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Efficacy and Safety of Sofosbuvir Plus Ribavirin in Chronic Genotype 1, 2 and 3 Hepatitis C Virus (HCV) and Human Immunodeficiency Virus (HIV) Co-infected Adults

Primary Purpose

Hepatitis C, Human Immunodeficiency Virus

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
SOF
RBV
Sponsored by
Gilead Sciences
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hepatitis C focused on measuring Hepatitis C, Chronic, HCV, HIV, Human Immunodeficiency Virus, Co-Infected

Eligibility Criteria

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

Inclusion Criteria:

  • Willing and able to provide written informed consent
  • Male or female, age ≥ 18 years with chronic HCV and HIV-1 infection
  • HCV RNA > 1 x 10^4 IU/mL at screening
  • Infection with HCV genotype 1, 2 or 3 as determined at screening
  • HIV-1 infection confirmed with positive ELISA or Western blot at screening
  • Medical records must be sufficient to be categorized on interferon (IFN) eligibility or prior treatment history with PEG/RBV.
  • Confirmation of chronic HCV infection
  • Ability to determine presence/absence of cirrhosis.
  • HIV antiretroviral therapy (ARV) criteria of one of the following:

    • ARV untreated with a CD4 T-cell count > 500 cells/mm^3
    • On a stable, protocol-approved, ARV for > 8 weeks prior to screening with a CD4 T-cell count > 200 cells/mm^3 and a documented undetectable plasma HIV-1 RNA level for ≥ 8 weeks preceding the screening visit
  • Approved HIV antiretroviral medications based on drug interaction studies
  • Not been treated with any investigational drug or device within 30 days of the screening visit
  • Females if confirmed that she is not pregnant or nursing of non-childbearing potential or of childbearing potential but has a negative serum pregnancy test at screening and agrees to use protocol approved method of birth control from screening through 6 months after the last dose of RBV
  • Males who agree to consistently and correctly use a condom while their female partner agrees to use protocol approved method of birth control from screening through 7 months after the last dose of RBV
  • Must be of generally good health as determined by the investigator.
  • Liver imaging within 6 months of baseline/Day 1 is required in cirrhotic patients only, to exclude hepatocellular carcinoma (HCC)

Exclusion Criteria:

  • Non-genotype 1/2/3 or mixed genotype at screening
  • Genotype 1 with prior treatment for HCV
  • Poor control with ARV regimen
  • Prior exposure to a direct-acting antiviral targeting the HCV nonstructural protein (NS)5B polymerase
  • Chronic liver disease of a non-HCV etiology (eg, hemochromatosis, Wilson's disease, α1 antitrypsin deficiency, cholangitis)
  • A new AIDS-defining condition diagnosed within 30 days prior to screening
  • Active, serious infection (other than HIV or HCV) requiring parenteral antibiotics, antivirals or antifungals within 30 days prior to baseline
  • Infection with hepatitis B virus (HBV)
  • Contraindication to RBV therapy
  • Chronic use of systemically administered immunosuppressive agents (eg, prednisone equivalent > 10 mg/day)
  • History of solid organ transplantation or malignancy diagnosed or treated within 5 years
  • Current or prior history of clinical hepatic decompensation or other significant gastrointestinal disorder

Sites / Locations

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

SOF+RBV 12 Weeks (GT 2/3, TN)

SOF+RBV 24 Weeks (GT 2/3, TE)

SOF+RBV 24 Weeks (GT 1, TN)

Arm Description

Treatment-naive (TN) participants coinfected with HIV-1 and genotype (GT) 2 or genotype 3 HCV infection will receive SOF+RBV for 12 weeks.

Treatment-experienced (TE) participants coinfected with HIV-1 and genotype 2 or genotype 3 HCV infection will receive SOF+RBV for 24 weeks.

Treatment-naive (TN) participants coinfected with HIV-1 and genotype 1 HCV infection will receive SOF+RBV for 24 weeks.

Outcomes

Primary Outcome Measures

Percentage of Participants With Sustained Virologic Response (SVR) at 12 Weeks After Discontinuation of Therapy (SVR12)
SVR12 was defined as HCV RNA < the lower limit of quantitation (LLOQ; ie, 25 IU/mL) at 12 weeks after stopping study treatment.
Incidence of Adverse Events Leading to Permanent Discontinuation of Study Drug(s)
The percentage of participants discontinuing any study drug due to an adverse event was summarized.

