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Treatment of Recently Acquired Hepatitis C Virus Infection (ATAHC-II)

Primary Purpose

Acute Hepatitis C

Status
Completed
Phase
Phase 4
Locations
Australia
Study Type
Interventional
Intervention
Peginterferon alfa-2a
Ribavirin
Sponsored by
Kirby Institute
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Acute Hepatitis C focused on measuring Hepatitis C, Acute Hepatitis C, Early chronic Hepatitis C

Eligibility Criteria

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

Inclusion Criteria:

  • Male and female patients ≥ 16 years of age
  • Recent hepatitis C infection with an estimated duration of Infection ≤ 18 months defined as

A)

  • i) First anti-HCV antibody or HCV RNA positive within the previous 6 months and
  • ii) Documented anti-HCV antibody negative or HCV RNA negative within the 24 months prior to anti-HCV antibody positive result

OR

B)

  • i) First anti-HCV antibody or HCV RNA positive within the previous 6 months and
  • ii) acute clinical hepatitis (jaundice or ALT> 10 X ULN) within the 12 months prior to first positive HCV antibody or HCV RNA with no other cause of acute hepatitis identifiable and
  • Adequate English to provide written, informed consent and to provide reliable responses to the study interview
  • Provision of written, informed consent.

Exclusion Criteria:

All patients:

• Individuals considered by the study investigators to be unlikely to participate in intensive follow-up and/or unwilling to provide extra blood samples

Treatment group only:

  • Age between 16 and 18 years
  • Women with ongoing pregnancy or breast feeding
  • Therapy with any systemic anti-viral, anti-neoplastic or immunomodulatory treatment (including supraphysiologic doses of steroids and radiation) *6 months prior to the first dose of study drug
  • Any investigational drug <6 weeks prior to the first dose of study drug
  • Positive test at screening for anti-HAV IgM Ab, anti-HBc IgM Ab
  • History or other evidence of a medical condition associated with chronic liver disease other than HCV (e.g. hemochromatosis, autoimmune hepatitis, metabolic liver disease, alcoholic liver disease, toxin exposures)
  • History or other evidence of bleeding from esophageal varices or other conditions consistent with decompensated liver disease
  • Neutrophil count <1500 cells/mm3 or platelet count <90,000 cells/mm3 at screening
  • Serum creatinine level >1.5 times the upper limit of normal at screening
  • Hgb< 12g/dL in women or < 13g/dL in men at screening (for patients who receive combination therapy with PEG-IFN and ribavirin only)
  • Male partners of women who are pregnant (for patients who receive combination therapy with PEG-IFN and ribavirin only)
  • History of a severe seizure disorder or current anticonvulsant use
  • History of immunologically mediated disease, chronic pulmonary disease associated with functional limitation, severe cardiac disease, major organ transplantation or other evidence of severe illness, malignancy, or any other conditions which would make the patient, in the opinion of the investigator, unsuitable for the study
  • History of thyroid disease poorly controlled on prescribed medications, elevated thyroid stimulating hormone (TSH) concentrations with elevation of antibodies to thyroid peroxidase and any clinical manifestations of thyroid disease
  • Evidence of severe retinopathy (e.g. CMV retinitis, macular degeneration)

Sites / Locations

  • Royal Prince Alfred Hospital
  • Kirketon Road Centre
  • St Vincent's Hospital
  • St Vincent's Hospital Melbourne
  • Nepean Hospital
  • Royal Adelaide Hospital
  • Alfred Hospital
  • Royal Melbourne Hospital

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm Type

Experimental

Experimental

Experimental

Experimental

Experimental

No Intervention

Arm Label

Group A - 8 weeks therapy

Group B - 16 weeks therapy

Group C - 24 weeks therapy

Group D - 32 weeks (gt1) or 24 weeks (gt 2/3)

Group E - 48 weeks (gt 1) or 24 weeks (gt 2/3)

Untreated Group

Arm Description

8 weeks total of Pegylated interferon and ribavirin if undetectable HCV RNA after 2 weeks of therapy.

16 weeks total of Pegylated interferon and ribavirin if undetectable HCV RNA after 4 weeks of therapy.

24 weeks total of Pegylated interferon and ribavirin if undetectable HCV RNA after 6 weeks of therapy.

32 weeks total of Pegylated interferon and ribavirin if undetectable HCV RNA after 8 weeks of therapy (genotype 1) or 24 weeks total of Pegylated interferon and ribavirin if undetectable HCV RNA after 8 weeks of therapy.

48 weeks total of Pegylated interferon and ribavirin if undetectable HCV RNA after 12 weeks of therapy (genotype 1) or 24 weeks total of Pegylated interferon and ribavirin if undetectable HCV RNA after 12 weeks of therapy (genotype 2/3).

