search
Back to results

A Comparison of Adefovir and Tenofovir for the Treatment of Lamivudine-Resistant Hepatitis B Virus in People With HIV

Primary Purpose

HIV Infections, Hepatitis B

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Adefovir dipivoxil
Tenofovir disoproxil fumarate
Sponsored by
National Institute of Allergy and Infectious Diseases (NIAID)
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for HIV Infections focused on measuring Antiviral Agents, Hepatitis B, Drug Resistance, Microbial, Lamivudine, DNA, Viral, Hepatitis B Virus, Adefovir dipivoxil, Tenofovir disoproxil fumarate, Treatment Experienced

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

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

Sites / Locations

  • UC Davis Medical Center
  • Univ. of California Davis Med. Ctr., ACTU
  • Ucsf Aids Crs
  • University of Colorado Hospital CRS
  • Northwestern University CRS
  • Cook County Hosp. CORE Ctr.
  • Johns Hopkins Adult AIDS CRS
  • Beth Israel Med. Ctr., ACTU
  • NY Univ. HIV/AIDS CRS
  • Cornell CRS
  • Weill Med. College of Cornell Univ., The Cornell CTU
  • Univ. of Cincinnati CRS
  • MetroHealth CRS
  • Vanderbilt Therapeutics CRS
  • University of Washington AIDS CRS

Outcomes

Primary Outcome Measures

Secondary Outcome Measures

Full Information

First Posted
April 8, 2002
Last Updated
October 28, 2021
Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)
search

1. Study Identification

Unique Protocol Identification Number
NCT00033163
Brief Title
A Comparison of Adefovir and Tenofovir for the Treatment of Lamivudine-Resistant Hepatitis B Virus in People With HIV
Official Title
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
Study Type
Interventional

2. Study Status

Record Verification Date
October 2021
Overall Recruitment Status
Completed
Study Start Date
undefined (undefined)
Primary Completion Date
undefined (undefined)
Study Completion Date
May 2005 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)

4. Oversight

5. Study Description

Brief Summary
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.
Detailed Description
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.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HIV Infections, Hepatitis B
Keywords
Antiviral Agents, Hepatitis B, Drug Resistance, Microbial, Lamivudine, DNA, Viral, Hepatitis B Virus, Adefovir dipivoxil, Tenofovir disoproxil fumarate, Treatment Experienced

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Allocation
Randomized
Enrollment
90 (false)

8. Arms, Groups, and Interventions

Intervention Type
Drug
Intervention Name(s)
Adefovir dipivoxil
Intervention Type
Drug
Intervention Name(s)
Tenofovir disoproxil fumarate

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
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
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Bruce Polsky, MD
Organizational Affiliation
St. Luke's-Roosevelt Hospital Center
Official's Role
Study Chair
First Name & Middle Initial & Last Name & Degree
Marion Peters, MD
Organizational Affiliation
University of California, San Francisco
Official's Role
Study Chair
Facility Information:
Facility Name
UC Davis Medical Center
City
Sacramento
State/Province
California
ZIP/Postal Code
95814
Country
United States
Facility Name
Univ. of California Davis Med. Ctr., ACTU
City
Sacramento
State/Province
California
Country
United States
Facility Name
Ucsf Aids Crs
City
San Francisco
State/Province
California
ZIP/Postal Code
94110
Country
United States
Facility Name
University of Colorado Hospital CRS
City
Aurora
State/Province
Colorado
ZIP/Postal Code
80262
Country
United States
Facility Name
Northwestern University CRS
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
Facility Name
Cook County Hosp. CORE Ctr.
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60612
Country
United States
Facility Name
Johns Hopkins Adult AIDS CRS
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21287
Country
United States
Facility Name
Beth Israel Med. Ctr., ACTU
City
New York
State/Province
New York
ZIP/Postal Code
10003
Country
United States
Facility Name
NY Univ. HIV/AIDS CRS
City
New York
State/Province
New York
ZIP/Postal Code
10016
Country
United States
Facility Name
Cornell CRS
City
New York
State/Province
New York
ZIP/Postal Code
10021
Country
United States
Facility Name
Weill Med. College of Cornell Univ., The Cornell CTU
City
New York
State/Province
New York
Country
United States
Facility Name
Univ. of Cincinnati CRS
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
452670405
Country
United States
Facility Name
MetroHealth CRS
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
441091998
Country
United States
Facility Name
Vanderbilt Therapeutics CRS
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37203
Country
United States
Facility Name
University of Washington AIDS CRS
City
Seattle
State/Province
Washington
ZIP/Postal Code
98104
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
10534354
Citation
Benhamou Y, Bochet M, Thibault V, Di Martino V, Caumes E, Bricaire F, Opolon P, Katlama C, Poynard T. Long-term incidence of hepatitis B virus resistance to lamivudine in human immunodeficiency virus-infected patients. Hepatology. 1999 Nov;30(5):1302-6. doi: 10.1002/hep.510300525.
Results Reference
background
PubMed Identifier
11551579
Citation
Benhamou Y, Bochet M, Thibault V, Calvez V, Fievet MH, Vig P, Gibbs CS, Brosgart C, Fry J, Namini H, Katlama C, Poynard T. Safety and efficacy of adefovir dipivoxil in patients co-infected with HIV-1 and lamivudine-resistant hepatitis B virus: an open-label pilot study. Lancet. 2001 Sep 1;358(9283):718-23. doi: 10.1016/s0140-6736(01)05840-8.
Results Reference
background
PubMed Identifier
12717046
Citation
Dieterich DT. HIV and hepatitis B virus: options for managing coinfection. Top HIV Med. 2003 Jan-Feb;11(1):16-9.
Results Reference
background
PubMed Identifier
14562859
Citation
Rockstroh JK. Management of hepatitis B and C in HIV co-infected patients. J Acquir Immune Defic Syndr. 2003 Sep;34 Suppl 1:S59-65. doi: 10.1097/00126334-200309011-00009.
Results Reference
background
PubMed Identifier
12800066
Citation
Thio CL. Hepatitis B in the human immunodeficiency virus-infected patient: epidemiology, natural history, and treatment. Semin Liver Dis. 2003 May;23(2):125-36. doi: 10.1055/s-2003-39951.
Results Reference
background
PubMed Identifier
17058225
Citation
Peters MG, Andersen J, Lynch P, Liu T, Alston-Smith B, Brosgart CL, Jacobson JM, Johnson VA, Pollard RB, Rooney JF, Sherman KE, Swindells S, Polsky B; ACTG Protocol A5127 Team. Randomized controlled study of tenofovir and adefovir in chronic hepatitis B virus and HIV infection: ACTG A5127. Hepatology. 2006 Nov;44(5):1110-6. doi: 10.1002/hep.21388.
Results Reference
result
PubMed Identifier
31099252
Citation
Johnson VA, Cramer YS, Rosenkranz SL, Becker S, Klingman KL, Kallungal B, Coakley E, Acosta EP, Calandra G, Saag MS; NIH/NIAID AIDS Clinical Trials Group A5210 Protocol Team. Antiretroviral Activity of AMD11070 (An Orally Administered CXCR4 Entry Inhibitor): Results of NIH/NIAID AIDS Clinical Trials Group Protocol A5210. AIDS Res Hum Retroviruses. 2019 Aug;35(8):691-697. doi: 10.1089/AID.2018.0256. Epub 2019 Jun 18.
Results Reference
derived

Learn more about this trial

A Comparison of Adefovir and Tenofovir for the Treatment of Lamivudine-Resistant Hepatitis B Virus in People With HIV

We'll reach out to this number within 24 hrs