HIV Patients With Chronic Hepatitis C Genotype 1 Infection Who Failed Previously to Peginterferon /Ribavirin

Phase 3

Terminated

Conditions: HIV Infections
Hepatitis C
COINFECTION

Interventions: Drug: boceprevir
Drug: Ribavirin
Drug: Peginterferon alfa-2a
Drug: Peginterferon alfa-2b

Registration Number: NCT01718301

Lead Sponsor: Anna Cruceta

Brief Summary: The primary objective of this study is to evaluate the safety and efficacy of a Response Guided Therapy of boceprevir 800 mg dosed three times a day (TID) orally (PO) in combination with Peginterferon (either alpha 2b or alpha 2a) and Ribavirin in HIV/HCV genotype 1 infected patients that failed to previous HCV therapy.

Detailed Description: In a total number of 108 patients the protocol was evaluated but only in 102 the protocol efectively was presented. In the remaining 6 patients we don't believe the trial could be performed.

Recruitment & Eligibility

Status: TERMINATED

Sex: All

Target Recruitment: 108

Inclusion Criteria

For inclusion in the study, subjects must have a qualifying regimen defined as peginterferon alfa-2a plus ribavirin or peginterferon alfa-2b plus ribavirin for a minimum of 12 weeks. If a subject has received more than one such regimen, the most recent regimen is considered the qualifying regimen.
Subject must have previously documented chronic hepatitis C (CHC) genotype 1 infection. Subjects with other or mixed genotypes are not eligible. The HCV-RNA result at the screening visit must confirm genotype 1 infection and be ≥10,000 IU/mL.
Subject must have a liver biopsy with histology consistent with CHC and no other etiology and/or Fibroscan assessment. In case of:
1. No cirrhosis. Biopsies and/or Fibroscan must be within 18 months of screening visit.
2. Cirrhosis. No specific length of time would be requested.
All patients with cirrhosis must have an ultrasound 6 month within of screening visit.
Patients must be on stable antiretroviral therapy including a CD4 cell count of more than 100 per mm3 and a HIV plasmatic viral load undetectable (it is < 50 copies/mL) for more than 6 months. Antiretroviral therapy must be Raltegravir-based (al least during the last 3 months).
Subject must be ≥18 years of age.
HIV treatment should not contain efavirenz (EFV), nevirapine (NVP), etravirine (ETV), didanosine (ddI), stavudine (d4T), zidovudine (AZT), or HIV protease inhibitors.
Subject must weight between 40 kg and 125 kg.
Subject and subject's partner(s) must each agree to use acceptable methods of contraception for at least 2 weeks prior to Day 1 and continue until at least 6 months after last dose of study drug.
Subjects must be willing to give written informed consent and by investigator opinion be able to follow the protocol visit design.

Exclusion Criteria

Subjects known to be coinfected with hepatitis B virus (HBsAg positive).
Patients chronically infected with HCV genotype other than 1
CD4 cell count < 100 cel/mm3.
Plasma HIV RNA more than 50 copies/mL
Platelet count less than 80.000 /mm3
Subjects who required discontinuation of previous interferon or ribavirin regimen for a severe adverse event considered by the investigator to be possibly or probably related to ribavirin and/or interferon.
Treatment with ribavirin within 90 days and any interferon-alpha within 1 month of Screening.
Treatment for hepatitis C with any investigational medication. Prior treatments with herbal remedies with known hepatotoxicity are exclusionary.
Participation in any other clinical trial within 30 days of randomization or intention to participate in another clinical trial during participation in this study.
History of hemoglobinopathy (e.g., thalassemia) or any other cause of or tendency to hemolysis.
Evidence of decompensate liver disease including, but not limited to, a history or presence of clinical ascites, bleeding varices, or hepatic encephalopathy.
Diabetic and/or hypertensive subjects with clinically significant ocular examination findings.
Unstable or untreated pre-existing psychiatric condition.
Any known pre-existing medical condition that could interfere with the subject's participation in and completion of the study.
Any current evidence of substance abuse of alcohol or other drugs.
Subjects receiving opioid agonist substitution therapy but not enrolled in an opiate substitution maintenance program.

Study & Design

Study Type: INTERVENTIONAL

Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
boceprevir + ribavirin + peginterferon	boceprevir	boceprevir 800 mg three times a day (v.o.) in combination with peginterferon (alfa-2b or alfa-2a) and ribavirin
boceprevir + ribavirin + peginterferon	Ribavirin	boceprevir 800 mg three times a day (v.o.) in combination with peginterferon (alfa-2b or alfa-2a) and ribavirin
boceprevir + ribavirin + peginterferon	Peginterferon alfa-2a	boceprevir 800 mg three times a day (v.o.) in combination with peginterferon (alfa-2b or alfa-2a) and ribavirin
boceprevir + ribavirin + peginterferon	Peginterferon alfa-2b	boceprevir 800 mg three times a day (v.o.) in combination with peginterferon (alfa-2b or alfa-2a) and ribavirin

Primary Outcome Measures

Name	Time	Method
Achievement of Sustained Virological Response (SVR) at 24 Weeks Post-Treatment	Week 24	Achievement of SVR, defined as undetectable plasma HCV-RNA at Follow-up Week (FW) 24. If a subject is missing FW 24 data and has undetectable HCV-RNA level at FW 12, the subject would be considered an SVR.

Secondary Outcome Measures

Name	Time	Method
Achievement of Sustained Virological Response at Weeks 2,4,8,12.	Weeks 2, 4, 8, 12	Proportion of participants with undetectable HCV RNA (\<15 IU/mL) at weeks 2, 4, 8, and 12 during treatment.
The Proportion of Subjects With Undetectable HCV-RNA at 72 Weeks After Randomization.	Week 72	The proportion of randomized subjects with undetectable HCV-RNA at 72 weeks after randomization.
Number of Adverse Events	From baseline to study completion (up to 72 weeks)	Safety: number of adverse events
The Proportion of Subjects With Undetectable HCV-RNA at FW 12.	Week 12	The proportion of subjects with undetectable HCV-RNA at follow-up week 12.
Resistance of HCV After Boceprevir (BOC) Containing Regimen	whenever resistance occurs during the study (from week 12 until the date the resistance occurs, assessed up to 72 weeks)	Resistance of HCV after boceprevir containing regimen. Blood samples will be collected at baseline and after HCV virological failure and resistance analysis will be done at the end of the study in a single Center (Hospital Clínic-Barcelona).