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Zidovudine Levels in HIV Infected Patients Being Treated for HCV

Primary Purpose

HIV Infections, Hepatitis C

Status
Completed
Phase
Phase 1
Locations
Puerto Rico
Study Type
Interventional
Intervention
Ribavirin plus interferon alfa-2b
Ribavirin
Peginterferon alfa-2b
Sponsored by
National Institute of Allergy and Infectious Diseases (NIAID)
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for HIV Infections focused on measuring HIV, HCV, Ribavirin, Interferon, Co-infection, Treatment experienced

Eligibility Criteria

21 Years - 60 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria HCV-infected HIV-1 infection CD4 cell count > 200 cells/mm³ within 30 days prior to study entry HIV RNA < 400 copies/ml within 90 days of study entry Use of zidovudine, lamivudine, and any PI and/or NNRTI ANC value >= 1,500 ml³ within 30 days of study entry Weight > 50 kg (110 lbs) for women and > 60 kg (132 lbs) for men Acceptable methods of contraception Ability and willingness to complete the Baseline Adherence Questionnaire Documentation of adherence confirmed by the Baseline Adherence Questionnaire and certified by the study officials Exclusion Criteria Previous ribavirin therapy More than 2 months of interferon therapy Current use of any NRTI other than ZDV and 3TC Hepatitis B surface antigen positive Infectious, autoimmune, tumoral, biliary, or vascular liver disease Alcohol consumption of more than 50 g/day Current use of intravenous drugs Hemoglobin levels < 10 gm/dl Methadone use Chemotherapy Certain medications Acute opportunistic or bacterial infection requiring therapy at the time of enrollment Hemoglobinopathy (e.g., thalassemia) or any other cause of tendency to hemolysis Psychiatric disorders, severe depression, history of suicide attempts, or suicidal ideation Renal disease requiring dialysis Significant coronary diseases or two or more risk factors for coronary diseases, such as > 55 years old, hypertension, and cholesterol > 250 mg/dl Any clinically significant diseases (other than HIV and HCV infection) that, in the opinion of study officials, would compromise the outcome of this study Pregnancy Participation in blinded clinical trial

Sites / Locations

  • UPR Adult ACTU

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

1

Arm Description

Participants will begin receive either Rebetron or PEG-Intron plus ribavirin therapy from Weeks 2 through 48

Outcomes

Primary Outcome Measures

Steady state area under the concentration time curve (AUC) between 0 and 12 hours of zidovudine (ZDV)-MP, ZDV-TP, and dTTP in PBMCs from HIV and hepatitis C virus (HCV) coinfected patients before and after peginterferon alfa-2b with or without ribavirin
Systemic exposure (AUC over 0 to 12 hours) of nelfinavir before and after peginterferon alfa-2b with or without ribavirin in HIV and HCV coinfected patients
Effect of peginterferon alfa-2b with or without ribavirin in HCV RNA viral titers, alanine aminotransferase (ALT) levels, CD4+, and HIV-RNA viral titers in HIV and HCV coinfected patients
Effect of peginterferon alfa-2b with or without ribavirin on liver histology

Secondary Outcome Measures

Full Information

First Posted
April 23, 2003
Last Updated
August 6, 2009
Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)
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1. Study Identification

Unique Protocol Identification Number
NCT00059358
Brief Title
Zidovudine Levels in HIV Infected Patients Being Treated for HCV
Official Title
Pharmacological Interactions Between Zidovudine and Ribavirin in HCV-HIV Co-Infected Patients Treated With Rebetron or Peg-Intron Plus Ribavirin
Study Type
Interventional

2. Study Status

Record Verification Date
August 2009
Overall Recruitment Status
Completed
Study Start Date
September 2001 (undefined)
Primary Completion Date
June 2005 (Actual)
Study Completion Date
June 2005 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)

