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- Klinische proef NCT07589985
Hep Mec Cohort in Zambia (Hep Mec)
9 mei 2026 bijgewerkt door: Michael Vinikoor, University of Alabama at Birmingham
Observational cohort of adults with acute and chronic hepatitis B infection in Zambia, with and without HIV coinfection.
Participants join the study at the time of diagnosis and before or at the time when they are starting antiviral treatments and then they are followed up over multiple years to assess changes to their liver and evolution of HBV (and HIV if applicable) infection.
All treatments for HBV and HIV are standard per local Ministry of Health guidelines.
Studie Overzicht
Toestand
Werving
Conditie
Studietype
Observationeel
Inschrijving (Geschat)
390
Contacten en locaties
In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.
Studiecontact
- Naam: Michael J Vinikoor, MD
- Telefoonnummer: 205-934-5191
- E-mail: mjv3@uab.edu
Studie Contact Back-up
- Naam: Ike Oyewole
- Telefoonnummer: 205-996-0441
- E-mail: ikeoluwaoyewole@uabmc.edu
Studie Locaties
-
-
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Lusaka, Zambia
- Werving
- University Teaching Hospital
-
Contact:
- Taonga Musonda, MS
- Telefoonnummer: 260 (country) 971964760
- E-mail: taonga@tropgan.com
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Contact:
- Edford Sinkala, MBChB, PhD
- Telefoonnummer: 260 (country) 974 662 483
- E-mail: sinkalaeddie@yahoo.com
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Lusaka, Zambia
- Werving
- Kanyama Level 1 Hospital
-
Contact:
- Carolyn Chibundi
- Telefoonnummer: 260 (contact) 977541659
- E-mail: carolyn.chibundi@cidrz.org
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Contact:
- Taonga Musonda, MS
- Telefoonnummer: 260 (country) 971964760
- E-mail: taonga@tropgan.com
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Lusaka, Zambia
- Werving
- Matero Level 1 Hospital
-
Contact:
- Taonga Musonda, MS
- Telefoonnummer: 260 (country) 971964760
- E-mail: taonga@tropgan.com
-
Contact:
- Carolyn Chibundi
- Telefoonnummer: 260 (country) 977541659
- E-mail: carolyn.chibundi@cidrz.org
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-
Deelname Criteria
Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
- Volwassen
- Oudere volwassene
Accepteert gezonde vrijwilligers
Nee
Bemonsteringsmethode
Niet-waarschijnlijkheidssteekproef
Studie Bevolking
This study will occur in Lusaka, Zambia, which has 12% adult HIV prevalence and ~4% adult HBsAg-positivity.
Both HIV and HBV treatment are free and provided through the Ministry of Health.
Tenofovir-based therapies are used for HBV monoinfection and HBV/HIV coinfection.
Potential participants will be recruited from Ministry of Health (i.e., public sector) clinics at study sites including from a pool of participants in past HBV research projects.
There are a 5 groups of participants we seek to enroll in the study, to facilitate addressing the scientific goals of the cohort.
Beschrijving
Inclusion Criteria:
Must meet the inclusion criteria for one of 5 groups, as follows:
- Group 1 (rx-naive chronic hbv mono): 18+ years old, HBsAg-positive, HIV-negative, eligible for tenofovir-based therapy, reports taking therapy no more than 7 days (could have previously taken if has stopped >1 year ago).
- Group 2 (acute hbv mono): 18+ years old, HBsAg-positive, HIV-negative, acute/subacute onset of hepatitis signs and symptoms and ALT >10 times upper limit of normal
- Group 3 (rx-naive hbv/hiv coinfection): 18+ years old, HBsAg-positive, HIV-negative, eligible for tenofovir-based therapy, reports taking therapy no more than 7 days (could have previously taken if has stopped >1 year ago).
- Group 4 (rx-experienced coinfection with hbv persistence): 18+ years old, history of chronic HBV infection based on two tests 6 months apart, HIV-positive, at least 4 years of tenofovir-based antiviral therapy, currently HBsAg-positive
- Group 5 (hbsag loss): 18+ years old, HIV-positive or negative, history of chronic HBV infection based on two tests 6 months apart, Currently HBsAg-negative confirmed by sensitive assay
Exclusion Criteria:
- Hepatitis C coinfection (antibody-positive and RNA-positive), current or recent (past 6 weeks) pregnancy, decompensated cirrhosis on physical examination, unlikely to remain in Lusaka for study duration
Studie plan
Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.
