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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
Lisa Barrett
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hepatitis C Virus

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)MaleDoes not accept healthy volunteers

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

    First Posted
    May 22, 2015
    Last Updated
    February 7, 2023
    Sponsor
    Lisa Barrett
    Collaborators
    PEI Provincial Correction Centre
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    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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