Caractérisation immunologique et virologique des patients atteints d'une infection chronique par le VHB-HDV : résultats et réponse au traitement par le bulévirtide (MPR_BD)
Caractérisation immunologique et virologique des patients atteints d'une infection chronique par le VHB-HDV : association avec les résultats de la maladie et la réponse au traitement par le bulévirtide
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).
Aperçu de l'étude
Statut
Statut
Les conditions
Les conditions
Intervention / Traitement
Intervention / Traitement
Type d'étude
Type d'étude
Inscription (Réel)
Inscription
Contacts et emplacements
Lieux d'étude
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Milan, Italie, 20122
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Division of Gastroenterology and Hepatology, Milan, Italy.
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Critères de participation
Critère d'éligibilité
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
Sexes éligibles pour l'étude
Méthode d'échantillonnage
Population étudiée
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
La description
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
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Modèles d'observation: COHORT
- Perspectives temporelles: PROSPECTIVE
Nombre de groupes / cohortes
Cohortes et interventions
Groupe / CohorteGroupe / Cohorte |
Intervention / TraitementIntervention / Traitement |
|---|---|
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Hepatis Delta naive
Patients with HDV infection naïve to Bulevirtide therapy |
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Hepatis Delta in therapy
Patients with HDV cirrhosis consecutively started on Bulevirtide therapy during the study enrollment period |
dose of 2 mg/day subcutaneously |
Que mesure l'étude ?
Principaux critères de jugement
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Calculate the prevalence of HDV-specific T responses in patients with chronic HBV-HDV infection naïve to treatment with Bulevirtide
Délai: through study completion, an average of 2 year
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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
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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)
Délai: Month 12
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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
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Mesures de résultats secondaires
Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Correlate HDV-specific T cell response with stage of liver disease
Délai: through study completion, an average of 2 year
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Correlation of HDV-specific T cell response with stage of liver disease |
through study completion, an average of 2 year
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Analyze the role of new HBV serum biomarkers (HBcrAg, HBV RNA, HBsAg isoforms) in predicting the stage of liver disease
Délai: through study completion, an average of 2 year
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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
|
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Correlate the quantification of HDV RNA within exosomes with the stage of liver disease
Délai: through study completion, an average of 2 year
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Correlation between the quantification of HDV RNA within exosomes and the disease phenotype |
through study completion, an average of 2 year
|
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Investigate the correlation between the genetic heritage of HDV and the stage of liver disease
Délai: through study completion, an average of 2 year
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Correlation between the genetic heritage of HDV and the stage of liver disease |
through study completion, an average of 2 year
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Define the transcriptional and molecular signatures of CD8 T cell dysfunction in patients with chronic HBV/HDV coinfection
Délai: 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
|
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Understanding the role of virus mutations in the virus's ability to escape CD8 T cell surveillance
Délai: through study completion, an average of 2 year
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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
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Correlate the prevalence of HDV-specific T cell responses with response to treatment over time
Délai: Month 6
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Correlation between the change in HDV-specific T responses |
Month 6
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Correlate the prevalence of HDV-specific T cell responses with response to treatment over time
Délai: Month 18
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Correlation between the change in HDV-specific T responses |
Month 18
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Correlate the prevalence of HDV-specific T cell responses with response to treatment over time
Délai: 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;
Délai: 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
Délai: 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
Délai: 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
|
Collaborateurs et enquêteurs
Parrainer
Parrainer
Collaborateurs
Collaborateurs
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Réel)
Début de l'étude
Achèvement primaire (Réel)
Achèvement primaire
Achèvement de l'étude (Réel)
Achèvement de l'étude
Dates d'inscription aux études
Première soumission
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première soumission répondant aux critères de contrôle qualité
Première publication (Réel)
Première publication
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour publiée
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Dernière vérification
Plus d'information
Termes liés à cette étude
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
Autres numéros d'identification d'étude
- P2022WEXP2
Informations sur les médicaments et les dispositifs, documents d'étude
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