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Viral Kinetics of Treatment With Peginterferon Alpha-2a, Ribavirin and Epoetin β in Patients Coinfected HCV/HIV

Phase 4
Completed
Conditions
HIV Infections
Interventions
Drug: Peginterferon alfa-2a + Ribavirin for 12 weeks
Drug: Peginterferon alfa-2a, Ribavirin, epoetin-β
Registration Number
NCT00356486
Lead Sponsor
Germans Trias i Pujol Hospital
Brief Summary

The purpose of this study is to compare the early virological response (EVR = undetectable \[ribonucleic acid-hepatitis C virus\] RNA-HCV or a reduction of \> 2 log10) of patients with chronic hepatitis C coinfected with HIV treated with induction doses of peginterferon alpha-2a (40 KD) 270 µg/week and ribavirin 1600 mg/day for 4 weeks, followed by 8 weeks of treatment with peginterferon alpha-2a (40 KD) 180 µg/week and ribavirin 1000-1200 mg/day versus treatment with peginterferon alpha-2a (40 KD) 180 µg/week and ribavirin 1000-1200 mg/day for 12 weeks.

Detailed Description

This study seeks to ascertain whether treatment with higher doses of PEGASYS (270 µg/week) and ribavirin (1600 mg/day) for the first four weeks achieves the plasma concentrations of the product in the blood needed to reduce the half-life of the virions and accelerate the elimination thereof. This would bring the viral kinetic curves in coinfected patients closer to the model described for mono-infected HCV patients, probably achieving improved rates of response in week 12 (early virological response) and posterior in week 72 (sustained virological response).

Therefore, the patients were randomised to treatment with two different doses, 270 µg and 180 µg of PEGASYS, and 1600 mg and 1000-1200 mg of ribavirin.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
74
Inclusion Criteria
  • Serological evidence of chronic hepatitis C infection in an anti-HCV antibody test
  • Detectable RNA-HCV plasma level genotype 1 and 4
  • ALT serum activity above the upper limit of normality
  • Chronic liver disease consistent with chronic hepatitis C infection in a biopsy obtained during the two years prior to inclusion in the study
  • Serological evidence of HIV-1 infection, diagnosed by Enzyme-Linked Immunosorbent Assay (ELISA) and confirmed by Western-blot.
  • Patients with CD4 cell count > 200 /µl
  • Stable status in HIV-1 infection, in the investigator's opinion, in other words, patients that are not expected to progress during the study.
  • Patients treated with stable anti-retroviral therapy (HAART), which does not include nucleoside analogues, for at least 6 weeks before the baseline assessment
  • Patients that do not receive HAART therapy
  • Negative pregnancy test in urine or blood
Exclusion Criteria
  • Women currently pregnant or in the lactation period.
  • Patients whose companion is pregnant.
  • Therapy with interferon (IFN) or ribavirin at any previous time.
  • Patients with cirrhosis in the hepatic biopsy.
  • Documented suspicion by ultrasound of hepatocarcinoma.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
BPeginterferon alfa-2a + Ribavirin for 12 weeksPeginterferon alfa-2a (40 KD) (180 µg/week) subcutaneous + Ribavirin(1000-1200 mg/day) oral/day for 12 weeks
APeginterferon alfa-2a, Ribavirin, epoetin-βPeginterferon alfa-2a (40 KD) (270 µg/week) + Ribavirin (1600 mg/day) + epoetin-β (450 UI/kg/week) for 4 weeks. Peginterferon alfa-2a (40 KD) (180 µg/week) + Ribavirin (1000-1200 mg/day) for 8 weeks
Primary Outcome Measures
NameTimeMethod
Percentage of patients with undetectable RNA-HCVat week 12 after starting treatment
Secondary Outcome Measures
NameTimeMethod
Levels of ALTAt weeks 4, 8, and 12
Variations in levels of haemoglobin, neutrophil, and platelet countat 4, 8, and 12 weeks with regard to baseline
Variations of the levels of RNA-HCVfrom baseline until weeks 4, 8, and 12 of the study
Percentage of patients that drop out of the study for adverse effects or intoleranceDuring the 12 weeks of follow-up
AIDS-defining events or deathDuring the 12 weeks of follow-up
Percentage of patients with undetectable HCV RNAin weeks 4 and 8 of the study
Percentage of patients that must reduce the dose of peginterferon alpha-2a (40 KD) and ribavirin.During the 12 weeks of follow-up
Changes in the CD4/CD8 cell countAt 4, 8, and 12 weeks of follow-up

Trial Locations

Locations (12)

Hospital de Donostia

🇪🇸

San Sebastián, Donostia, Spain

Hospital General Universitario de Alicante

🇪🇸

Alicante, Spain

Hospital del Mar

🇪🇸

Barcelona, Spain

Hospital Clínic i Provincial

🇪🇸

Barcelona, Spain

Hospital Puerta del Mar

🇪🇸

Cádiz, Spain

Hospital Gregorio Marañón.

🇪🇸

Madrid, Spain

Hospital Ramón y Cajal

🇪🇸

Madrid, Spain

Hospital Clínico San Carlos

🇪🇸

Madrid, Spain

Hospital La Paz

🇪🇸

Madrid, Spain

Hospital Germans Trias i Pujol, Badalona

🇪🇸

Badalona, Barcelona, Spain

Consorci Sanitari de Terrassa

🇪🇸

Terrassa, Barcelona, Spain

Hospital General de Vic

🇪🇸

Vic, Barcelona, Spain

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