- ICH GCP
- US Clinical Trials Registry
- Klinisk utprøving NCT01318096
Safety and Efficacy of Raltegravir+TDF+3TC in HBV/HIV Co-infected Patients
A Randomized, Pilot Estimation Study to Compare the Safety and Efficacy of Raltegravir+TDF+3TC Versus TDF+3TC+EFV in HBV/HIV Co-infected Patients
Studieoversikt
Status
Forhold
Intervensjon / Behandling
Detaljert beskrivelse
There are in total more than 72939 HIV infected people reported in Yunnan, the largest number for any province in China. About 800 HIV inpatients are admitted to our hospital every year, amongst them about 10% co-infected with HBV. HIV and HBV co-infection patients must receive two drugs active against both HIV and HBV, for example Tenofovir disoproxil fumarate (TDF)+ lamivudine (3TC) or TDF+FTC. TDF and 3TC are nucleotide analogues that can inhibit both HIV and HBV DNA polymerases (Dore, Cooper et al. 2004). Combination therapy could decrease drug resistance. In China, TDF is a second-line drug of the national free ART program; however FTC is not in the list of free drugs. There is likely higher risk of causing drug resistance in treating HBV or HIV infection with 3TC or TDF monotherapy than combination therapy.
Raltegravir inhibits the catalytic activity of HIV-1 integrase, and does not significantly inhibit human phosphoryl transferases including DNA polymerases α, β, and γ, and may have less adverse effects. In chronic HBV infection, HBV-DNA does integrate into human DNA which results in difficulty eradicating HBV from the patient's body.
In this pilot study, the investigators would examine the safety and efficacy of integrase inhibitor-Raltegravir in the control of HIV/HBV co-infection.
Studietype
Registrering (Forventet)
Fase
- Ikke aktuelt
Kontakter og plasseringer
Studiesteder
-
-
Yunnan Provice
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Kunming, Yunnan Provice, Kina, 650301
- Yunnan Provincial Hospital of Infectious Diseases/Yunnan AIDS Care Center
-
-
Deltakelseskriterier
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
Tar imot friske frivillige
Kjønn som er kvalifisert for studier
Beskrivelse
Inclusion Criteria:
- Ability and willingness to provide written informed consent
- HIV-1 infection, documented in patient medical record. Acceptable forms of documentation include positive HIV antibody or detectable HIV RNA
- HIV-1 antiretroviral therapy naïve
- Chronic HBV infection, defined as HBsAg positive >6 months. Both HBeAg positive and negative subjects will be eligible
- Detectable HBV DNA ( > 300 copies/ml)
- Serum alpha-fetoprotein (AFP) of ≤ 50 ng/ml within 4 weeks of study entry, or if elevated > 50 ng/ml, an imaging study demonstrating no evidence of hepatic tumor within 4 weeks of enrollment
Exclusion Criteria:
- Allergy or sensitivity to study drug
- Pregnancy, breastfeeding or unwillingness/inability to adhere to contraceptive methods for the duration of the study (Female study volunteers must not participate in a conception process (e.g., active attempt to become pregnant). If participating in sexual activity that could lead to pregnancy, the female study volunteer must use the following forms of contraception while receiving study-specific medication(s) and for 30 days after stopping the medication. One of the following methods MUST be used appropriately: (1)Condoms* (male or female) with or without a spermicidal agent; (2)Diaphragm or cervical cap with spermicide; (3)IUD; (4)Hormonal-based method.Condoms are recommended because their appropriate use is the only contraception method effective for preventing HIV transmission.
- Prisoners or subjects who are incarcerated
- Receipt of the following drugs with anti-HBV activity within 90 days prior to study entry or anticipated receipt during the course of the study including: ADV, telbivudine, alpha interferon, and other investigational agents with anti-HBV activity
- Active opportunistic infection
- Other causes of chronic liver disease identified (autoimmune hepatitis, haemochromatosis, Wilsons disease, alfa-1-antitrypsin deficiency)
- Concurrent malignancy requiring cytotoxic chemotherapy
- Decompensated or Child's C cirrhosis
- Any other condition which in the opinion of the investigator might interfere with compliance or outcome of the study
Studieplan
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Behandling
- Tildeling: Randomisert
- Intervensjonsmodell: Parallell tildeling
- Masking: Ingen (Open Label)
Våpen og intervensjoner
Deltakergruppe / Arm |
Intervensjon / Behandling |
---|---|
Eksperimentell: A:Raltegravir + tenofovir+lamivudine
|
raltegravir 400mg BID and tenofovir 300mg qd and lamivudine 300mg gd for 48 weeks
Andre navn:
|
Aktiv komparator: B:Efavirenz+tenofovir+lamivudine
|
efavirenz 600mg QN +tenofovir 300mg qd +lamivudine 300mg qd for 48 weeks
Andre navn:
|
Hva måler studien?
