/mL at Week 48.
• Change from baseline in log10 HIV-1 RNA and in CD4+ cell count at Weeks 24 and 48 [ Time Frame: 24 & 48 Weeks ] [ Designated as safety issue: No ]
  The change from baseline in log10 HIV-1 RNA and in CD4+ cell count at Weeks 24 and 48.

To evaluate the efficacy of a regimen containing darunavir/cobicistat/emtricitabine/GS-7340 versus darunavir and cobicistat plus emtricitabine/tenofovir disoproxil fumarate in HIV-1 infected, antiretroviral treatment-naive adult subjects as determined by the achievement of HIV-1 RNA < 50 copies/mL at Week 24.

Randomized, double-blinded, multicenter, active-controlled study to assess the safety and efficacy of a regimen containing darunavir/cobicistat/emtricitabine/GS-7340 (DRV/COBI/FTC/GS-7340 administered as a single tablet regimen) versus cobicistat-boosted darunavir (DRV+COBI) plus emtricitabine/tenofovir disoproxil fumarate (Truvada® or FTC/TDF) in HIV-1 infected, antiretroviral treatment-naive adult subjects.

• Acquired Immunodeficiency Syndrome
• HIV Infections

• Drug: darunavir/cobicistat/emtricitabine/GS-7340
  Single-tablet regimen (STR) of darunavir 800 mg/cobicistat 150 mg/emtricitabine 200mg/GS-7340 10 mg administered orally once daily with food.
• Drug: darunavir + cobicistat + emtricitabine/tenofovir df
  darunavir 800mg (400mg tablet x2), cobicistat 150 mg tablet, and a fixed-dose combination tablet of emtricitabine 200 mg/tenofovir disoproxil fumarate 300 mg all administered orally once daily with food.
  Other Names:

  • Prezista®
  • Truvada®

• Experimental: darunavir/cobicistat/emtricitabine/GS-7340
  Single-tablet regimen of darunavir 800mg/cobicistat 150mg/emtricitabine 200mg/GS-7340 10 mg + Placebos to match darunavir 800mg (400mg tablet x2) and cobicistat 150 mg and fixed-dose combination tablet emtricitabine 200 mg/tenofovir disoproxil fumarate 300 mg once daily (n = 100)
  Intervention: Drug: darunavir/cobicistat/emtricitabine/GS-7340
• Active Comparator: darunavir + cobicistat + emtricitabine/tenofovir df
  darunavir 800 mg (400mg tablet x2) + cobicistat 150mg + fixed-dose combination tablet emtricitabine 200mg/tenofovir disoproxil fumarate 300mg + Placebo to match single-tablet regimen of darunavir 800mg/cobicistat 150mg/emtricitabine 200mg/GS-7340 10mg once daily (n = 50)
  Intervention: Drug: darunavir + cobicistat + emtricitabine/tenofovir df

Inclusion Criteria:

• Adult (≥ 18 years) males or non-pregnant females
• Ability to understand and sign a written informed consent form
• General medical condition which does not interfere with the assessments and the completion of the trial
• Plasma HIV-1 RNA levels ≥ 5,000 copies/mL
• CD4+ cell count > 50 cells/µL
• Treatment Naïve: No prior use of any approved or experimental anti-HIV drug for any length of time
• Screening genotype report must show sensitivity to DRV, TDF and FTC
• Normal ECG
• Adequate renal function: Estimated glomerular filtration rate ≥ 70 mL/min according to the Cockcroft Gault formula
• Hepatic transaminases ≤ 2.5 x upper limit of normal (ULN)
• Total bilirubin ≤ 1.5 mg/dL
• Serum amylase ≤ 5 x ULN
• Adequate hematologic function
• Normal TSH
• Females of childbearing potential must have a negative serum pregnancy test
• Females of childbearing potential must agree to utilize highly effective contraception methods from screening throughout the duration of study treatment and for 30 days following the last dose of study drugs
• Female subjects who are postmenopausal must have documentation of cessation of menses for ≥ 12 months and hormonal failure
• Female subjects who have stopped menstruating for ≥ 12 months but do not have documentation of ovarian hormonal failure must have a serum follicle stimulating hormone (FSH) level test
• Male subjects must agree to utilize a highly effective method of contraception during heterosexual intercourse throughout the study period and for 90 days following discontinuation of investigational medicinal product

Exclusion Criteria:

• A new AIDS defining condition diagnosed within the 30 days prior to screening
• Hepatitis B surface Antigen positive
• Hepatitis C Antibody positive
• Proven acute hepatitis in the 30 days prior to study entry
• Have a history or experiencing decompensated cirrhosis
• Current alcohol or substance use that potentially interferes with study compliance
• Any other clinical condition or prior therapy that would make the subject unsuitable for the study or unable to comply with the dosing requirements
• History of malignancy within the past 5 years or ongoing malignancy other than cutaneous Kaposi's sarcoma (KS), basal cell carcinoma, or resected, non-invasive cutaneous squamous carcinoma
• Females who are breastfeeding
• Positive serum pregnancy test (female of childbearing potential)
• Female subjects who utilize non-estrogen hormonal contraceptive as one of their birth control methods must have used the same method for at least three months prior to study dosing
• Have an implanted defibrillator or pacemaker
• Active, serious infections (other than HIV-1 infection) requiring parenteral antibiotic or antifungal therapy within 30 days prior to Baseline
• Participation in any other clinical trial without prior approval is prohibited while participating in this trial
• Receiving ongoing therapy with any of the disallowed medications, including drugs not to be used with darunavir and cobicistat
• Note: Darunavir is a sulfonamide. Subjects who previously experienced a sulfonamide allergy will be allowed to enter the trial. To date, no potential for cross sensitivity between drugs in the sulfonamide class and darunavir has been identified in patients participating in Phase 2 and Phase 3 trials.