4. Oversight

5. Study Description

Brief Summary
This study will test the amount of anti-HIV drugs in the blood cells of HIV-infected patients who are also being treated for hepatitis C virus (HCV) infection.
Detailed Description
An estimated 50,000 people in Puerto Rico are infected with HCV. HIV and HCV have similar routes of transmission, and HCV co-infection occurs in 8% to 23% of HIV infected patients. Researchers have shown that treatment for HCV with Rebetron (ribavirin plus interferon alfa-2b) significantly decreases HCV viral load without affecting HIV viral load. However, measurements of intracellular levels of the active forms of zidovudine (ZDV-MP and ZDV-TP) were not performed. Such measurements are needed to provide a more rational basis for dosing in HIV/HCV co-infected patients. This study will investigate the intracellular exposure to active ZDV metabolites prior to and after treatment with Rebetron or treatment with PEG-Intron (pegylated interferon) and ribavirin. Participants in this study will remain on their usual antiretroviral regimen; no changes may be made to that regimen for the first 4 weeks of the study. Upon study entry, participants will have intracellular pharmacokinetic studies. During Week 2, participants will start either Rebetron or PEG-Intron plus ribavirin therapy, will have intracellular pharmacokinetic studies, and will undergo liver biopsy. Additional intracellular pharmacokinetic studies will be performed at Weeks 12 and 24. Rebetron or PEG-Intron plus ribavirin will be given for 48 weeks. A second liver biopsy will be performed 24 weeks after discontinuing Rebetron or PEG-Intron plus ribavirin therapy. Participants will be followed for 72 weeks.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HIV Infections, Hepatitis C
Keywords
HIV, HCV, Ribavirin, Interferon, Co-infection, Treatment experienced

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
16 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
1
Arm Type
Experimental
Arm Description
Participants will begin receive either Rebetron or PEG-Intron plus ribavirin therapy from Weeks 2 through 48
Intervention Type
Drug
Intervention Name(s)
Ribavirin plus interferon alfa-2b
Intervention Description
Oral tablets taken daily
Intervention Type
Drug
Intervention Name(s)
Ribavirin
Intervention Description
Oral tablet taken daily
Intervention Type
Drug
Intervention Name(s)
Peginterferon alfa-2b
Intervention Description
Subcutaneous injection
Primary Outcome Measure Information:
Title
Steady state area under the concentration time curve (AUC) between 0 and 12 hours of zidovudine (ZDV)-MP, ZDV-TP, and dTTP in PBMCs from HIV and hepatitis C virus (HCV) coinfected patients before and after peginterferon alfa-2b with or without ribavirin
Time Frame
Throughout study
Title
Systemic exposure (AUC over 0 to 12 hours) of nelfinavir before and after peginterferon alfa-2b with or without ribavirin in HIV and HCV coinfected patients
Time Frame
Throughout study
Title
Effect of peginterferon alfa-2b with or without ribavirin in HCV RNA viral titers, alanine aminotransferase (ALT) levels, CD4+, and HIV-RNA viral titers in HIV and HCV coinfected patients
Time Frame
Through Week 48
Title
Effect of peginterferon alfa-2b with or without ribavirin on liver histology
Time Frame
At Week 72

10. Eligibility

Sex
All
Minimum Age & Unit of Time
21 Years
Maximum Age & Unit of Time
60 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria HCV-infected HIV-1 infection CD4 cell count > 200 cells/mm³ within 30 days prior to study entry HIV RNA < 400 copies/ml within 90 days of study entry Use of zidovudine, lamivudine, and any PI and/or NNRTI ANC value >= 1,500 ml³ within 30 days of study entry Weight > 50 kg (110 lbs) for women and > 60 kg (132 lbs) for men Acceptable methods of contraception Ability and willingness to complete the Baseline Adherence Questionnaire Documentation of adherence confirmed by the Baseline Adherence Questionnaire and certified by the study officials Exclusion Criteria Previous ribavirin therapy More than 2 months of interferon therapy Current use of any NRTI other than ZDV and 3TC Hepatitis B surface antigen positive Infectious, autoimmune, tumoral, biliary, or vascular liver disease Alcohol consumption of more than 50 g/day Current use of intravenous drugs Hemoglobin levels < 10 gm/dl Methadone use Chemotherapy Certain medications Acute opportunistic or bacterial infection requiring therapy at the time of enrollment Hemoglobinopathy (e.g., thalassemia) or any other cause of tendency to hemolysis Psychiatric disorders, severe depression, history of suicide attempts, or suicidal ideation Renal disease requiring dialysis Significant coronary diseases or two or more risk factors for coronary diseases, such as > 55 years old, hypertension, and cholesterol > 250 mg/dl Any clinically significant diseases (other than HIV and HCV infection) that, in the opinion of study officials, would compromise the outcome of this study Pregnancy Participation in blinded clinical trial
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jose F. Rodriguez, PhD
Organizational Affiliation
MSC-UPR
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Jorge L. Santana, MD
Organizational Affiliation
MSC-UPR
Official's Role
Principal Investigator
Facility Information:
Facility Name
UPR Adult ACTU
City
San Juan
ZIP/Postal Code
00936-5067
Country
Puerto Rico

12. IPD Sharing Statement

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Zidovudine Levels in HIV Infected Patients Being Treated for HCV

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