Hepatitis C Treatment to Prevent HIV, Initiate Opioid Substitution Therapy, and Reduce Risky Behavior (ANCHOR)
A Novel Model of Hepatitis C Treatment as Anchor to Prevent HIV, Initiate Opioid Substitution Therapy, and Reduce Risky Behavior
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Hepatitis C (HCV) is a chronic infection with significant morbidity and mortality. The development of directly acting antivirals (DAA) has dramatically improved the cure rate of HCV treatment. However, despite the availability of effective therapy, the global epidemic of HCV infection continues to be driven by people with ongoing injection drug use (PWID), who are largely excluded from HCV therapy. Several critical barriers exist preventing high-risk patients' entry to care, including (1) lack of engagement in the traditional healthcare system by marginalized patient populations, and (2) insurance restrictions due to concerns regarding treatment adherence and HCV reinfection. Furthermore, ongoing injection drug use places these individuals at high risk of HIV acquisition. However, studies have repeatedly demonstrated that pre-exposure prophylaxis (PrEP) reduces HIV acquisition and opioid substitution therapy with buprenorphine reduces HIV and HCV acquisition in PWID.
As such, we propose a comprehensive model of care to engage individuals with ongoing injection drug use in treatment of HCV, in conjunction with collocated services to prevent HIV acquisition and HCV reinfection, including pre-exposure prophylaxis and opioid substitution therapy. This pilot trial will demonstrate whether a comprehensive model of care can simultaneously treat HCV, and prevent HCV reinfection, HIV acquisition and effectively treat opioid use disorder.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Contacts and Locations
Study Locations
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District of Columbia
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Washington D.C., District of Columbia, United States, 20002
- HIPS
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Maryland
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Batlimore, Maryland, United States, 21223
- University of Maryland Drug Treatment Center
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria:
- Age 18 years old
- Able and willing to sign informed consent
- Chronically infected with HCV, defined as any individual with documentation of positive HCV antibody and positive HCV RNA test (HCV RNA of 2,000 IU/mL or greater).
- Willing to have samples stored for future use
Ongoing injection drug use, defined as self-report of either:
- Phase 1 (first 100 enrolled participants) Injection non-prescription drug use within three months of screening visit or
- Phase 2 (enrolled participants 101-200) Use of non-prescription opioids within twelve months of screening visit
Exclusion Criteria:
- Decompensated liver disease (Childs Pugh B or C)
- Unable to comply with research study visits
- Poor venous access not allowing screening laboratory collection
- Have any condition that the investigator considers a contraindication to study participation
- Pregnant or breastfeeding woman
Study Plan
How is the study designed?
Design Details
- Observational Models: Cohort
- Time Perspectives: Prospective
Number of groups / cohorts
Cohorts and Interventions
Group / CohortGroup / Cohort |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Adults infected with HCV
Phase 1 (first 100 enrolled participants) HCV-infected adults with on-going injection drug use use with opioids with 3 months of screening Phase 2 (enrolled participants 101-200) HCV-infected adults with on-going opioid misuse of non-prescription opioids within twelve months of screening |
Participants will be treated with direct-acting antivirals per standard of care and will be concomittantly be offered PreP for HIV prevention and buprenorphine for treatment of opioid-use disorder when clinically indicated
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Hepatitis C Virus (HCV) Cure (Sustained Virologic Response)
Time Frame: 24 weeks
|
Undetectable HCV viral load 12 weeks after the end of treatment
|
24 weeks
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Uptake of HIV Pre-exposure Prophylaxis (PrEP)
Time Frame: 24 weeks
|
Number of participants who initiated PrEP between Day 0 and Week 24
|
24 weeks
|
|
Retention on HIV PrEP
Time Frame: 48 weeks
|
Number of participants who initiated PrEP between Day 0 and Week 24 and continued on PrEP through week 48
|
48 weeks
|
|
Uptake of Buprenorphine
Time Frame: 24 weeks
|
Number of participants who initiated on-site co-located buprenorphine between Day 0 and Week 24
|
24 weeks
|
|
Retention in Buprenorphine Program
Time Frame: 48 weeks
|
Number of participants who initiated buprenorphine between Day 0 and Week 24 and were retained in buprenorphine treatment at week 48
|
48 weeks
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Elana Rosenthal, MD, University of Maryland
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Blood-Borne Infections
- Infections
- RNA Virus Infections
- Virus Diseases
- Digestive System Diseases
- Liver Diseases
- Hepatitis, Viral, Human
- Communicable Diseases
- Flaviviridae Infections
- Hepatitis
- Hepatitis C
- Physiological Effects of Drugs
- Central Nervous System Depressants
- Peripheral Nervous System Agents
- Analgesics
- Sensory System Agents
- Narcotics
- Analgesics, Opioid
Other Study ID Numbers
Other Study ID Numbers
- HP-00071577
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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