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A Comparison of the Effectiveness, Safety, and Tolerability of Two Different Hepatitis C Treatments in Patients Infected With Both HIV and Hepatitis C Virus (HCV)

28 ottobre 2021 aggiornato da: National Institute of Allergy and Infectious Diseases (NIAID)

A Prospective, Multicenter, Phase II/III, Open-Label, Controlled, Randomized Trial Evaluating the Efficacy, Safety, and Tolerability of Interferon-alfa-2a Plus Ribavirin Versus PEG-interferon-alfa-2a Plus Ribavirin for Chronic Hepatitis C Virus (HCV) Infection in Individuals Co-Infected With Human Immunodeficiency Virus-1 (HIV-1)

The purpose of this study is to see if treatment with PEG-interferon-alfa-2a (PEG-IFN) plus ribavirin is a more effective treatment for hepatitis C virus (HCV) than interferon-alfa-2a (IFN) plus ribavirin for patients infected with both HCV and HIV. The study will also compare the 2 regimens to see which has fewer side effects.

HCV infection is common in patients infected with HIV. Patients infected with both HIV and HCV viruses seem to have more severe hepatitis C. A combination of IFN and ribavirin has been shown to lessen the severity of HCV. PEG-IFN is a modified form of IFN that stays in the blood longer, which means that patients would not have to take the treatment as often. This study will compare the safety and effectiveness of PEG-IFN to IFN when each is combined with ribavirin.

Panoramica dello studio

Stato

Completato

Condizioni

Intervento / Trattamento

Descrizione dettagliata

Infection with HCV is common in patients infected with HIV owing to similar routes of transmission. The cellular immunosuppression caused by HIV infection appears to lead to an increased HCV plasma load, more progressive liver disease, and, in patients with chronic hepatitis C, increased mortality. Ribavirin treatment combined with IFN has shown improved sustained virologic response rates over IFN monotherapy. PEG-IFN, a chemically modified formulation of IFN, circulates for a much longer time in the blood than the parent compound. Pharmacokinetic and pharmacodynamic data suggest that PEG-IFN injected weekly would have the potential for superior efficacy as compared with IFN injected 3 times per week. The efficacy and safety profiles of combination therapy with PEG-IFN and ribavirin are not well known. This study will compare combination therapy consisting of PEG-IFN and ribavirin with that of IFN and ribavirin.

Patients are stratified according to HCV genotype and CD4 count and viral load, then randomized to either Arm A (IFN plus ribavirin) or Arm B (PEG-IFN plus ribavirin). Patients receive up to 48 weeks of treatment. Virologic response is assessed at Week 24 and a decision to continue or discontinue treatment is made. If a virologic response is shown at Week 24, the patient continues treatment for an additional 24 weeks. If no virologic response is observed, then the histologic response is assessed by a liver biopsy. If biopsy shows a histologic response is present, treatment is continued for 24 weeks. If biopsy shows no histologic response, treatment is discontinued. [AS PER AMENDMENT 07/20/01: Patients with virologic response who discontinue after Week 24 will have liver biopsy at time of discontinuation. Patients with no virologic response continuing study treatment after having a liver biopsy within 2 weeks of Week 24, who also demonstrate histologic response and decide to discontinue after Week 24, are strongly encouraged to have a 2nd liver biopsy at the end of treatment. Patients with no virologic response who discontinue after Week 24 will not have liver biopsy at time of discontinuation.] Physical examinations are done regularly and blood samples collected for routine laboratory tests, confidential genetic testing, and to measure HCV and HIV-1 plasma viral loads. Women able to become pregnant have regular pregnancy tests. All patients are followed for an additional 24 weeks after treatment discontinuation.

Patients may enroll in 1 or none of the following substudies: A5091s, Hepatic C Viral Kinetics in Subjects Co-infected with Human Immunodeficiency Virus-1 (HIV-1) and Hepatitis C Virus Genotype 1 (HCV-1); [AS PER AMENDMENT 07/20/01: The following text has been deleted: or A5092s, Evaluation of the Effects of Ribavirin on Zidovudine (ZDV) or Stavudine (d4T) Triphosphate Formation] [AS PER AMENDMENT 07/20/01: Substudy A5092s, Evaluation of the Effects of Ribavirin on Zidovudine (ZDV) or Stavudine (d4T) Triphosphate Formation is now a stand-alone study.]

