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Safety and Efficacy of Raltegravir+TDF+3TC in HBV/HIV Co-infected Patients

2011年3月17日 更新者:Yunnan AIDS Care Center

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

In this pilot study, the investigators would examine the safety and efficacy of integrase inhibitor-Raltegravir in the control of HIV/HBV co-infection.

研究概览

详细说明

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.

研究类型

介入性

注册 (预期的)

60

阶段

  • 不适用

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

    • Yunnan Provice
      • Kunming、Yunnan Provice、中国、650301
        • Yunnan Provincial Hospital of Infectious Diseases/Yunnan AIDS Care Center

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

不

有资格学习的性别

全部

描述

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

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
  • 屏蔽:无(打开标签)

武器和干预

参与者组/臂
干预/治疗
实验性的:A:Raltegravir + tenofovir+lamivudine
raltegravir 400mg BID and tenofovir 300mg qd and lamivudine 300mg gd for 48 weeks
其他名称:
  • raltegravir: Isentress
有源比较器:B:Efavirenz+tenofovir+lamivudine
efavirenz 600mg QN +tenofovir 300mg qd +lamivudine 300mg qd for 48 weeks
其他名称:
  • efavirenz: Sustiva

研究衡量的是什么?

主要结果指标

结果测量
措施说明
大体时间
Frequency and severity of adverse events
大体时间: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)

次要结果测量

结果测量
大体时间
Change of plasma HIV-1 RNA levels
大体时间:week 0,24 and 48
week 0,24 and 48
Change of Peripheral blood CD4 cell counts
大体时间:week 0,4,8,12,24,36 and 48
week 0,4,8,12,24,36 and 48
Change of plasma HBV-DNA levels
大体时间:week 0,12,24,36,and 48
week 0,12,24,36,and 48
Change of serum total bilirubin levels(TBI)
大体时间:week 0,2,4,8,12,24,36 and 48
week 0,2,4,8,12,24,36 and 48
Proportion of subjects with HBeAg seroconversion (HBeAg loss and presence of anti HBe)
大体时间:week 0,12,24,36,and week 48
week 0,12,24,36,and week 48
Emergence of drug resistance mutations, if appropriate
大体时间:week 0, 24 and 48
week 0, 24 and 48
Paired liver biopsy comparison according to inflammatory activity and fibrosis score
大体时间:week 0 and 48
week 0 and 48
Change of serum alanine aminotransferase levels (ALT)
大体时间: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)
大体时间: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)
大体时间: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)
大体时间: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)
大体时间: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)
大体时间: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)
大体时间: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
大体时间:week 0,2,4,8,12,24,36 and 48
week 0,2,4,8,12,24,36 and 48

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

  • 首席研究员:Cheng Xi Wang, M.D.、Yunnan Provincial Hospital of Infectious Diseases/Yunnan AIDS Care Center

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

学习开始

2011年3月1日

初级完成 (预期的)

2012年7月1日

研究完成 (预期的)

2013年9月1日

研究注册日期

首次提交

2011年3月8日

首先提交符合 QC 标准的

2011年3月17日

首次发布 (估计)

2011年3月18日

研究记录更新

最后更新发布 (估计)

2011年3月18日

上次提交的符合 QC 标准的更新

2011年3月17日

最后验证

2011年3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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