Understanding HCV Reinfection Rates in an Incarcerated Population After Cure With Interferon Free HCV Treatment
Primary Purpose
Hepatitis C Virus
Status
Active
Phase
Phase 4
Locations
Study Type
Interventional
Intervention
Paritaprevir
Ritonavir
Dasabuvir
Ombitasvir
Ribavirin
Sponsored by

About this trial
This is an interventional treatment trial for Hepatitis C Virus
Eligibility Criteria
Inclusion Criteria:
- An offender at the PEI Provincial Correction Centre during the enrollment time
- Male, 18 -70 years of age, inclusive, at time of screening
- Chronic HCV genotype 1 infection
- HCV infection, as demonstrated by positive HCV immunosorbant assay and detectable HCV viral load
- No evidence of decompensated liver disease (refractory ascites, variceal bleed within 1 year, active hepatic encephalopathy or Child-Pugh score greater than 6)
- HIV negative
Males must be abstinent from sexual intercourse, surgically sterile or agree to practice two effective forms of birth control from those listed below, throughout the course of the study, starting with Study Day 1 and for 7 months after the last dose of study drug (or per local RBV label):
- Partner(s) using an IUD (intrauterine device),
- Partner(s) using oral, injected, or implanted methods of hormonal contraceptives,
- Subject and/or partner(s) using condoms, contraceptive sponge, or diaphragm with spermicidal jellies or creams.
- Subjects must be able to understand and adhere to the study visit schedule and all other protocol requirements
- Must voluntarily sign and date an informed consent form, approved by a Research Ethics Board prior to the initiation of any screening or study specific procedures
Exclusion Criteria:
- History of severe, life-threatening or other significant sensitivity to any drug
- Positive test result at screening for Hepatitis B surface antigen
- Prior therapy with direct acting antivirals for the treatment of HCV
- Evidence of decompensated liver disease (current or past refractory ascites, variceal bleed within 1 year, active hepatic encephalopathy)
- HIV positive screening test
- Unwilling to follow up for 48 weeks after treatment completion
- Use of any herbal supplements (including milk thistle) within 2 weeks or 10 half-lives of the respective supplement, whichever is longer, prior to the first dose of study drug
- HCV genotype performed during screening indicating unable to genotype or co-infection with any other HCV genotype
- Use of any medications contraindicated for use with the study regimen
- Clinically significant abnormalities, other than HCV-infection, based upon the results of a medical history, physical examination, vital signs, and laboratory profile that make the subject an unsuitable candidate for this study in the opinion of the investigator
- Serum Alpha-Fetoprotein (AFP) > 200 ng/mL at screening
Any cause of liver disease other than chronic HCV-infection, including but not limited to the following:
- Hemochromatosis
- Alpha-1 antitrypsin deficiency
- Wilson's disease
- Autoimmune hepatitis
- Alcoholic liver disease
- Nonalcoholic steatohepatitis
- Drug-related liver disease
Screening laboratory analyses showing any of the following abnormal laboratory results:
- ALT > 5 × upper limit of normal (ULN)
- Aspartate aminotransferase (AST) > 5 × ULN
- Calculated creatinine clearance (using Cockcroft-Gault method) < 60 mL/min
- Albumin 25 g/L
- Prothrombin time/International normalized ratio (INR) > 2.3.
- Hemoglobin < LLN
- Platelets < 60,000 cells per mm3
- Absolute neutrophil count (ANC) < 1500 cells/μL
- Total bilirubin ≥ 51 umol/L
- History of solid organ transplantation.
- Receipt of any investigational product within a time period equal to 10 half-lives of the product, if known, or a minimum of 6 weeks prior to study drug administration.
- Consideration by the investigator, for any reason, that the subject is an unsuitable candidate to receive paritaprevir, dasabuvir, ombitasvir, ritonavir and/or RBV.
- Current enrollment in another clinical study, prior enrollment in this study, or previous exposure to paritaprevir, ombitasvir, or dasabuvir. Concurrent participation in a non-interventional, epidemiologic or registry trials may be permitted with approval of the principal investigator.