Hoe is de studie opgezet?
Ontwerpdetails
Cohorten en interventies
Groep / Cohort |
|---|
|
Treatment-naive chronic HBV monoinfection and eligible for antiviral therapy
Adults who are HBsAg-positive, HIV-positive, eligible for HBV antiviral therapy and has not yet or just started taking therapy
|
|
Treatment-naive acute HBV monoinfection
Adults who are HBsAg-positive, HIV-negative, and have the syndrome of acute hepatitis
|
|
Treatment-naive HBV/HIV coinfection
Adults who are both HBsAg and HIV positive, and are not yet or just started taking HBV-active ART
|
|
Treatment-experienced HBV/HIV coinfection with persistent HBsAg-emia
Adults with HBV/HIV coinfection and persistent HBsAg-emia after at least 4 years of HBV-active ART
|
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Treatment-experienced HBV infection with HBsAg loss
Adults with and without HIV coinfection who have a documented history of chronic HBV infection that subsequently resolved (i.e., HBsAg loss) during antiviral therapy
|
Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Change in Intrahepatic Immune Cell Subset Frequencies
Tijdsspanne: Baseline and 1 year
|
Percentage of immune cell subsets (CD4+ T cells, CD8+ T cells, B cells, NK cells, Macrophages, and Neutrophils) among total liver immune cells as measured by single-cell RNA sequencing.
Comparisons will be made between acute and chronic HBV infection, with and without HIV coinfection, and before and after nucleoside analog antiviral therapy.
|
Baseline and 1 year
|
|
Number of Differentially Expressed Hepatic Genes Associated with HBsAg Reduction/Loss
Tijdsspanne: Baseline and 1 year
|
Count of genes showing differential expression (fold change ≥2.0, adjusted p-value <0.05) by single-cell RNA sequencing in liver biopsies from participants achieving HBsAg loss compared to those without HBsAg loss.
Gene expression will be analyzed at baseline (predictive analysis), longitudinally (trajectory analysis), and at end of follow-up.
Analysis will include comparison across acute vs. chronic HBV infection and with vs. without HIV coinfection.
|
Baseline and 1 year
|
Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
HBV viral suppression
Tijdsspanne: Baseline, 1 year, 2 years, 3 years, 4 years, and 5 years
|
Reduction of HBV DNA in blood to below detectable levels
|
Baseline, 1 year, 2 years, 3 years, 4 years, and 5 years
|
|
HIV viral suppression
Tijdsspanne: Baseline, 1 year, 2 years, 3 years, 4 years, and 5 years
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HIV RNA suppression in blood below the level of assay detection
|
Baseline, 1 year, 2 years, 3 years, 4 years, and 5 years
|
|
HBsAg seroclearance
Tijdsspanne: Through study completion, an average of 5 years
|
Loss of hepatitis B surface antigen in blood samples
|
Through study completion, an average of 5 years
|
|
HBeAg seroconversion
Tijdsspanne: Through study completion, an average of 5 years
|
HBeAg-negativity in blood
|
Through study completion, an average of 5 years
|
Medewerkers en onderzoekers
Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.
Medewerkers
Onderzoekers
- Hoofdonderzoeker: Michael Vinikoor, MD, University of Alabama at Birmingham
Publicaties en nuttige links
De persoon die verantwoordelijk is voor het invoeren van informatie over het onderzoek stelt deze publicaties vrijwillig ter beschikking. Dit kan gaan over alles wat met het onderzoek te maken heeft.
Algemene publicaties
- Vinikoor MJ, Hamusonde K, Muula G, Asombang M, Riebensahm C, Chitundu H, Sunkuntu-Sichizya V, Bhattacharya D, Sinkala E, Lauer G, Chung R, Mbewe W, Egger M, Bosomprah S, Wandeler G. Long-term Hepatitis B and Liver Outcomes Among Adults Taking Tenofovir-Containing Antiretroviral Therapy for HBV/HIV Coinfection in Zambia. Clin Infect Dis. 2024 Jun 14;78(6):1583-1590. doi: 10.1093/cid/ciad654.
- Chihota BV, Wandeler G, Chilengi R, Mulenga L, Chung RT, Bhattacharya D, Egger M, Vinikoor MJ. High Rates of Hepatitis B Virus (HBV) Functional Cure Among Human Immunodeficiency Virus-HBV Coinfected Patients on Antiretroviral Therapy in Zambia. J Infect Dis. 2020 Jan 2;221(2):218-222. doi: 10.1093/infdis/jiz450.
