Efficacy of PTX+IFN Alpha+ RBV on Hepatitis C Virus Coinfected HIV Patients
Efficacy of Pentoxyfylline Addition to a Treatment Scheme Based on Interferon Alpha and Ribavirin on Hepatitis C Virus Coinfected HIV Patients, Considering Interleukin 28B Polymorphism rs12979860
Current Hepatitis C virus (HCV) treatment consists of the combination of interferon alpha 2a (IFN-alpha 2a) plus ribavirin (RBV) and it provides sustained virologic responses (SVR) on 54 to 56% on HCV monoinfected patients and this response is even lower on HIV-HCV coinfected patients. A previous study on HCV monoinfected patients showed that the addition of pentoxyfylline (PTX) to a treatment scheme based on interferon-alfa and ribavirin increased SVR on 25%, although it is not known if the same effect is to be obtained in HCV-HIV coinfected patients.
On the other hand, other factors such as host genetics, have proved to influence treatment response on HCV infected patients. The best described genetic factor so far is the interleukin 28B (IL28B) polymorphism rs12979860, where a cytosine-cytosine (CC) genotype provides an almost twice increase on SVR than the rest of the genotypes.
Therefore, this is a randomized, double blind study to assess the efficacy of pentoxyfylline addition to a treatment scheme based on interferon-alfa and ribavirin in chronic HCV genotype 1, co-infected HIV-1 positive subjects, considering the IL28B polymorphism rs12979860.
HIV-HCV coinfected subjects currently receiving Highly active antiretroviral therapy (HAART), with at least 8 months on undetectable HIV viral load and T helper cells count of 200 or higher will be included. Patients will be randomized on one of two groups:
- Group A: IFN alpha 2a + RBV + PTX
- Group B: IFN alpha 2a + RBV + placebo
Patients will be followed for primary outcome during 72 (for rapid responders) or 96 weeks (for non rapid responses). Outcome measures will be the following:
- SVR rate 24 weeks after the end of treatment
- Grade of Hepatic fibrosis from baseline to the end of treatment, measured by transient elastography and the AST to platelet ratio index (APRI index)
- IL28B rs12979860 genotype
The study hypothesis is that the addition of PTX to a treatment scheme based on IFN-alfa2a and RBV in chronic HCV genotype 1, co-infected HIV-1 positive subjects will improve SVR rate and fibrosis progression irrespectively of IL28B rs12979860 genotype.
연구 개요
연구 유형
등록 (예상)
단계
- 4단계
연락처 및 위치
연구 장소
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Jalisco
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Guadalajara, Jalisco, 멕시코, 44280
- Hospital Civil de Guadalajara
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참여기준
자격 기준
공부할 수 있는 나이
건강한 자원 봉사자를 받아들입니다
연구 대상 성별
설명
Inclusion Criteria:
- HIV/HCV coinfected patients
- 18 to 65 years old
- currently receiving HAART
- non-pregnant women
- HIV infection controlled as: undetectable viral load (<40 copies/mL) for at least 8 months and T helper cells count of 200 cells/μL or above
- no contraindications to IFN alpha2a, RBV or PTX treatment
- sign informed consent form
- laboratory parameters within acceptable ranges
Exclusion Criteria:
- Women that present a positive pregnancy test during the study
- Patients that for any reason no longer wish to receive IFN alpha2a, RBV or PTX treatment
- Serious adverse events that prevent to continue IFN alpha2a, RBV or PTX treatment; such as severe neutropenia, severe thrombocytopenia or severe anemia
- Presence of an opportunistic infection or malignancy that requires treatment with drugs interacting with IFN alpha2a, RBV or PTX
- Patients that fail to adhere to treatment
공부 계획
연구는 어떻게 설계됩니까?
디자인 세부사항
- 주 목적: 치료
- 할당: 무작위
- 중재 모델: 병렬 할당
- 마스킹: 더블
무기와 개입
참가자 그룹 / 팔 |
개입 / 치료 |
|---|---|
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실험적: PTX
IFN 180 micrograms subcutaneous weekly RBV 400 mg each 12 h, oral PTX 400 mg each 12 h, oral
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Addition of pentoxifylline to current HCV treatment
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위약 비교기: Placebo
IFN 180 micrograms subcutaneous weekly RBV 400 mg each 12 h, oral Placebo oral daily
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Placebo matching pentoxifylline dosage
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연구는 무엇을 측정합니까?
주요 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
|
sustained virologic rate 24 weeks post treatment with IFNalpha 2a/RBV/PTX with genotype 1 chronic HCV infection + HIV infection
기간: SVR rate at 24 weeks after the end of therapy
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Primary objective: is to evaluate sustained virologic response at post treatment week 24 following treatment with IFNalpha 2a/RBV/PTX with genotype 1 chronic HCV infection + HIV infection
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SVR rate at 24 weeks after the end of therapy
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2차 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
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grade of hepatic fibrosis
기간: Baseline and week 72 (for quick responders) or week 96 (for non-quick responders)
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The liver stiffness (hepatic fibrosis) will be measured by transient elastography and the APRI index on the baseline visit and then at the follow up visit after treatment, which will be after 72 weeks, for patients that turn out to be quick responders; or 96 weeks, for patients that turn out to be non-quick responders.
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Baseline and week 72 (for quick responders) or week 96 (for non-quick responders)
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rapid virologic response (RVR) and extended rapid virologic response (eRVR) rates
기간: RVR at week 4 and eRVR at week 48 post treatment
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secondary objective (2): Evaluate rapid virologic response (RVR) and extended rapid virologic response (eRVR)
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RVR at week 4 and eRVR at week 48 post treatment
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기타 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
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Percentage of patients with CC genotype on the IL28B rs12979860 polymorphism
기간: week 72
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We will compare the percentage of patients with CC genotype among patients that achieved sustained virologic response and those who did not achieved it.
This is to confirm if the intervention provides a beneficial effect, irrespectively of host genetic factors.
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week 72
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공동 작업자 및 조사자
연구 기록 날짜
연구 주요 날짜
연구 시작
기본 완료 (예상)
연구 완료 (예상)
연구 등록 날짜
최초 제출
QC 기준을 충족하는 최초 제출
처음 게시됨 (추정)
연구 기록 업데이트
마지막 업데이트 게시됨 (추정)
QC 기준을 충족하는 마지막 업데이트 제출
마지막으로 확인됨
추가 정보
이 연구와 관련된 용어
키워드
추가 관련 MeSH 약관
기타 연구 ID 번호
- PTX-HCV/HIV
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