- The use of colony stimulating factors, such as granulocyte colony stimulating factor (GCSF) or erythropoietin within 2 months of the screening period.
- Uncontrolled clinically significant cardiac, respiratory (except mild asthma), hepatic, gastrointestinal, hematologic or psychiatric disease or disorder, or any uncontrolled medical illness, which is unrelated to the hepatic disease.
Sites / Locations
Arms of the Study
Arm 1
Arm Type
Other
Arm Label
HCV Genotype 1, with and without cirrhosis
Arm Description
Outcomes
Primary Outcome Measures
Re-infection rate in individuals treated with DAA therapy
This will require HCV quasispecies determination at baseline and in potentially re-infected individuals. Re-infection will require demonstration of HCV RNA above level of detection after SVR12 with a phyogenetically distinct HCV species.
Secondary Outcome Measures
Percentage of subjects with sustained virologic response at 12 weeks post treatment
Change in fibrosis measured by transient elastography
Global and HCV-specific T cell function before and after treatment with DAA therapy.
Global and HCV-specific B cell function before and after treatment with DAA therapy.
Global and HCV-specific NK cell function before and after treatment with DAA therapy.
Full Information
NCT ID
NCT02460133
First Posted
May 22, 2015
Last Updated
February 7, 2023
Sponsor
Lisa Barrett
Collaborators
PEI Provincial Correction Centre
1. Study Identification
Unique Protocol Identification Number
NCT02460133
Brief Title
Understanding HCV Reinfection Rates in an Incarcerated Population After Cure With Interferon Free HCV Treatment
Official Title
Understanding HCV Reinfection Rates in an Incarcerated Population After Cure With Interferon Free HCV Treatment: A Pilot Project
Study Type
Interventional
2. Study Status
Record Verification Date
February 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
July 2015 (undefined)
Primary Completion Date
October 2023 (Anticipated)
Study Completion Date
October 2023 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Lisa Barrett
Collaborators
PEI Provincial Correction Centre
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
This pilot study is crucial to determining whether treating individuals who are at high risk for transmission or re-infection will impact HCV reinfection rates. It will establish the feasibility of DAA treatment in corrections facilities, as well as delineate the underlying immune basis of HCV cure and reinfection.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hepatitis C Virus
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
44 (Actual)
8. Arms, Groups, and Interventions
Arm Title
HCV Genotype 1, with and without cirrhosis
Arm Type
Other
Intervention Type
Drug
Intervention Name(s)
Paritaprevir
Intervention Type
Drug
Intervention Name(s)
Ritonavir
Intervention Type
Drug
Intervention Name(s)
Dasabuvir
Intervention Type
Drug
Intervention Name(s)
Ombitasvir
Intervention Type
Drug
Intervention Name(s)
Ribavirin
Intervention Description
In genotype 1b individuals without cirrhosis, treatment will NOT include ribavirin.
Primary Outcome Measure Information:
Title
Re-infection rate in individuals treated with DAA therapy
Description
This will require HCV quasispecies determination at baseline and in potentially re-infected individuals. Re-infection will require demonstration of HCV RNA above level of detection after SVR12 with a phyogenetically distinct HCV species.
Time Frame
1 year following treatment.
Secondary Outcome Measure Information:
Title
Percentage of subjects with sustained virologic response at 12 weeks post treatment
Time Frame
12 Weeks post treatment
Title
Change in fibrosis measured by transient elastography
Time Frame
From day 0 to the end of follow-up
Title
Global and HCV-specific T cell function before and after treatment with DAA therapy.
Time Frame
From day 0 to end of follow-up
Title
Global and HCV-specific B cell function before and after treatment with DAA therapy.
Time Frame
From day 0 to end of follow-up
Title
Global and HCV-specific NK cell function before and after treatment with DAA therapy.