- Muula GK, Bosomprah S, Sinkala E, Nsokolo B, Musonda T, Hamusonde K, Bhattacharya D, Lauer G, Chung RT, Mulenga LB, Wandeler G, Vinikoor MJ. Hepatitis B viral replication markers and hepatic fibrosis in untreated chronic hepatitis B virus infection with and without HIV coinfection in Zambia. AIDS. 2023 Nov 1;37(13):2015-2020. doi: 10.1097/QAD.0000000000003659. Epub 2023 Jul 17.
- Vinikoor MJ, Walker A, Nsokolo B, Musonda T, Muula G, Michailidis E, Wandeler G, Alatrakchi N, Kelly P, Damagnez M, Le DB, Voges A, Lubke N, Kanunga A, Bosomprah S, Bhattacharya D, Chibundi C, Bwalya G, Musukuma-Chifulo K, Suslov A, Feuerherd M, Heim MH, Schwartz RE, Chung RT, Lauer G, Sinkala E, Timm J. Whole-Genome Sequencing of Hepatitis B Virus Genotypes E and A in Zambia Reveals Limited Viral Diversity in HIV Coinfection. Open Forum Infect Dis. 2025 Oct 1;12(11):ofaf616. doi: 10.1093/ofid/ofaf616. eCollection 2025 Nov.
- Musonda T, Wallace MS, Patel H, Martin OP, Oetheimer C, Mwakamui S, Sinkala E, Nsokolo B, Kanunga A, Lauer G, Chung RT, Wandeler G, Bhattacharya D, Kelly P, Alatrakchi N, Vinikoor MJ. New Window Into Hepatitis B in Africa: Liver Sampling Combined With Single-Cell Omics Enables Deep and Longitudinal Assessment of Intrahepatic Immunity in Zambia. J Infect Dis. 2024 Nov 15;230(5):e1171-e1175. doi: 10.1093/infdis/jiae054.
Studie record data
Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.
Bestudeer belangrijke data
Studie start (Werkelijk)
28 september 2020
Primaire voltooiing (Geschat)
31 augustus 2029
Studie voltooiing (Geschat)
31 augustus 2030
Studieregistratiedata
Eerst ingediend
5 februari 2026
Eerst ingediend dat voldeed aan de QC-criteria
9 mei 2026
Eerst geplaatst (Werkelijk)
15 mei 2026
Updates van studierecords
Laatste update geplaatst (Werkelijk)
15 mei 2026
Laatste update ingediend die voldeed aan QC-criteria
9 mei 2026
Laatst geverifieerd
1 januari 2026
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
- IRB-300003590
- R37AI179640 (Subsidie/contract van de Amerikaanse NIH)
- R01AI147727 (Subsidie/contract van de Amerikaanse NIH)
- R01AI195435 (Subsidie/contract van de Amerikaanse NIH)
- 316-2019 (Andere identificatie: University of Zambia Biomedical Research Ethics Committee)
Plan Individuele Deelnemersgegevens (IPD)
Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?
JA
Beschrijving IPD-plan
All study results and anonymized participant data will be made publicly-available.
The timing will be based on when analysis is completed and results are disseminated.
The study also will adhere to Zambian laws around data protection and sharing.
IPD-tijdsbestek voor delen
Supporting information will be made available at study completion.
IPD will be made available after completion of primary outcome analyses.
We expect primary outcomes analyses will be completed in 2027, 2028, and 2029.
IPD-toegangscriteria voor delen
During the study, only staff in Zambia and collaborating investigators will have access to IPD and supporting information.
After the end of the study, this will be gradually made publicly available.
IPD delen Ondersteunend informatietype
- LEERPROTOCOOL
- ICF
Informatie over medicijnen en apparaten, studiedocumenten
Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel
Nee
Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct
Nee
Deze informatie is zonder wijzigingen rechtstreeks van de website clinicaltrials.gov gehaald. Als u verzoeken heeft om uw onderzoeksgegevens te wijzigen, te verwijderen of bij te werken, neem dan contact op met register@clinicaltrials.gov. Zodra er een wijziging wordt doorgevoerd op clinicaltrials.gov, wordt deze ook automatisch bijgewerkt op onze website .