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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

Control of hepatitis B virus (HBV) infection can be difficult in HIV infected people who have taken the antiviral lamivudine (3TC). These people may have HBV that has become resistant to 3TC. Adefovir dipivoxil (ADV) has shown promising anti-HBV activity in clinical trials; tenofovir disoproxil fumarate (TDF) is used to treat HIV and may also be effective against HBV. The purpose of this study is to find out if adding ADV or TDF to a highly active antiretroviral therapy (HAART) regimen that includes 3TC has an effect on HBV infection in patients coinfected with HIV and HBV. The tolerability and safety of these drugs will be examined.

研究概览

详细说明

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.

研究类型

介入性

注册

90

阶段

  • 阶段2

联系人和位置

本节提供了进行研究的人员的详细联系信息,以及有关进行该研究的地点的信息。

学习地点

    • California
      • Sacramento、California、美国、95814
        • UC Davis Medical Center
      • Sacramento、California、美国
        • Univ. of California Davis Med. Ctr., ACTU
      • San Francisco、California、美国、94110
        • Ucsf Aids Crs
    • Colorado
      • Aurora、Colorado、美国、80262
        • University of Colorado Hospital CRS
    • Illinois
      • Chicago、Illinois、美国、60612
        • Cook County Hosp. CORE Ctr.
      • Chicago、Illinois、美国、60611
        • Northwestern University CRS
    • Maryland
      • Baltimore、Maryland、美国、21287
        • Johns Hopkins Adult AIDS CRS
    • New York
      • New York、New York、美国、10003
        • Beth Israel Med. Ctr., ACTU
      • New York、New York、美国
        • Weill Med. College of Cornell Univ., The Cornell CTU
      • New York、New York、美国、10016
        • NY Univ. HIV/AIDS CRS
      • New York、New York、美国、10021
        • Cornell CRS
    • Ohio
      • Cincinnati、Ohio、美国、452670405
        • Univ. of Cincinnati CRS
      • Cleveland、Ohio、美国、441091998
        • MetroHealth CRS
    • Tennessee
      • Nashville、Tennessee、美国、37203
        • Vanderbilt Therapeutics CRS
    • Washington
      • Seattle、Washington、美国、98104
        • University of Washington AIDS CRS

参与标准

研究人员寻找符合特定描述的人,称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

18年 及以上 (成人、年长者)

接受健康志愿者

有资格学习的性别

全部

描述

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

学习计划

本节提供研究计划的详细信息,包括研究的设计方式和研究的衡量标准。

研究是如何设计的?

设计细节

  • 主要用途:治疗
  • 分配:随机化
  • 介入模型:并行分配

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

调查人员

  • 学习椅:Bruce Polsky, MD、St. Luke's-Roosevelt Hospital Center
  • 学习椅:Marion Peters, MD、University of California, San Francisco

出版物和有用的链接

负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。

一般刊物

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查,以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

研究完成 (实际的)

2005年5月1日

研究注册日期

首次提交

2002年4月8日

首先提交符合 QC 标准的

2002年4月8日

首次发布 (估计)

2002年4月9日

研究记录更新

最后更新发布 (实际的)

2021年11月1日

上次提交的符合 QC 标准的更新

2021年10月28日

最后验证

2021年10月1日

更多信息

此信息直接从 clinicaltrials.gov 网站检索,没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求,请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改,我们的网站上也会自动更新.

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