A Comparison of Adefovir and Tenofovir for the Treatment of Lamivudine-Resistant Hepatitis B Virus in People With HIV
A Randomized, Phase II, Controlled Trial Comparing the Efficacy of Adefovir Dipivoxil and Tenofovir Disoproxil Fumarate for the Treatment of Lamivudine-Resistant Hepatitis B Virus in Subjects Who Are Co-Infected With HIV
調査の概要
詳細な説明
HBV presents a worldwide health crisis and is difficult to treat when a patient's HBV strain is no longer responsive to 3TC. Given the significant incidence of 3TC-resistant HBV in patients receiving this drug as part of an antiretroviral regimen, other agents with anti-HBV activity are needed. ADV has shown promising anti-HBV activity in preclinical assessments and in Phase I, II, and III clinical trials. TDF, developed for the treatment of HIV infection, has in vitro activity against HBV. This study will compare TDF/3TC combination therapy with ADV/3TC combination therapy to determine which treatment regimen is more effective in patients coinfected with HBV and HIV.
This study will include two populations of patients. Patients in Population A are on stable HAART that includes TDF and will either be in Group I (compensated liver disease) or Group II (decompensated liver disease). All patients in Population A will be randomly assigned to one of two arms: Arm 1 patients will receive 10 mg ADV daily and TDF placebo; Arm 2 patients will receive ADV placebo and 300 mg TDF. Patients in Population B are on stable HAART and have never taken TDF as part of their HAART. Population B patients will receive 300 mg TDF daily during the course of the study.
Study visits will occur every 4 weeks for the 96-week study period. Targeted clinical and medication assessments and blood work assessing clotting time, liver function, and blood chemistry will be conducted at each study visit. HIV and HBV DNA viral load will be tested every 12 weeks. CD4 cell counts will be tested at Weeks 24, 48, 72, and 96.
研究の種類
入学
段階
- フェーズ2
連絡先と場所
研究場所
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California
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Sacramento、California、アメリカ、95814
- UC Davis Medical Center
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Sacramento、California、アメリカ
- Univ. of California Davis Med. Ctr., ACTU
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San Francisco、California、アメリカ、94110
- Ucsf Aids Crs
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Colorado
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Aurora、Colorado、アメリカ、80262
- University of Colorado Hospital CRS
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Illinois
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Chicago、Illinois、アメリカ、60612
- Cook County Hosp. CORE Ctr.
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Chicago、Illinois、アメリカ、60611
- Northwestern University CRS
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Maryland
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Baltimore、Maryland、アメリカ、21287
- Johns Hopkins Adult AIDS CRS
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New York
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New York、New York、アメリカ、10003
- Beth Israel Med. Ctr., ACTU
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New York、New York、アメリカ
- Weill Med. College of Cornell Univ., The Cornell CTU
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New York、New York、アメリカ、10016
- NY Univ. HIV/AIDS CRS
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New York、New York、アメリカ、10021
- Cornell CRS
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Ohio
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Cincinnati、Ohio、アメリカ、452670405
- Univ. of Cincinnati CRS
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Cleveland、Ohio、アメリカ、441091998
- MetroHealth CRS
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Tennessee
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Nashville、Tennessee、アメリカ、37203
- Vanderbilt Therapeutics CRS
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Washington
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Seattle、Washington、アメリカ、98104
- University of Washington AIDS CRS
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria for All Participants:
- HIV infected
- HBV infected
- Serum HBV DNA of 100,000 copies/ml or greater
- Positive for serum hepatitis B surface antigen (HBsAg) within 12 weeks prior to study entry
- Agree to use acceptable methods of contraception
- Serum alpha-fetoprotein (AFP) of 50 ng/ml or less within 30 days of study entry. If AFP is greater than 50 ng/ml, the patient must have an imaging study of the liver showing no tumor within 30 days prior to study entry