Secondary Outcome Measures

Percentage of Participants With Sustained Virologic Response at 4 and 24 Weeks After Discontinuation of Therapy (SVR4 and SVR24)
SVR4 and SVR24 were defined as HCV RNA < LLOQ at 4 and 24 weeks following the last dose of study drug, respectively.
Change From Baseline in HCV RNA at Week 1
Change From Baseline in HCV RNA at Week 2
Change From Baseline in HCV RNA at Week 4
Change From Baseline in HCV RNA at Week 6
Change From Baseline in HCV RNA at Week 8
Percentage of Participants Experiencing On-treatment Virologic Failure
On-treatment virologic failure was defined as: Viral breakthrough: HCV RNA ≥ LLOQ after having previously had HCV RNA < LLOQ while on treatment, confirmed with 2 consecutive values (second confirmation value may have been posttreatment) or with a last available on-treatment measurement and no subsequent follow-up values, or Viral rebound: > 1 log10 IU/mL increase in HCV RNA from nadir while on treatment, confirmed with 2 consecutive values (second confirmation value may have been posttreatment) or with a last available on-treatment measurement and no subsequent follow-up values, or Nonresponse: HCV RNA persistently ≥ LLOQ through 8 weeks of treatment
Percentage of Participants Experiencing Viral Relapse
Viral relapse was defined as having achieved undetectable HCV RNA levels (HCV RNA < LLOQ) at end of treatment, but did not achieve an SVR.

Full Information

First Posted
August 9, 2012
Last Updated
November 14, 2014
Sponsor
Gilead Sciences
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1. Study Identification

Unique Protocol Identification Number
NCT01667731
Brief Title
Efficacy and Safety of Sofosbuvir Plus Ribavirin in Chronic Genotype 1, 2 and 3 Hepatitis C Virus (HCV) and Human Immunodeficiency Virus (HIV) Co-infected Adults
Official Title
A Phase 3, Open-label Study to Investigate the Efficacy and Safety of GS-7977 Plus Ribavirin in Chronic Genotype 1, 2 and 3 Hepatitis C Virus (HCV) and Human Immunodeficiency Virus (HIV) Co-infected Subjects
Study Type
Interventional

2. Study Status

Record Verification Date
November 2014
Overall Recruitment Status
Completed
Study Start Date
July 2012 (undefined)
Primary Completion Date
November 2013 (Actual)
Study Completion Date
February 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Gilead Sciences

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This study will evaluate the efficacy, safety, and tolerability of sofosbuvir (SOF; GS-7977) plus ribavirin (RBV) in adults with chronic genotypes 1, 2, and 3 HCV infection who are coinfected with HIV-1.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hepatitis C, Human Immunodeficiency Virus
Keywords
Hepatitis C, Chronic, HCV, HIV, Human Immunodeficiency Virus, Co-Infected

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
224 (Actual)

