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Hep Mec Cohort in Zambia (Hep Mec)

9 maj 2026 uppdaterad av: 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.

Studieöversikt

Status

Rekrytering

Betingelser

Studietyp

Observationell

Inskrivning (Beräknad)

390

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studiekontakt

  • Namn: Michael J Vinikoor, MD
  • Telefonnummer: 205-934-5191
  • E-post: mjv3@uab.edu

Studera Kontakt Backup

Studieorter

  • Zambia
      • Lusaka, Zambia
        • Rekrytering
        • University Teaching Hospital
        • Kontakt:
        • Kontakt:
      • Lusaka, Zambia
        • Rekrytering
        • Kanyama Level 1 Hospital
        • Kontakt:
        • Kontakt:
      • Lusaka, Zambia
        • Rekrytering
        • Matero Level 1 Hospital
        • Kontakt:
        • Kontakt:

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

  • Vuxen
  • Äldre vuxen

Tar emot friska volontärer

Nej

Testmetod

Icke-sannolikhetsprov

Studera befolkning

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.

Beskrivning

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

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

Kohorter och interventioner

Grupp / Kohort
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
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

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Change in Intrahepatic Immune Cell Subset Frequencies
Tidsram: 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
Tidsram: 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

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
HBV viral suppression
Tidsram: 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
Tidsram: Baseline, 1 year, 2 years, 3 years, 4 years, and 5 years
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
Tidsram: 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
Tidsram: Through study completion, an average of 5 years
HBeAg-negativity in blood
Through study completion, an average of 5 years

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

University of Alabama at Birmingham

Samarbetspartners

National Institute of Allergy and Infectious Diseases (NIAID)
Massachusetts General Hospital
Weill Medical College of Cornell University
Centre for Infectious Disease Research in Zambia
University of Zambia
Tropical Gastroenterology and Nutrition Group

Utredare

  • Huvudutredare: Michael Vinikoor, MD, University of Alabama at Birmingham

Publikationer och användbara länkar

Den som ansvarar för att lägga in information om studien tillhandahåller frivilligt dessa publikationer. Dessa kan handla om allt som har med studien att göra.

Allmänna publikationer

Användbara länkar

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Faktisk)

28 september 2020

Primärt slutförande (Beräknad)

31 augusti 2029

Avslutad studie (Beräknad)

31 augusti 2030

Studieregistreringsdatum

Först inskickad

5 februari 2026

Först inskickad som uppfyllde QC-kriterierna

9 maj 2026

Första postat (Faktisk)

15 maj 2026

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

15 maj 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

9 maj 2026

Senast verifierad

1 januari 2026

Mer information

Termer relaterade till denna studie

Nyckelord

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • IRB-300003590
  • R37AI179640 (U.S.S. NIH-anslag/kontrakt)
  • R01AI147727 (U.S.S. NIH-anslag/kontrakt)
  • R01AI195435 (U.S.S. NIH-anslag/kontrakt)
  • 316-2019 (Annan identifierare: University of Zambia Biomedical Research Ethics Committee)

Plan för individuella deltagardata (IPD)

Planerar du att dela individuella deltagardata (IPD)?

JA

IPD-planbeskrivning

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.

Tidsram för IPD-delning

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.

Kriterier för IPD Sharing Access

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-delning som stöder informationstyp

  • STUDY_PROTOCOL
  • ICF

Läkemedels- och apparatinformation, studiedokument

Studerar en amerikansk FDA-reglerad läkemedelsprodukt

Nej

Studerar en amerikansk FDA-reglerad produktprodukt

Nej

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