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Telaprevir in HIV-HCV Coinfected Patients Who Had Previously Failed a Peginterferon-Ribavirin Regimen
Telaprevir in HIV-HCV Coinfected Patients Who Had Previously Failed a Peginterferon-Ribavirin Regimen

NCT01332955

CompletedPhase 2

Sponsor: ANRS, Emerging Infectious Diseases

Conditions: Hepatitis C, Chronic, HIV Infection

Interventions: Telaprevir, pegIFN alfa-2a, Ribavirin

Countries: France

This phase II, multicentric, national pilot trial is designed to estimate the sustained virological response rate (SVR) following a 12 weeks treatment by telaprevir combined with a 48 or 72 weeks treatment by peginterferon and ribavirin, based upon the rapid virological response (RVR) at week 8 (4 weeks after telaprevir start), and to compare the observed SVR to 20%, a rate determining a significant therapeutic benefit in this population of patients. The primary endpoint will be the SVR defined as undetectable HCV-RNA measured 24 weeks after the end of therapy (EOT).

Eligibility overview

Sex: ALL

Age: 18 Years to

Healthy volunteers: No

Study type: INTERVENTIONAL

Eligibility criteria
Inclusion Criteria:

* Informed consent form signed at screening visit at the latest
* Patient registered with or covered by a social security scheme
* HIV-1 infection
* Chronic, genotype 1, hepatitis C with detectable HCV RNA at screening
* Virological failure following a previous treatment of at least 12 weeks by peginterferon alpha-2a ≥ 135 µg once weekly or peginterferon alpha-2b ≥ 1.0 µg per kg once weekly + ribavirin ≥ 600 mg once daily. Virological failure defined by persistence of a detectable HCV-RNA, with the same genotype than before. Null responder patient, with less than 2 Log10 HCV-RNA decline at week 12 with cirrhosis are excluded from the study. Null responder patients without cirrhosis (equal or below METAVIR F3) are limited to less than 30 % of all patients included
* No Interferon and/or Ribavirin within past 6 months
* Stable antiretroviral treatment for over 3 months at screening. Authorized combinations: tenofovir-emtricitabine-boosted atazanavir,tenofovir-emtricitabine-efavirenz,tenofovir-emtricitabine-raltegravir, once Drug-Drug interaction data will be available. Patients with a stable combination of at least 3 of the following drugs: tenofovir, emtricitabine/lamivudine, efavirenz, atazanavir-boosted or not, raltegravir. These patients cannot participate in the pharmacokinetic study
* CD4 \>200/mm3 and \>15% at screening
* Plasma HIV-RNA \<50 copies/mL for at least 6 months at screening visit
* Body weight ≥ 40 kg to equal or below 125 kg
* Fibrosis stage have to be documented by a significant liver biopsy (cumulative length ≥ 15 mm or ≥ 6 portal spaces), within 3 years. Patients with a previous liver biopsy exhibiting cirrhosis lesions (METAVIR F4) are allowed to enter the study without a new biopsy. The proportion of patients with cirrhosis lesions (METAVIR F4) is limited to 50% of all patients.
* Male patients, female patients with child-bearing potency and their heterosexual partners must use an adequate contraception from 1 month before initiation of treatment to 7 months following the end of treatment for men and to 4 months following the end of treatment for women. Subjects (or their female partners) must not be pregnant or planning to become pregnant within 2 years after enrolling in the study

Exclusion Criteria:

* Patient with liver failure (Child B and C) or past history of decompensated cirrhosis
* Significant oesophageal varices (Stages 2-3) on a gastrointestinal endoscopy within 3 years
* Detectable AgHBs
* HIV-2 co-infection
* Contra-indication to ribavirin or peginterferon
* Severe pre-existing cardiac or pulmonary disease
* Untreated dysthyroidism
* Uncontrolled Type 2 diabetes
* Optic neuritis past history and retinal condition
* History of organ transplant
* Severe hemoglobinopathy
* Congenital QT prolongation, family history of congenital QT prolongation or sudden unexpected death
* Contra-indication to telaprevir, hypersensitivity to any component of the drug product
* Any disease requiring long term, systemic corticotherapy or immunosuppressive therapy during study
* Alcohol intake that may represent an obstacle for the participation of the subject
* Substance abuse that may represent an obstacle for the participation of the subject
* Acute CDC stage C opportunistic infection within the previous 6 months
* Past history of cancer within the previous 5 years (except skin basal cell carcinoma, Kaposi's disease in stable remission, in situ cervical cancer and in situ anal cancer)
* Any active malignant disease including hepatocellular carcinoma
* Patients unable to observe the study procedures
* Participation to another clinical trial within the previous 30 days
* Haemoglobin \<120 g/L for women and \<130 g/L for men
* Platelets \<90 000/mm3
* Neutrophils \<1 500/mm3
* Renal insufficiency defined by an estimated Glomerular Filtration Rate \< 60 mL/mn (MDRD equation)
* Associated medication susceptible to interfere with the pharmacokinetic parameters of telaprevir and/or antiretroviral associated drugs
Locations (1)
  • Lyon, France