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
---|---|---|
Frequency and severity of adverse events
Tidsramme: In 48 weeks (from baseline to study completion at 48 weeks)
|
The investigators will collect the adverse events at every follow-up, and record them in CRFs.
All AEs during the study will be analyzed according to the type, frequency and severity.
|
In 48 weeks (from baseline to study completion at 48 weeks)
|
Sekundære resultatmål
Resultatmål |
Tidsramme |
---|---|
Change of plasma HIV-1 RNA levels
Tidsramme: week 0,24 and 48
|
week 0,24 and 48
|
Change of Peripheral blood CD4 cell counts
Tidsramme: week 0,4,8,12,24,36 and 48
|
week 0,4,8,12,24,36 and 48
|
Change of plasma HBV-DNA levels
Tidsramme: week 0,12,24,36,and 48
|
week 0,12,24,36,and 48
|
Change of serum total bilirubin levels(TBI)
Tidsramme: week 0,2,4,8,12,24,36 and 48
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week 0,2,4,8,12,24,36 and 48
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Proportion of subjects with HBeAg seroconversion (HBeAg loss and presence of anti HBe)
Tidsramme: week 0,12,24,36,and week 48
|
week 0,12,24,36,and week 48
|
Emergence of drug resistance mutations, if appropriate
Tidsramme: week 0, 24 and 48
|
week 0, 24 and 48
|
Paired liver biopsy comparison according to inflammatory activity and fibrosis score
Tidsramme: week 0 and 48
|
week 0 and 48
|
Change of serum alanine aminotransferase levels (ALT)
Tidsramme: week 0,2,4,8,12,24,36 and 48
|
week 0,2,4,8,12,24,36 and 48
|
Change of serum aspartate aminotransferase levels (AST)
Tidsramme: week 0,2,4,8,12,24,36 and 48
|
week 0,2,4,8,12,24,36 and 48
|
Change of blood urine nitrogen levels (BUN)
Tidsramme: week 0,2,4,8,12,24,36 and 48
|
week 0,2,4,8,12,24,36 and 48
|
Change of serum creatinine levels (SCr)
Tidsramme: week 0,2,4,8,12,24,36 and 48
|
week 0,2,4,8,12,24,36 and 48
|
Change of blood haemoglobin levels (HB)
Tidsramme: week 0,2,4,8,12,24,36 and 48
|
week 0,2,4,8,12,24,36 and 48
|
Change of white blood cell counts (WBC)
Tidsramme: week 0,2,4,8,12,24,36 and 48
|
week 0,2,4,8,12,24,36 and 48
|
Change of blood platelet counts (PLT)
Tidsramme: week 0,2,4,8,12,24,36 and 48
|
week 0,2,4,8,12,24,36 and 48
|
Change of urine protein levels
Tidsramme: week 0,2,4,8,12,24,36 and 48
|
week 0,2,4,8,12,24,36 and 48
|
Samarbeidspartnere og etterforskere
Sponsor
Etterforskere
- Hovedetterforsker: Cheng Xi Wang, M.D., Yunnan Provincial Hospital of Infectious Diseases/Yunnan AIDS Care Center
Studierekorddatoer
Studer hoveddatoer
Studiestart
Primær fullføring (Forventet)
Studiet fullført (Forventet)
Datoer for studieregistrering
Først innsendt
Først innsendt som oppfylte QC-kriteriene
Først lagt ut (Anslag)
Oppdateringer av studieposter
Sist oppdatering lagt ut (Anslag)
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Sist bekreftet
Mer informasjon
Begreper knyttet til denne studien
Nøkkelord
Ytterligere relevante MeSH-vilkår
- Infeksjoner
- Saminfeksjon
- Molekylære mekanismer for farmakologisk virkning
- Anti-infeksjonsmidler
- Antivirale midler
- Revers transkriptasehemmere
- Nukleinsyresyntesehemmere
- Enzymhemmere
- Anti-HIV-midler
- Antiretrovirale midler
- Cytokrom P-450 enzymhemmere
- Cytokrom P-450 enzymindusere
- Cytokrom P-450 CYP3A indusere
- HIV-integrasehemmere
- Integrasehemmere
- Cytokrom P-450 CYP2B6 indusere
- Cytokrom P-450 CYP2C9-hemmere
- Cytokrom P-450 CYP2C19-hemmere
- Tenofovir
- Raltegravir kalium
- Lamivudin
- Efavirenz
Andre studie-ID-numre
- MSD-38154
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