Boceprevir in HIV-HCV Coinfected Patients Who Have Failed to a Previous Therapy With Peg-Interferon/Ribavirin (BocepreVIH)
HCV Coinfection, HIV-1 Infection
About this trial
This is an interventional treatment trial for HCV Coinfection focused on measuring HCV infection, HIV-1 infection
Eligibility Criteria
Inclusion Criteria:
- Adult ≥18 years
- HIV-1 infection
- Infection to genotype 1 HCV only
- Patients must have received at least 12 weeks of treatment with Peg-Interferon alfa 2a ≥ 135 µg / once weekly or Peg-Interferon alfa 2b ≥ 1,0 µg/kg/ once weekly + Ribavirin ≥ 600 mg daily and must have failed to treatment.
- Anti-HCV treatment stopped for at least 6 months
Patients must be already treated at screen since at least 3 months with a stable combination of antiretroviral treatment as following:
- Either tenofovir - emtricitabine, and atazanavir in combination with ritonavir
- Or tenofovir - emtricitabine, and raltegravir
- If patients cannot receive neither of the two antiretroviral regimens proposed, for virologic, safety or toxicity reasons, patients could receive any effective antiretroviral therapy including : tenofovir, emtricitabine, lamivudine, atazanavir alone or in combination with ritonavir, raltegravir, abacavir. These patients are not allowed to take part in the pharmacokinetic sub-study.
- CD4 > 200/mm3 et >15%, at screen
- HIV-RNA < 50 copies/ml since at least 6 months at screen
- ≥ 40 Kg and ≤ 125 Kg
- Patients with any fibrosis grade. Proportion of F4 subjects should not excess 50% of the overall subjects.
- Male and female subjects must agree to use acceptable methods of contraception 1 month prior to starting the study treatment and to continue until 7 months after the last doses of study drugs for male subjects and their partner(s), 4 months for female subjects.
- Subjects must be willing to give written informed consent for principal study (signed at least at screen visit and prior to any study investigation)and + for the pharmacokinetic sub-study (for the concerned centers).
- Subjects must be willing to give written informed consent for biological collection.
- Subjects must be willing to give written informed consent for treatment of genetics data.
- Subjects affiliated or beneficiary to a medical insurance.
Exclusion Criteria:
History:
- Patients with cirrhosis (F4) and nul responders to prior treatment
- Cirrhosis classified Child-Pugh B or C or history of decompensated cirrhosis of the liver. If Child A classification, significant varicose veins (grade 2 or 3) observed with a fibroscopy realized for < 3 years.
- History of ocular neuritis, retinal disorders, transplant
- Opportunistic infections (classification C), active or occurred within the 6 months prior to baseline.
- History of neoplasia within the last 5 years, except cutaneous basocellular carcinoma, recovering Kaposi's sarcoma, in situ cervical or anal canal cancer.
Current condition:
- Co-infection with Hepatitis B virus
- Pregnancy and lactation
- Cardiac or severe pulmonary disease
- Untreated dysthyroidism
- Autoimmune disease contraindicating to an interferon treatment
- Severe haemoglobinopathies
- Any condition needing a systemic corticotherapy or an immunosuppressive treatment
- Evolutive current malignancy, including hepatocarcinoma which should be specifically controlled prior to baseline.
- Alcohol consumption which may disturb the study participation according to the investigator
- Drug addiction which may disturb the study participation according to the investigator. Patients taking part to a substitution program with methadone or buprenorphine are allowed to be enrolled in the study.
Biological criteria:
• Haemoglobin < 12 g/dL (female) or < 13g/dL (male), Platelets < 90 000/mm3, Neutrophil count < 1500/mm3, Renal failure defined as creatinine clearance < 50ml/min, Uncontrolled thyroid function, HbA1c ≥ 7% in case of diabetes
Criteria related to study drugs
- Contra-indication to Ribavirin, interferon treatment including psychiatric contra-indications.
- History of discontinuation for intolerance to anti-HCV treatment.Patients with a history of discontinuation for intolerance, especially anaemia or leuconeutropenia, and who were not treated with hematopoietic growth factor, are eligible
- Concomitant medication which may interfere with Boceprevir, atazanavir, ritonavir and raltegravir pharmacokinetic
- St.John's-wort consumption
Sites / Locations
- CHU Sainte Marguerite
Arms of the Study
Arm 1
Experimental
Boceprevir, PegIFN alfa 2b, Ribavirin
Standard Treatment : Peg-Interferon (PegIFN) alfa 2b by subcutaneous injection 1,5 µg/kg/week Ribavirin capsules 200mg: dosage delivered in weight categories (< 65 kg: 800 mg ; 65-80 kg: 1000 mg; 81-105 kg: 1200mg; > 105 kg: 1400mg) Three-drug-regimen: Peg-Interferon alfa 2b by subcutaneous injection 1,5 µg/kg/week Ribavirin capsules 200mg: dosage delivered in weight categories like in standard treatment Boceprevir tablets 200mg: 800 mg 3 times a day (2400 mg/j) with food