- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03645044
Towards a Functional Cure for HBV - The COMMIT Cohort Study (COMMIT)
Towards a Functional Cure for HBV: Exploiting Lessons From HIV-HBV Co-infection: The COMMIT Cohort Study
Study Overview
Status
Conditions
Detailed Description
A) Aims and Objectives. Effective antiviral treatments of HBV are available, but treatment is lifelong in most so comes at considerable cost and with some toxicity. An effective therapeutic strategy to achieve a cure for HBV remains an unmet need. This project examines the key steps to HBV cure in the setting of HIV-HBV co-infection. Seroconversion is key to the cure. Seroconversion is the process where detectable antibody (specific protective protein produced by the immune system) against virus proteins (antigens) are developed in the blood. This proposed Asian HIV-HBV co-infection cohort (where treatment initiation is later and hence at lower cluster of differentiation 4 (CD4) counts) will provide a unique opportunity to test our hypothesis that following initiation of antiviral therapy, HB surface and "e" antigen loss is more frequent (i) early in treatment and (ii) with lower CD4 cell counts, and that predictors of losing HB surface and 'e" antigen (Ag) and gaining antibody (Ab) against them are directly associated with B-cell functions.
B) Key Questions. Primary objective: to determine the rates & clinical determinants of HBsAg and HBeAg loss and seroconversion in HIV-HBV co-infected patients commencing HBV-active antiretroviral (ART). We will test the hypotheses that: (i) seroconversion occurs predominantly in the early phase of treatment (≤12 months) with HBV active ART and (ii) seroconversion is more frequent in HIV-HBV co-infected individuals commencing treatment with lower CD4+ T cell counts (≤100 cells/mm3) compared to those with higher counts (>100 cells/mm3).
Secondary objectives: (i) identify predictive biomarkers of HBsAg loss/seroconversion and (ii) examine predictors of HBeAg loss/seroconversion in this setting
C) Research Design. This is a large prospective, observational cohort study of treatment-naïve HIV-HBV co-infected patients (n=150). Clinical sites are - (1) HIV-Netherland-Australia-Thailand (HIV-NAT)/Thai Red Cross AIDS Research Centre, Bangkok, Thailand; (2) Y.R. Gaitonde Centre for AIDS Research and Education (YRG CARE), Chennai, India; and (3) Clinical Investigation Centre (CIC), University of Malaya, Infectious Diseases Directorate, Kuala Lumpur, Malaysia. Participants will be followed for 2 years, with study visits at baseline (study entry/initiation of treatment), months 3, 6, 12, 18, and 24 of follow-up. Clinical and laboratory information/data and blood samples will be collected at study visits.
Study Type
Enrollment (Actual)
Contacts and Locations
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria:
- Male or female, aged 18 years and older
- HIV antibody positive
Chronically-infected with HBV, as defined by:
i. Positive Hepatitis B surface antigen HBsAg) or HBV DNA result with a subsequent positive HBsAg or HBV DNA result at least 6 months after first positive result (the 2nd HBsAg test may be taken at the baseline visit) ii. HBsAg positive with the absence of immunoglobulin M antibodies to HBV core at screening
- Current or ever hepatitis C virus (HCV) antibody negative
- Hepatitis D virus (HDV) negative
- ART naïve or within 7-10 days of ART start at sites where immediate ART start (test and treat) is practice
- Provide signed and dated informed consent form.
- Willing to comply with all study procedures and be available for the duration of the study.
Exclusion Criteria:
- Hepatitis C virus (HCV) antibody positive
- Hepatitis delta antibody positive
- Anything that would place the individual at increased risk or preclude the individual's full compliance with or completion of the study.
Study Plan
How is the study designed?
Design Details
- Observational Models: Cohort
- Time Perspectives: Prospective
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
HBsAg loss/seroconversion on ART
Time Frame: 24 months
|
Frequency of HBsAg loss/seroconversion in early (first 12 months) compared to later stage
|
24 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
HBeAg loss/seroconversion on ART
Time Frame: 24 months
|
Frequency of HBeAg loss/seroconversion in early (first 12 months) compared to later stage
|
24 months
|
HBsAg epitope profiles
Time Frame: 24 months
|
HBsAg epitope profiles at study entry and after 2 years of antiviral therapy in HBsAg responders and non-responders
|
24 months
|
Differential B cell gene expression
Time Frame: 24 months
|
Differential B cell gene expression (genetic testing) in HBsAg responders and non-responders after 2 years of antiviral therapy
|
24 months
|
B-cell activating factor (BAFF) levels
Time Frame: 24 months
|
Levels of BAFF in plasma at study entry and after 2 years of antiviral therapy in HBsAg responders and non-responders
|
24 months
|
HBeAg and HBsAg specific memory B cells
Time Frame: 24 months
|
Proportion of HBeAg and HBsAg specific memory B cells at study entry and after 2 years of antiviral therapy
|
24 months
|
B cell subtypes
Time Frame: 24 months
|
Percentage of B cell subtypes at study entry and after 2 years of antiviral therapy
|
24 months
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Joe Sasadeusz, MBBS, PhD, University of Melbourne
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- COMMIT study (NMHRC 1123988)
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
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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