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
研究概览
地位
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
注册 (预期的)
阶段
- 不适用
联系人和位置
学习地点
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Yunnan Provice
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Kunming、Yunnan Provice、中国、650301
- Yunnan Provincial Hospital of Infectious Diseases/Yunnan AIDS Care Center
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
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
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 |
|---|---|
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实验性的:A:Raltegravir + tenofovir+lamivudine
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raltegravir 400mg BID and tenofovir 300mg qd and lamivudine 300mg gd for 48 weeks
其他名称:
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有源比较器:B:Efavirenz+tenofovir+lamivudine
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efavirenz 600mg QN +tenofovir 300mg qd +lamivudine 300mg qd for 48 weeks
其他名称:
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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 |
|---|---|---|
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Frequency and severity of adverse events
大体时间:In 48 weeks (from baseline to study completion at 48 weeks)
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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.
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In 48 weeks (from baseline to study completion at 48 weeks)
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次要结果测量
结果测量 |
大体时间 |
|---|---|
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Change of plasma HIV-1 RNA levels
大体时间:week 0,24 and 48
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week 0,24 and 48
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Change of Peripheral blood CD4 cell counts
大体时间:week 0,4,8,12,24,36 and 48
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week 0,4,8,12,24,36 and 48
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Change of plasma HBV-DNA levels
大体时间:week 0,12,24,36,and 48
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week 0,12,24,36,and 48
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Change of serum total bilirubin levels(TBI)
大体时间: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)
大体时间:week 0,12,24,36,and week 48
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week 0,12,24,36,and week 48
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Emergence of drug resistance mutations, if appropriate
大体时间:week 0, 24 and 48
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week 0, 24 and 48
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Paired liver biopsy comparison according to inflammatory activity and fibrosis score
大体时间:week 0 and 48
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week 0 and 48
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Change of serum alanine aminotransferase levels (ALT)
大体时间: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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Change of serum aspartate aminotransferase levels (AST)
大体时间: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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Change of blood urine nitrogen levels (BUN)
大体时间: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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Change of serum creatinine levels (SCr)
大体时间: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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Change of blood haemoglobin levels (HB)
大体时间: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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Change of white blood cell counts (WBC)
大体时间: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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Change of blood platelet counts (PLT)
大体时间: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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Change of urine protein levels
大体时间: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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合作者和调查者
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
研究主要日期
学习开始
初级完成 (预期的)
研究完成 (预期的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (估计)
研究记录更新
最后更新发布 (估计)
上次提交的符合 QC 标准的更新
最后验证
更多信息
与本研究相关的术语
关键字
其他相关的 MeSH 术语
其他研究编号
- MSD-38154
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