Time Frame
From day 0 to end of follow-up
10. Eligibility
Sex
Male
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
An offender at the PEI Provincial Correction Centre during the enrollment time
Male, 18 -70 years of age, inclusive, at time of screening
Chronic HCV genotype 1 infection
HCV infection, as demonstrated by positive HCV immunosorbant assay and detectable HCV viral load
No evidence of decompensated liver disease (refractory ascites, variceal bleed within 1 year, active hepatic encephalopathy or Child-Pugh score greater than 6)
HIV negative
Males must be abstinent from sexual intercourse, surgically sterile or agree to practice two effective forms of birth control from those listed below, throughout the course of the study, starting with Study Day 1 and for 7 months after the last dose of study drug (or per local RBV label):
Partner(s) using an IUD (intrauterine device),
Partner(s) using oral, injected, or implanted methods of hormonal contraceptives,
Subject and/or partner(s) using condoms, contraceptive sponge, or diaphragm with spermicidal jellies or creams.
Subjects must be able to understand and adhere to the study visit schedule and all other protocol requirements
Must voluntarily sign and date an informed consent form, approved by a Research Ethics Board prior to the initiation of any screening or study specific procedures
Exclusion Criteria:
History of severe, life-threatening or other significant sensitivity to any drug
Positive test result at screening for Hepatitis B surface antigen
Prior therapy with direct acting antivirals for the treatment of HCV
Evidence of decompensated liver disease (current or past refractory ascites, variceal bleed within 1 year, active hepatic encephalopathy)
HIV positive screening test
Unwilling to follow up for 48 weeks after treatment completion
Use of any herbal supplements (including milk thistle) within 2 weeks or 10 half-lives of the respective supplement, whichever is longer, prior to the first dose of study drug
HCV genotype performed during screening indicating unable to genotype or co-infection with any other HCV genotype
Use of any medications contraindicated for use with the study regimen
Clinically significant abnormalities, other than HCV-infection, based upon the results of a medical history, physical examination, vital signs, and laboratory profile that make the subject an unsuitable candidate for this study in the opinion of the investigator
Serum Alpha-Fetoprotein (AFP) > 200 ng/mL at screening
Any cause of liver disease other than chronic HCV-infection, including but not limited to the following:
Hemochromatosis
Alpha-1 antitrypsin deficiency
Wilson's disease
Autoimmune hepatitis
Alcoholic liver disease
Nonalcoholic steatohepatitis
Drug-related liver disease
Screening laboratory analyses showing any of the following abnormal laboratory results:
ALT > 5 × upper limit of normal (ULN)
Aspartate aminotransferase (AST) > 5 × ULN
Calculated creatinine clearance (using Cockcroft-Gault method) < 60 mL/min
Albumin 25 g/L
Prothrombin time/International normalized ratio (INR) > 2.3.
Hemoglobin < LLN
Platelets < 60,000 cells per mm3
Absolute neutrophil count (ANC) < 1500 cells/μL
Total bilirubin ≥ 51 umol/L
History of solid organ transplantation.
Receipt of any investigational product within a time period equal to 10 half-lives of the product, if known, or a minimum of 6 weeks prior to study drug administration.
Consideration by the investigator, for any reason, that the subject is an unsuitable candidate to receive paritaprevir, dasabuvir, ombitasvir, ritonavir and/or RBV.
Current enrollment in another clinical study, prior enrollment in this study, or previous exposure to paritaprevir, ombitasvir, or dasabuvir. Concurrent participation in a non-interventional, epidemiologic or registry trials may be permitted with approval of the principal investigator.
The use of colony stimulating factors, such as granulocyte colony stimulating factor (GCSF) or erythropoietin within 2 months of the screening period.
Uncontrolled clinically significant cardiac, respiratory (except mild asthma), hepatic, gastrointestinal, hematologic or psychiatric disease or disorder, or any uncontrolled medical illness, which is unrelated to the hepatic disease.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Lisa Barrett, MD PhD FRCPC
Organizational Affiliation
Department of Medicine, Division of Infectious Diseases, Nova Scotia Health Authority, Dalhousie University
Official's Role
Principal Investigator
12. IPD Sharing Statement
Learn more about this trial
Understanding HCV Reinfection Rates in an Incarcerated Population After Cure With Interferon Free HCV Treatment
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