8. Arms, Groups, and Interventions

Arm Title
SOF+RBV 12 Weeks (GT 2/3, TN)
Arm Type
Experimental
Arm Description
Treatment-naive (TN) participants coinfected with HIV-1 and genotype (GT) 2 or genotype 3 HCV infection will receive SOF+RBV for 12 weeks.
Arm Title
SOF+RBV 24 Weeks (GT 2/3, TE)
Arm Type
Experimental
Arm Description
Treatment-experienced (TE) participants coinfected with HIV-1 and genotype 2 or genotype 3 HCV infection will receive SOF+RBV for 24 weeks.
Arm Title
SOF+RBV 24 Weeks (GT 1, TN)
Arm Type
Experimental
Arm Description
Treatment-naive (TN) participants coinfected with HIV-1 and genotype 1 HCV infection will receive SOF+RBV for 24 weeks.
Intervention Type
Drug
Intervention Name(s)
SOF
Other Intervention Name(s)
GS-7977, PSI-7977, Sovaldi®
Intervention Description
Sofosbuvir (SOF) 400 mg tablet administered orally once daily
Intervention Type
Drug
Intervention Name(s)
RBV
Intervention Description
Ribavirin (RBV) tablets administered orally in a divided daily dose according to package insert weight-based dosing recommendations (< 75kg = 1000 mg and ≥ 75 kg = 1200 mg)
Primary Outcome Measure Information:
Title
Percentage of Participants With Sustained Virologic Response (SVR) at 12 Weeks After Discontinuation of Therapy (SVR12)
Description
SVR12 was defined as HCV RNA < the lower limit of quantitation (LLOQ; ie, 25 IU/mL) at 12 weeks after stopping study treatment.
Time Frame
Posttreatment Week 12
Title
Incidence of Adverse Events Leading to Permanent Discontinuation of Study Drug(s)
Description
The percentage of participants discontinuing any study drug due to an adverse event was summarized.
Time Frame
Up to 24 weeks
Secondary Outcome Measure Information:
Title
Percentage of Participants With Sustained Virologic Response at 4 and 24 Weeks After Discontinuation of Therapy (SVR4 and SVR24)
Description
SVR4 and SVR24 were defined as HCV RNA < LLOQ at 4 and 24 weeks following the last dose of study drug, respectively.
Time Frame
Posttreatment Weeks 4 and 24
Title
Change From Baseline in HCV RNA at Week 1
Time Frame
Baseline; Week 1
Title
Change From Baseline in HCV RNA at Week 2
Time Frame
Baseline; Week 2
Title
Change From Baseline in HCV RNA at Week 4
Time Frame
Baseline; Week 4
Title
Change From Baseline in HCV RNA at Week 6
Time Frame
Baseline; Week 6
Title
Change From Baseline in HCV RNA at Week 8
Time Frame
Baseline; Week 8
Title
Percentage of Participants Experiencing On-treatment Virologic Failure
Description
On-treatment virologic failure was defined as: Viral breakthrough: HCV RNA ≥ LLOQ after having previously had HCV RNA < LLOQ while on treatment, confirmed with 2 consecutive values (second confirmation value may have been posttreatment) or with a last available on-treatment measurement and no subsequent follow-up values, or Viral rebound: > 1 log10 IU/mL increase in HCV RNA from nadir while on treatment, confirmed with 2 consecutive values (second confirmation value may have been posttreatment) or with a last available on-treatment measurement and no subsequent follow-up values, or Nonresponse: HCV RNA persistently ≥ LLOQ through 8 weeks of treatment
Time Frame
Up to 24 weeks
Title
Percentage of Participants Experiencing Viral Relapse
Description
Viral relapse was defined as having achieved undetectable HCV RNA levels (HCV RNA < LLOQ) at end of treatment, but did not achieve an SVR.
Time Frame
Up to Posttreatment Week 24

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Willing and able to provide written informed consent Male or female, age ≥ 18 years with chronic HCV and HIV-1 infection HCV RNA > 1 x 10^4 IU/mL at screening Infection with HCV genotype 1, 2 or 3 as determined at screening HIV-1 infection confirmed with positive ELISA or Western blot at screening Medical records must be sufficient to be categorized on interferon (IFN) eligibility or prior treatment history with PEG/RBV. Confirmation of chronic HCV infection Ability to determine presence/absence of cirrhosis. HIV antiretroviral therapy (ARV) criteria of one of the following: ARV untreated with a CD4 T-cell count > 500 cells/mm^3 On a stable, protocol-approved, ARV for > 8 weeks prior to screening with a CD4 T-cell count > 200 cells/mm^3 and a documented undetectable plasma HIV-1 RNA level for ≥ 8 weeks preceding the screening visit Approved HIV antiretroviral medications based on drug interaction studies Not been treated with any investigational drug or device within 30 days of the screening visit Females if confirmed that she is not pregnant or nursing of non-childbearing potential or of childbearing potential but has a negative serum pregnancy test at screening and agrees to use protocol approved method of birth control from screening through 6 months after the last dose of RBV Males who agree to consistently and correctly use a condom while their female partner agrees to use protocol approved method of birth control from screening through 7 months after the last dose of RBV Must be of generally good health as determined by the investigator. Liver imaging within 6 months of baseline/Day 1 is required in cirrhotic patients only, to exclude hepatocellular carcinoma (HCC) Exclusion Criteria: Non-genotype 1/2/3 or mixed genotype at screening Genotype 1 with prior treatment for HCV Poor control with ARV regimen Prior exposure to a direct-acting antiviral targeting the HCV nonstructural protein (NS)5B polymerase Chronic liver disease of a non-HCV etiology (eg, hemochromatosis, Wilson's disease, α1 antitrypsin deficiency, cholangitis) A new AIDS-defining condition diagnosed within 30 days prior to screening Active, serious infection (other than HIV or HCV) requiring parenteral antibiotics, antivirals or antifungals within 30 days prior to baseline Infection with hepatitis B virus (HBV) Contraindication to RBV therapy Chronic use of systemically administered immunosuppressive agents (eg, prednisone equivalent > 10 mg/day) History of solid organ transplantation or malignancy diagnosed or treated within 5 years Current or prior history of clinical hepatic decompensation or other significant gastrointestinal disorder
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Anuj Gaggar, MD, PhD
Organizational Affiliation
Gilead Sciences
Official's Role
Study Director
Facility Information:
City
Birmingham
State/Province
Alabama
Country
United States
City
Coronado
State/Province
California
Country
United States
City
Los Angeles
State/Province
California
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United States
City
Lutherville
State/Province
California
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United States
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Oakland
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California
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United States
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Sacramento
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California
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United States
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San Francisco
State/Province
California
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United States
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Torrance
State/Province
California
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United States
City
Washington DC
State/Province
District of Columbia
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United States
City
Miami
State/Province
Florida
Country
United States
City
Orlando
State/Province
Florida
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United States
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Tampa
State/Province
Florida
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United States
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Chicago
State/Province
Illinois
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United States
City
Springfield
State/Province
Massachusetts
Country
United States
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Kansas City
State/Province
Missouri
Country
United States
City
Hillsborough
State/Province
New Jersey
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United States
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Santa Fe
State/Province
New Mexico
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United States
City
New York
State/Province
New York
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United States
City
Chapel Hill
State/Province
North Carolina
Country
United States
City
Durham
State/Province
North Carolina
Country
United States
City
Allentown
State/Province
Pennsylvania
Country
United States
City
Philadelphia
State/Province
Pennsylvania
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United States
City
Providence
State/Province
Rhode Island
Country
United States
City
Dallas
State/Province
Texas
Country
United States
City
Houston
State/Province
Texas
Country
United States
City
Seattle
State/Province
Washington
Country
United States
City
San Juan
Country
Puerto Rico