Observation only. No treatment for hepatitis C administered. Subjects who have undetectable HCV RNA at baseline, do not wish to commence treatment or are ineligible for treatment.

Outcomes

Primary Outcome Measures

Evaluate the safety and efficacy of response-guided pegylated interferon and ribavirin for the treatment of recent HCV infection. Response-guided means the duration of treatment will be determined by the subject's early response to treatment.
Treatment duration will be determined by time to undetectable HCV RNA. Undetectable at week 2=8 weeks of therapy; Undetectable at week 4=16 weeks of therapy; Undetectable at week 6=24 weeks of therapy; Undetectable at week 8=32 weeks of therapy (24 weeks for genotypes 2/3); Undetectable at week 12=48 weeks of therapy (24 weeks for genotypes 2/3);

Secondary Outcome Measures

Full Information

First Posted
April 13, 2011
Last Updated
August 31, 2015
Sponsor
Kirby Institute
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1. Study Identification

Unique Protocol Identification Number
NCT01336010
Brief Title
Treatment of Recently Acquired Hepatitis C Virus Infection
Acronym
ATAHC-II
Official Title
Treatment of Recently Acquired Hepatitis C Virus Infection
Study Type
Interventional

2. Study Status

Record Verification Date
August 2015
Overall Recruitment Status
Completed
Study Start Date
August 2011 (undefined)
Primary Completion Date
June 2015 (Actual)
Study Completion Date
June 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Kirby Institute

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
To determine whether response guided treatment with pegylated interferon +/- ribavirin is effective for the treatment of recently acquired hepatitis C infection. Response guided treatment is when the length of treatment is determined by how quickly you respond to the treatment.
Detailed Description
A prospective longitudinal study of natural history and treatment outcomes following response guided treatment of recent hepatitis C infection.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acute Hepatitis C
Keywords
Hepatitis C, Acute Hepatitis C, Early chronic Hepatitis C