Tipo di studio

Interventistico

Iscrizione

132

Fase

  • Fase 2

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Luoghi di studio

  • Stati Uniti
    • California
      • San Diego, California, Stati Uniti, 92103
        • Ucsd, Avrc Crs
      • San Francisco, California, Stati Uniti, 941104206
        • Ucsf Aids Crs
    • Colorado
      • Aurora, Colorado, Stati Uniti, 80262
        • University of Colorado Hospital CRS
    • Florida
      • Miami, Florida, Stati Uniti, 331361013
        • Univ. of Miami AIDS CRS
    • Georgia
      • Atlanta, Georgia, Stati Uniti, 30308
        • The Ponce de Leon Ctr. CRS
    • Hawaii
      • Honolulu, Hawaii, Stati Uniti, 96816
        • Univ. of Hawaii at Manoa, Leahi Hosp.
    • Indiana
      • Indianapolis, Indiana, Stati Uniti, 46202
        • Methodist Hosp. of Indiana
      • Indianapolis, Indiana, Stati Uniti, 46202
        • Indiana Univ. School of Medicine, Wishard Memorial
      • Indianapolis, Indiana, Stati Uniti, 462025250
        • Indiana Univ. School of Medicine, Infectious Disease Research Clinic
    • Iowa
      • Iowa City, Iowa, Stati Uniti, 52242
        • Univ. of Iowa Healthcare, Div. of Infectious Diseases
    • Massachusetts
      • Boston, Massachusetts, Stati Uniti, 02114
        • Massachusetts General Hospital ACTG CRS
      • Boston, Massachusetts, Stati Uniti, 02118
        • Bmc Actg Crs
      • Boston, Massachusetts, Stati Uniti, 02215
        • Beth Israel Deaconess Med. Ctr., ACTG CRS
      • Boston, Massachusetts, Stati Uniti, 02215
        • Brigham and Women's Hosp. ACTG CRS
    • Minnesota
      • Minneapolis, Minnesota, Stati Uniti, 55455
        • University of Minnesota, ACTU
    • New York
      • New York, New York, Stati Uniti, 10003
        • Beth Israel Med. Ctr., ACTU
      • New York, New York, Stati Uniti, 10016
        • NY Univ. HIV/AIDS CRS
      • New York, New York, Stati Uniti, 10029
        • Mt. Sinai Med. Ctr. A0404 CRS
      • New York, New York, Stati Uniti
        • HIV Prevention & Treatment CRS
      • Rochester, New York, Stati Uniti, 14642
        • Univ. of Rochester ACTG CRS
      • Rochester, New York, Stati Uniti, 14642
        • AIDS Care CRS
    • Ohio
      • Cincinnati, Ohio, Stati Uniti, 452670405
        • Univ. of Cincinnati CRS
    • Pennsylvania
      • Philadelphia, Pennsylvania, Stati Uniti, 19104
        • Philadelphia Veterans Admin. Med. Ctr. A6205 CRS
    • Texas
      • Dallas, Texas, Stati Uniti, 75390
        • Univ. of Texas Southwestern Med. Ctr., Amelia Court Continuity Clinic

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

Da 18 anni a 65 anni (Adulto, Adulto più anziano)

Accetta volontari sani

No

Sessi ammissibili allo studio

Tutto

Descrizione

Inclusion Criteria

Patients may be eligible for this study if they:

  • Are HIV-positive.
  • Have chronic liver disease consistent with chronic hepatitis C.
  • Have evidence of hepatitis C within the 48 weeks prior to entry.
  • Are 18 to 65 years old.
  • Agree to use 2 barrier methods of birth control during the study and for 6 months after stopping the medications.
  • Meet 1 of the following sets of guidelines: 1) have a CD4 count of more than 100 cells/mm3 and have a viral load (level of HIV in the blood) of less than 10,000 copies/ml within 35 days prior to study entry, and have taken stable anti-HIV drugs for at least 12 weeks prior to study entry and plan to remain on the same treatment for the first 24 weeks of the study; or 2) have a CD4 count of more than 300 cells/mm3 within 35 days prior to study entry and have not taken any anti-HIV drugs in the 12 weeks prior to entry, and do not plan to start anti-HIV treatment within the first 24 weeks of study entry.

Exclusion Criteria

Patients will not be eligible for this study if they:

  • Have a positive test for hepatitis B.
  • Show evidence of medical conditions associated with long-term liver disease other than HCV.
  • Have severe mental illness, especially depression, or have been hospitalized for mental illness within the previous 24 weeks.
  • Are allergic to any of the study products.
  • Have uncontrolled seizures.
  • Have had or currently have any immune diseases.
  • Have lung disease such that function is limited.
  • Have had evidence of heart disease or certain heart problems within 24 weeks of study entry.
  • Have severe retinopathy (eye disease).
  • Have had a major organ transplant and still have the graft.
  • Have any other severe disease or cancer that would interfere with the study.
  • Have had anti-cancer or immune-regulating drugs or radiation treatment within 24 weeks of study entry or expect to need such treatment during the study.
  • Have received rifampin, rifabutin, pyrazinamide, isoniazid, ganciclovir, hydroxyurea, granulocyte colony-stimulating factor (G-CSF), or granulocyte-macrophage colony-stimulating factor (GM-CSF) within 6 weeks of study entry.
  • Abuse drugs or alcohol. Patients in methadone programs may participate.
  • Have a blood disorder such as thalassemia.
  • Have received interferon or oral ribavirin therapy.
  • Have taken an experimental drug that affects HCV, within 6 weeks of study entry.
  • Need to use during the study any of the drugs prohibited by the study.
  • Have had an opportunistic (AIDS-related) infection within 4 weeks of study entry.
  • Are pregnant or breast-feeding.

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Scopo principale: Trattamento

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Sponsor

National Institute of Allergy and Infectious Diseases (NIAID)

Investigatori

  • Cattedra di studio: Raymond Chung, MD, Harvard/Massachusetts General Hospital
  • Cattedra di studio: Paul Volberding, MD, San Francisco General Hospital

Pubblicazioni e link utili

La persona responsabile dell'inserimento delle informazioni sullo studio fornisce volontariamente queste pubblicazioni. Questi possono riguardare qualsiasi cosa relativa allo studio.

Pubblicazioni generali

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio

1 novembre 2000

Completamento dello studio

1 agosto 2006

Date di iscrizione allo studio

Primo inviato

9 gennaio 2001

Primo inviato che soddisfa i criteri di controllo qualità

30 agosto 2001

Primo Inserito (Stima)

31 agosto 2001

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Effettivo)

1 novembre 2021

Ultimo aggiornamento inviato che soddisfa i criteri QC

28 ottobre 2021

Ultimo verificato

1 ottobre 2021

Maggiori informazioni

Termini relativi a questo studio

Parole chiave

Termini MeSH pertinenti aggiuntivi

Altri numeri di identificazione dello studio

  • A5071
  • 10675 (DAIDS ES Registry Number)
  • Substudy AACTG A5091s
  • ACTG A5071
  • AACTG A5071

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .

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