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Immunologisk og virologisk karakterisering af patienter med kronisk HBV-HDV-infektion: resultater og respons på Bulevirtide-behandling (MPR_BD)

Immunologisk og virologisk karakterisering af patienter med kronisk HBV-HDV-infektion: sammenhæng med sygdomsudfald og respons på Bulevirtide-behandling

Pharmacological, single-center, non-profit observational study.

The present study is part of a cooperation project between the SC Gastroenterology and Hepatology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (Milan, Italy), the University of Milan, the University of Parma and Rome Tor Vergata, funded under the call for Research Projects of Significant National Interest - 2022 PNRR Call (Prot. P2022WEXP2).

Hepatitis D virus (HDV) is a defective RNA virus, which requires the presence of hepatitis B virus (HBV) to infect liver cells and propagate. To date, the mechanisms underlying the accelerated disease progression in the natural history of Delta hepatitis are poorly understood, as is the course of the HDV-specific immune response (CD4 and CD8 T cells). As in chronic HBV and HCV infections, the outcome of chronic HDV infection appears to be dictated primarily by the host immune response, which represents a key determinant for virus control or persistence. For HBV/HDV coinfection, the role of T cells has not been well defined, as suitable animal models are lacking and so far few HDV-specific T cell epitopes have been precisely mapped, mainly limited to HLA-B alleles.

The study is divided into two substudies (cross-sectional and longitudinal). The primary objective of the cross-sectional study is to calculate the prevalence of HDV-specific T responses in patients with chronic HBV-HDV infection naïve to treatment with Bulevirtide. The primary objective of the longitudinal study is the change in the prevalence of HDV-specific T responses in patients with chronic HBV-HDV infection during treatment with Bulevirtide compared to baseline (pre-treatment).

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Undersøgelsestype

Observationel

Tilmelding (Faktiske)

192

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

      • Milan, Italien, 20122
        • Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Division of Gastroenterology and Hepatology, Milan, Italy.

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Prøveudtagningsmetode

Ikke-sandsynlighedsprøve

Studiebefolkning

The study will enroll patients co-infected with HBV-HDV (defined by positivity of HDV RNA for at least 6 months) who meet the inclusion criteria and no exclusion criteria

Beskrivelse

Inclusion Criteria:

  • 18 years of age or older
  • Ability to understand and sign the informed consent
  • Chronic HDV infection defined by positivity of HBsAg antigen (HBV) and HDV RNA (HBV-HDV co-infection) for at least 6 months at the time of enrollment.

Exclusion Criteria:

  • Co-infection with other viruses (HCV, HIV)
  • Treatment with immunosuppressive/immunomodulatory drugs
  • Other congenital and/or acquired immunodeficiency conditions

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Observationsmodeller: COHORT
  • Tidsperspektiver: PROSPECTIVE

Kohorter og interventioner

Gruppe / kohorte
Intervention / Behandling
Hepatis Delta naive

Patients with HDV infection naïve to Bulevirtide therapy

Hepatis Delta in therapy

Patients with HDV cirrhosis consecutively started on Bulevirtide therapy during the study enrollment period

dose of 2 mg/day subcutaneously

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Calculate the prevalence of HDV-specific T responses in patients with chronic HBV-HDV infection naïve to treatment with Bulevirtide
Tidsramme: through study completion, an average of 2 year

Prevalence of HDV-specific T responses in patients with chronic HBV-HDV infection naïve to treatment with Bulevirtide

through study completion, an average of 2 year
Change in the prevalence of HDV-specific T responses in patients with chronic HBV-HDV infection during treatment with Bulevirtide compared to baseline (pre-treatment)
Tidsramme: Month 12

Prevalence of HDV-specific T responses in patients with chronic HBV-HDV infection after 12 months of treatment with Bulevirtide compared to baseline (pre-therapy)

Month 12

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Correlate HDV-specific T cell response with stage of liver disease
Tidsramme: through study completion, an average of 2 year

Correlation of HDV-specific T cell response with stage of liver disease

through study completion, an average of 2 year
Analyze the role of new HBV serum biomarkers (HBcrAg, HBV RNA, HBsAg isoforms) in predicting the stage of liver disease
Tidsramme: through study completion, an average of 2 year

Quantification of new HBV serum biomarkers (HBcrAg, HBV RNA, HBsAg isoforms) and correlation with the stage of liver disease

through study completion, an average of 2 year
Correlate the quantification of HDV RNA within exosomes with the stage of liver disease
Tidsramme: through study completion, an average of 2 year

Correlation between the quantification of HDV RNA within exosomes and the disease phenotype

through study completion, an average of 2 year
Investigate the correlation between the genetic heritage of HDV and the stage of liver disease
Tidsramme: through study completion, an average of 2 year

Correlation between the genetic heritage of HDV and the stage of liver disease

through study completion, an average of 2 year
Define the transcriptional and molecular signatures of CD8 T cell dysfunction in patients with chronic HBV/HDV coinfection
Tidsramme: through study completion, an average of 2 year

Transcriptional and molecular signatures of CD8 T cell dysfunction in patients with chronic HBV/HDV coinfection

through study completion, an average of 2 year
Understanding the role of virus mutations in the virus's ability to escape CD8 T cell surveillance
Tidsramme: through study completion, an average of 2 year

Correlation between HDV mutations and the ability of the virus itself to escape CD8 T cell surveillance

through study completion, an average of 2 year
Correlate the prevalence of HDV-specific T cell responses with response to treatment over time
Tidsramme: Month 6

Correlation between the change in HDV-specific T responses

Month 6
Correlate the prevalence of HDV-specific T cell responses with response to treatment over time
Tidsramme: Month 18

Correlation between the change in HDV-specific T responses

Month 18
Correlate the prevalence of HDV-specific T cell responses with response to treatment over time
Tidsramme: through study completion, an average of 2 year

Correlation between the change in HDV-specific T responses

through study completion, an average of 2 year
Analyze the role of new HBV serum biomarkers (HBcrAg, HBV RNA, HBsAg isoforms) in predicting response to treatment with Bulevirtide;
Tidsramme: through study completion, an average of 2 year

Quantification of new HBV serum biomarkers (HBcrAg, HBV RNA, HBsAg isoforms) and correlation with response to treatment with Bulevirtide

through study completion, an average of 2 year
Correlate quantification of HDV RNA within exosomes with response to Bulevirtide treatment
Tidsramme: through study completion, an average of 2 year

Correlation between the quantification of HDV RNA within exosomes and the response to treatment with Bulevirtide

through study completion, an average of 2 year
Investigate the correlation between the genetic heritage of HDV and the response to treatment with Bulevirtide
Tidsramme: through study completion, an average of 2 year

Correlation between HDV genetic heritage and response to treatment with Bulevirtide

through study completion, an average of 2 year

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Samarbejdspartnere

Datoer for undersøgelser

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Studer store datoer

Studiestart (Faktiske)

1. september 2024

Primær færdiggørelse (Faktiske)

30. november 2025

Studieafslutning (Faktiske)

28. februar 2026

Datoer for studieregistrering

Først indsendt

5. juli 2024

Først indsendt, der opfyldte QC-kriterier

15. juli 2024

Først opslået (Faktiske)

16. juli 2024

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

5. november 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

4. november 2026

Sidst verificeret

1. december 2025

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • P2022WEXP2

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