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
82 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Group A - 8 weeks therapy
Arm Type
Experimental
Arm Description
8 weeks total of Pegylated interferon and ribavirin if undetectable HCV RNA after 2 weeks of therapy.
Arm Title
Group B - 16 weeks therapy
Arm Type
Experimental
Arm Description
16 weeks total of Pegylated interferon and ribavirin if undetectable HCV RNA after 4 weeks of therapy.
Arm Title
Group C - 24 weeks therapy
Arm Type
Experimental
Arm Description
24 weeks total of Pegylated interferon and ribavirin if undetectable HCV RNA after 6 weeks of therapy.
Arm Title
Group D - 32 weeks (gt1) or 24 weeks (gt 2/3)
Arm Type
Experimental
Arm Description
32 weeks total of Pegylated interferon and ribavirin if undetectable HCV RNA after 8 weeks of therapy (genotype 1) or 24 weeks total of Pegylated interferon and ribavirin if undetectable HCV RNA after 8 weeks of therapy.
Arm Title
Group E - 48 weeks (gt 1) or 24 weeks (gt 2/3)
Arm Type
Experimental
Arm Description
48 weeks total of Pegylated interferon and ribavirin if undetectable HCV RNA after 12 weeks of therapy (genotype 1) or 24 weeks total of Pegylated interferon and ribavirin if undetectable HCV RNA after 12 weeks of therapy (genotype 2/3).
Arm Title
Untreated Group
Arm Type
No Intervention
Arm Description
Observation only. No treatment for hepatitis C administered. Subjects who have undetectable HCV RNA at baseline, do not wish to commence treatment or are ineligible for treatment.
Intervention Type
Drug
Intervention Name(s)
Peginterferon alfa-2a
Other Intervention Name(s)
Pegasys
Intervention Description
PEG-IFN 180 mcg in 0.5 ml (prefilled syringes) administered subcutaneously (SC) once weekly
Intervention Type
Drug
Intervention Name(s)
Ribavirin
Intervention Description
Genotype 1: 1000mg or 1200mg p.o. daily in split doses (1000mg for patients weighing <75kg and 1200mg for patients weighing ≥ 75kg) Genotypes 2/3: 800mg daily p.o. daily in split doses for genotype 2 and 3 patients
Primary Outcome Measure Information:
Title
Evaluate the safety and efficacy of response-guided pegylated interferon and ribavirin for the treatment of recent HCV infection. Response-guided means the duration of treatment will be determined by the subject's early response to treatment.
Description
Treatment duration will be determined by time to undetectable HCV RNA. Undetectable at week 2=8 weeks of therapy; Undetectable at week 4=16 weeks of therapy; Undetectable at week 6=24 weeks of therapy; Undetectable at week 8=32 weeks of therapy (24 weeks for genotypes 2/3); Undetectable at week 12=48 weeks of therapy (24 weeks for genotypes 2/3);
Time Frame
8-48 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
16 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male and female patients ≥ 16 years of age Recent hepatitis C infection with an estimated duration of Infection ≤ 18 months defined as A) i) First anti-HCV antibody or HCV RNA positive within the previous 6 months and ii) Documented anti-HCV antibody negative or HCV RNA negative within the 24 months prior to anti-HCV antibody positive result OR B) i) First anti-HCV antibody or HCV RNA positive within the previous 6 months and ii) acute clinical hepatitis (jaundice or ALT> 10 X ULN) within the 12 months prior to first positive HCV antibody or HCV RNA with no other cause of acute hepatitis identifiable and Adequate English to provide written, informed consent and to provide reliable responses to the study interview Provision of written, informed consent. Exclusion Criteria: All patients: • Individuals considered by the study investigators to be unlikely to participate in intensive follow-up and/or unwilling to provide extra blood samples Treatment group only: Age between 16 and 18 years Women with ongoing pregnancy or breast feeding Therapy with any systemic anti-viral, anti-neoplastic or immunomodulatory treatment (including supraphysiologic doses of steroids and radiation) *6 months prior to the first dose of study drug Any investigational drug <6 weeks prior to the first dose of study drug Positive test at screening for anti-HAV IgM Ab, anti-HBc IgM Ab History or other evidence of a medical condition associated with chronic liver disease other than HCV (e.g. hemochromatosis, autoimmune hepatitis, metabolic liver disease, alcoholic liver disease, toxin exposures) History or other evidence of bleeding from esophageal varices or other conditions consistent with decompensated liver disease Neutrophil count <1500 cells/mm3 or platelet count <90,000 cells/mm3 at screening Serum creatinine level >1.5 times the upper limit of normal at screening Hgb< 12g/dL in women or < 13g/dL in men at screening (for patients who receive combination therapy with PEG-IFN and ribavirin only) Male partners of women who are pregnant (for patients who receive combination therapy with PEG-IFN and ribavirin only) History of a severe seizure disorder or current anticonvulsant use History of immunologically mediated disease, chronic pulmonary disease associated with functional limitation, severe cardiac disease, major organ transplantation or other evidence of severe illness, malignancy, or any other conditions which would make the patient, in the opinion of the investigator, unsuitable for the study History of thyroid disease poorly controlled on prescribed medications, elevated thyroid stimulating hormone (TSH) concentrations with elevation of antibodies to thyroid peroxidase and any clinical manifestations of thyroid disease Evidence of severe retinopathy (e.g. CMV retinitis, macular degeneration)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Gregory J Dore, MBBS, PhD
Organizational Affiliation
University of New South Wales
Official's Role
Principal Investigator
Facility Information:
Facility Name
Royal Prince Alfred Hospital
City
Camperdown
State/Province
New South Wales
ZIP/Postal Code
2050
Country
Australia
Facility Name
Kirketon Road Centre
City
Darlinghurst
State/Province
New South Wales
ZIP/Postal Code
2010
Country
Australia
Facility Name
St Vincent's Hospital
City
Darlinghurst
State/Province
New South Wales
ZIP/Postal Code
2010
Country
Australia
Facility Name
St Vincent's Hospital Melbourne
City
Melbourne
State/Province
New South Wales
ZIP/Postal Code
3065
Country
Australia
Facility Name
Nepean Hospital
City
Penrith
State/Province
New South Wales
ZIP/Postal Code
2751
Country
Australia
Facility Name
Royal Adelaide Hospital
City
Adelaide
State/Province
South Australia
ZIP/Postal Code
5000
Country
Australia
Facility Name
Alfred Hospital
City
Melbourne
State/Province
Victoria
ZIP/Postal Code
3004
Country
Australia
Facility Name
Royal Melbourne Hospital
City
Parkville
State/Province
Victoria
ZIP/Postal Code
3065
Country
Australia

12. IPD Sharing Statement

Citations:
PubMed Identifier
26867206
Citation
Martinello M, Hellard M, Shaw D, Petoumenos K, Applegate T, Grebely J, Yeung B, Maire L, Iser D, Lloyd A, Thompson A, Sasadeusz J, Haber P, Dore GJ, Matthews GV. Short duration response-guided treatment is effective for most individuals with recent hepatitis C infection: the ATAHC II and DARE-C I studies. Antivir Ther. 2016;21(5):425-34. doi: 10.3851/IMP3035. Epub 2016 Feb 11.
Results Reference
derived

Learn more about this trial

Treatment of Recently Acquired Hepatitis C Virus Infection

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