Thalidomide for Treatment of Oral and Esophageal Aphthous Ulcers and HIV Viremia in Patients With HIV Infection

Inclusion Criteria

Concurrent Medication:

Allowed:

• Anti-HIV therapy provided therapy has remained constant in the 4 weeks prior to study entry.
• Narcotic analgesia after the first week of treatment ONLY IF the patient is not experiencing somnolence.

Patients must have:

• Documented HIV infection or AIDS.
• Biopsy-confirmed aphthous ulceration of the mouth or esophagus lasting at least 2 weeks.
• Negative culture of ulcer for Herpes simplex.
• En face diameter of >= 5 mm for largest aphthous ulcer.
• Life expectancy of at least 3 months.

NOTE:

• This study is approved for prisoner participation.

Exclusion Criteria

Co-existing Condition:

Patients with the following symptoms or conditions are excluded:

• Known allergy to thalidomide.
• Grade 2 or worse bilateral peripheral neuropathy.

EXCLUDED FOR MAINTENANCE PHASE:

• Toxicity other than somnolence in acute phase that required discontinuation of drug.

Concurrent Medication:

Excluded:

• Acute therapy for opportunistic infection.
• ddC.
• Pentoxifylline.
• Methotrexate, trimetrexate, antineoplastic alkylating agents.
• Other putative immunomodulators.
• CNS depressants and/or medications with sedative or hypnotic effect.
• Systemic and/or oral topical corticosteroids.
• Systemic chemotherapy for Kaposi's sarcoma or other malignancies.
• Compounded antibacterial mouthwashes containing anti-infective agents (such as doxycycline, minocycline, tetracycline, or nystatin).

Concurrent Treatment:

Excluded:

• Radiation to head and/or neck.

Patients with the following prior conditions are excluded:

• History of grade 2 or worse bilateral peripheral neuropathy.
• Change in anti-HIV therapy within 4 weeks prior to study entry.
• Prior enrollment in ACTG 251 or prior treatment of aphthous ulcers with thalidomide.

Prior Medication:

Excluded:

• Systemic and/or oral topical corticosteroids within 1 week prior to first set of bloods drawn.
• Other putative immunomodulators within 2 weeks prior to study entry.
• Prior thalidomide for aphthous ulcers.

History of severe allergic reactions to study medication Currently pregnant or breastfeeding Recent participation in another clinical trial within the last 30 days Presence of uncontrolled medical conditions that could affect safety