An Open-label Randomized Multicenter Phase III Clinical Study Comparing Safety and Efficacy of Algeron (Cepeginterferon Alfa-2b) and and PegIntron (Peginterferon Alfa-2b) in Combination With Ribavirin as Combined Treatment of Chronic Hepatitis C in Human Immunodeficiency Virus-1 Infected Patients
Condition: Hepatitis; Hepatitis C; Hepatitis C/ Human Immunodeficiency Virus Coinfection
MeSH terms: Hepatitis A; Hepatitis C; Hepatitis C, Chronic; Acquired Immunodeficiency Syndrome; HIV Infections; Coinfection; Hepatitis; Immunologic Deficiency Syndromes
Intervention: Algeron; PegIntron
Intervention description: 1.5 µg/kg of body weight subcutaneously, once a week; 1.5 µg/kg of body weight subcutaneously, once a week
Intervention MeSH terms: Peginterferon alfa-2b
Phase: Phase 3
Study type: Interventional
Primary purpose: Treatment
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Enrollment: 140.0
Sex: All
Minimum age: 18 Years
Maximum age: 70 Years
Healthy volunteers: No
Keywords: Hepatitis C; Cepeginterferon alfa; Peginterferon; Treatment

Summary:

      The purpose of the study is to demonstrate the noninferiority of Algeron in combination with
      ribavirin compared to PegIntron in combination with ribavirin in treatment of chronic
      hepatitis C in Human Immunodeficiency Virus-1 infected patients
    

Eligibility criteria:

        Inclusion Criteria:

          -  Signed Informed Consent Form.

          -  Chronic hepatitis C (genotypes 1а, 1b, 2, 3, 4) confirmed by positive result of
             hepatitis C virus ribonucleic acid during > 6 months before screening visit or
             accompanied with increase in alanine aminotransferase (ALT) level > 6 months before
             screening visit.

          -  Confirmed Human Immunodeficiency Virus-1 infection based on enzyme-linked
             immunosorbent assay and immune blotting results.

          -  Clinically sustained phase of Human Immunodeficiency Virus-1 infection with absence of
             active opportunistic Human Immunodeficiency Virus-associated diseases for at least 30
             calendar days before inclusion in the study.

          -  Level of CD4+-lymphocytes is not less than 500 cells/mm3 for patients not requiring
             highly active antiretroviral therapy and which will not be assigned to antiretroviral
             therapy during the study period.

          -  For patients receiving sustained highly active antiretroviral therapy for not less
             than 12 weeks and planning to continue comply with this treatment regimen during the
             following 24 weeks, level of CD4+-lymphocytes ≥300 cells/mm3, Human Immunodeficiency
             Virus ribonucleic acid ≤50 copies/ml.

          -  Men and women aged 18 to 70 inclusively.

          -  Body mass index in the range of 18 - 30 kg/m2 inclusively .

          -  Preserved protein-synthetizing liver function (International Normalized Ratio < 1.7,
             albumin > 35 g/l).

          -  Absence of signs of hepatic encephalopathy and ascites according to clinical
             examination and ultrasound examination.

          -  Patients with preserved child-bearing potential and their partners agree to use
             barrier method of contraception during the whole period of therapy and during 7 months
             after the treatment completion.

          -  Documentary confirmed results of liver elastography (fibroscan) during last year
             before enrollment in the study or patient agreement to undergo this examination during
             screening.

        Exclusion Criteria:

          -  Intolerance of alfa-interferons, ribavirin or any components of tested drug product
             based on medical history.

          -  Presence of hepatitis B, A, E markers.

          -  Presence of documentary confirmed clinically significant concurrent liver diseases
             (alcoholic liver cirrhosis, drug-induced liver cirrhosis, autoimmune hepatitis,
             hemochromatosis, Wilson's disease, non-alcoholic steatohepatitis, biliary cirrhosis
             etc.).

          -  Past history of Hepatitis C Virus treatment with interferon alfa or pegylated
             interferon alfa.

          -  For patients receiving sustained highly active antiretroviral therapy - presence of
             nevirapine, stavudine, zidovudine, didanosine in treatment regimen.

          -  Use of injectable and non-injectable interferons alfa/ interferon inducers for any
             indication (except for hepatitis C), radiotherapy, cytotoxic chemotherapy for one
             month prior to inclusion in the study.

          -  Cholestic hepatitis (level of direct bilirubin, alkaline phosphatase, gamma
             glutamyltransferase, exceeding upper normal limit in > 5 times).

          -  Decompensated liver cirrhosis confirmed with results of laboratory analyses
             (Child-Pugh class B, C) or ultrasound examination.

          -  Any documentary confirmed autoimmune diseases (such as Crohn's disease, ulcerative
             colitis, systemic lupus erythematosus, idiopathic thrombocytopenic purpura,
             scleroderma, autoimmune hemolytic anemia, severe psoriasis).

          -  Deviations of hematologic (hemoglobin less than lower normal limit; neutrophils < 1.5
             x 10^9/l; thrombocytes < 90 x 10^9/ l) and biochemical (creatinine level > 1.5 times
             higher upper normal limit, ALT is > 10 times higher upper normal limit) parameters.

          -  Documentary confirmed diagnosis of hemoglobinopathy (for example, thalassemia,
             sickle-cell anemia).

          -  Severe depression, schizophrenia, any other mental disorders which according to the
             investigator are contraindications for antiviral treatment.

          -  Epilepsy and/or central nervous system disorder.

          -  Disorder of thyroid function (level of thyroid stimulating hormone out of the normal
             range).

          -  Documentary confirmed or suspected hepatocellular carcinoma based on the results of
             alfa-fetoprotein (AFP) assay ≥ upper normal limit.

          -  Antinuclear antibodies (ANA) titer measured at screening is not less than 1:640 or
             documentary confirmed signs of autoimmune hepatitis based on the results of biopsy.

          -  Documentary confirmed malignant neoplasms.

          -  Documentary confirmed lung diseases associated with respiratory failure.

          -  Treatment of Human Immunodeficiency Virus-1 with immunotherapeutic vaccines within 90
             days prior to screening.

          -  Necessity in assignment of antimycobacterial therapy.

          -  Pregnancy, lactation period.

          -  Documentary confirmed retinopathy (for example, cytomegalovirus retinitis, macular
             degeneration).

          -  Severe concurrent diseases (for example, severe arterial hypertension, sever coronary
             heart disease, heart failure, decompensated diabetes mellitus and other) which are
             contraindications for antiviral therapy according to the investigator opinion.