Inclusion Criteria for Population A:
- Uninterrupted stable HAART regimen at study entry for at least 12 continuous weeks prior to study entry
- HIV viral load of 10,000 copies/ml or less within 12 weeks of study entry
Inclusion Criteria for Population A, Group I:
- Compensated liver disease
- Child-Pugh-Turcotte (CPT) score of less than 7
Exclusion Criteria for Population A, Group I:
- Excess fluid in the space between the membranes lining the abdomen and abdominal organs (ascites)
- Gastrointestinal (variceal) bleeding
- Brain and nervous system damage as a result of liver disease
- Abnormal blood clotting time
Inclusion Criteria for Population A, Group II:
- Decompensated liver disease
- CPT score of 7-12
Inclusion Criteria for Population B:
- Prior HAART regimen
- Never taken TDF as part of HAART regimen
- Serum HBV DNA of 100,000 copies/ml or greater within 12 weeks of study entry
- HIV viral load of greater than 10,000 copies/ml within 12 weeks of study entry
- CPT score less than 13
Exclusion Criteria
- Serious kidney problems within the last 12 months
- Allergic or sensitive to ADV or TDF
- Active hepatitis C virus (HCV) disease or unknown HCV status within 24 weeks of study entry
- Any medical or mental illness that, in the opinion of the investigator, would interfere with the protocol
- Past or current alcohol or drug abuse that would affect the protocol
- Malignancy that, in the opinion of the investigator, would make the patient unsuitable for the study
- Certain anti-HBV drugs within 90 days of study entry or expected use of these agents during the course of the study
- Drugs that may damage the kidneys within 8 weeks prior to study screening or expected use of these agents during the course of the study
- Systemic corticosteroids within 90 days of study entry
- Current use of drugs containing pivalic acid
- Certain investigational anti-HIV agents
- Pregnant or breastfeeding
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:ランダム化
- 介入モデル:並列代入
協力者と研究者
捜査官
- スタディチェア:Bruce Polsky, MD、St. Luke's-Roosevelt Hospital Center
- スタディチェア:Marion Peters, MD、University of California, San Francisco
出版物と役立つリンク
一般刊行物
- Benhamou Y, Bochet M, Thibault V, Di Martino V, Caumes E, Bricaire F, Opolon P, Katlama C, Poynard T. Long-term incidence of hepatitis B virus resistance to lamivudine in human immunodeficiency virus-infected patients. Hepatology. 1999 Nov;30(5):1302-6. doi: 10.1002/hep.510300525.
- Benhamou Y, Bochet M, Thibault V, Calvez V, Fievet MH, Vig P, Gibbs CS, Brosgart C, Fry J, Namini H, Katlama C, Poynard T. Safety and efficacy of adefovir dipivoxil in patients co-infected with HIV-1 and lamivudine-resistant hepatitis B virus: an open-label pilot study. Lancet. 2001 Sep 1;358(9283):718-23. doi: 10.1016/s0140-6736(01)05840-8.
- Dieterich DT. HIV and hepatitis B virus: options for managing coinfection. Top HIV Med. 2003 Jan-Feb;11(1):16-9.
- Rockstroh JK. Management of hepatitis B and C in HIV co-infected patients. J Acquir Immune Defic Syndr. 2003 Sep;34 Suppl 1:S59-65. doi: 10.1097/00126334-200309011-00009.
- Thio CL. Hepatitis B in the human immunodeficiency virus-infected patient: epidemiology, natural history, and treatment. Semin Liver Dis. 2003 May;23(2):125-36. doi: 10.1055/s-2003-39951.
- Peters MG, Andersen J, Lynch P, Liu T, Alston-Smith B, Brosgart CL, Jacobson JM, Johnson VA, Pollard RB, Rooney JF, Sherman KE, Swindells S, Polsky B; ACTG Protocol A5127 Team. Randomized controlled study of tenofovir and adefovir in chronic hepatitis B virus and HIV infection: ACTG A5127. Hepatology. 2006 Nov;44(5):1110-6. doi: 10.1002/hep.21388.
- Johnson VA, Cramer YS, Rosenkranz SL, Becker S, Klingman KL, Kallungal B, Coakley E, Acosta EP, Calandra G, Saag MS; NIH/NIAID AIDS Clinical Trials Group A5210 Protocol Team. Antiretroviral Activity of AMD11070 (An Orally Administered CXCR4 Entry Inhibitor): Results of NIH/NIAID AIDS Clinical Trials Group Protocol A5210. AIDS Res Hum Retroviruses. 2019 Aug;35(8):691-697. doi: 10.1089/AID.2018.0256. Epub 2019 Jun 18.
研究記録日
主要日程の研究
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
追加の関連 MeSH 用語
その他の研究ID番号
- A5127
- 10678 (DAIDS ES)
- ACTG A5127
- AACTG A5127
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。
HIV感染症の臨床試験
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Erasmus Medical Centerまだ募集していません
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University of Maryland, Baltimore引きこもった
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Hospital Clinic of Barcelona完了
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University of WashingtonNational Institute of Mental Health (NIMH)募集