12. IPD Sharing Statement

Citations:
PubMed Identifier
26743093
Citation
Saeed S, Strumpf EC, Walmsley SL, Rollet-Kurhajec K, Pick N, Martel-Laferriere V, Hull M, Gill MJ, Cox J, Cooper C, Klein MB; Canadian Co-Infection Cohort Study; Cohen J, Conway B, Cooper C, Cote P, Cox J, Gill J, Haider S, Harris M, Haase D, Hull M, Montaner J, Moodie E, Pick N, Rachlis A, Rouleau D, Sandre R, Tyndall JM, Vachon ML, Walmsley S, Wong D. How Generalizable Are the Results From Trials of Direct Antiviral Agents to People Coinfected With HIV/HCV in the Real World? Clin Infect Dis. 2016 Apr 1;62(7):919-926. doi: 10.1093/cid/civ1222. Epub 2016 Jan 6.
Results Reference
derived
PubMed Identifier
25583164
Citation
Younossi ZM, Stepanova M, Sulkowski M, Naggie S, Puoti M, Orkin C, Hunt SL. Sofosbuvir and Ribavirin for Treatment of Chronic Hepatitis C in Patients Coinfected With Hepatitis C Virus and HIV: The Impact on Patient-Reported Outcomes. J Infect Dis. 2015 Aug 1;212(3):367-77. doi: 10.1093/infdis/jiv005. Epub 2015 Jan 12.
Results Reference
derived
PubMed Identifier
25038354
Citation
Sulkowski MS, Naggie S, Lalezari J, Fessel WJ, Mounzer K, Shuhart M, Luetkemeyer AF, Asmuth D, Gaggar A, Ni L, Svarovskaia E, Brainard DM, Symonds WT, Subramanian GM, McHutchison JG, Rodriguez-Torres M, Dieterich D; PHOTON-1 Investigators. Sofosbuvir and ribavirin for hepatitis C in patients with HIV coinfection. JAMA. 2014 Jul 23-30;312(4):353-61. doi: 10.1001/jama.2014.7734. Erratum In: JAMA. 2014 Nov 12;312(18):1932.
Results Reference
derived

Learn more about this trial

Efficacy and Safety of Sofosbuvir Plus Ribavirin in Chronic Genotype 1, 2 and 3 Hepatitis C Virus (HCV) and Human Immunodeficiency Virus (HIV) Co-infected Adults

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