The Safety and Effectiveness of a Two-Drug Combination in the Treatment of Patients With Hepatitis C Plus Advanced HIV Infections

Study Overview
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Brief Summary
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To investigate the toxicity of interferon alfa-2b ( IFN alfa-2b ) in combination with nucleoside analog therapy in HIV-positive patients with chronic hepatitis C. To determine the efficacy of treatment with IFN alfa-2b for chronic hepatitis C in patients with advanced HIV infections treated with nucleoside analog therapy. IFN alfa-2b has HIV inhibitory properties and has also been approved for treatment of chronic hepatitis C. Studies have shown that IFN alfa-2b is effective in asymptomatic HIV-positive patients with chronic hepatitis C, but the drug's benefit against hepatitis C in patients with advanced HIV infection has not been determined.

Detailed Description
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IFN alfa-2b has HIV inhibitory properties and has also been approved for treatment of chronic hepatitis C. Studies have shown that IFN alfa-2b is effective in asymptomatic HIV-positive patients with chronic hepatitis C, but the drug's benefit against hepatitis C in patients with advanced HIV infection has not been determined. Patients receive interferon alpha-2b subcutaneously 3 times weekly for 6 months. If no response is seen after 18 weeks of therapy or if an initial response is followed by relapse while on therapy, dose is increased. Patients who require a dose escalation should continue on IFN alfa-2b for an additional 6 months. All patients will also receive available nucleoside analog therapy ( zidovudine, didanosine, zalcitabine ) at currently accepted doses as clinically appropriate.

Official Title
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A Phase I Pilot Study of the Safety and Efficacy of Interferon Alfa-2b (IFN Alfa-2b) in Combination With Nucleoside Analog Therapy in Patients With Combined Hepatitis C (HCV) and Advanced Human Immunodeficiency Virus (HIV) Infections

Conditions
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HIV Infections, Hepatitis C

Intervention / Treatment
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* Drug: Interferon alfa-2b
* Drug: Zidovudine
* Drug: Zalcitabine
* Drug: Didanosine


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria Concurrent Medication: Allowed: Treatment or suppression of opportunistic infections with standard drugs. Pneumovax, HIB, tetanus, influenza, and hepatitis B vaccines. Clinically indicated antibiotics. Short courses of steroids (< 21 days) for acute problems not related to hepatitis C. Other regularly prescribed medications such as analgesics, nonsteroidal anti-inflammatory agents, antipyretics, allergy medications, and oral contraceptives. Patients must have: HIV positivity. Documented hepatitis C virus. CD4 count <= 200 cells/mm3. No severe liver disease (Grade C Childs-Pugh classification) or chronic liver disease not caused by hepatitis C. Willingness to be followed for the duration of treatment and follow-up period. Prior Medication: Allowed: Prior AZT, ddI, and ddC. Exclusion Criteria Co-existing Condition: Patients with the following symptoms or conditions are excluded: Hepatitis B (HBsAg positive). Autoimmune hepatitis (FANA titer >= 1:160 and anti-smooth muscle antibody titer >= 1:160). Wilson's disease. alpha-1 antitrypsin deficiency. Hemochromatosis. Malignancy requiring systemic chemotherapy. Concurrent Medication: Excluded: Nonnucleoside analog therapy for HIV. Biologic response modifiers. Systemic cytotoxic chemotherapy. Chronic systemic steroid use. Concurrent Treatment: Excluded: Radiation therapy other than local irradiation to the skin. Prior Medication: Excluded: Prednisone within 12 weeks prior to study entry (if patient has received prior daily doses for 1 month or longer duration). Acute therapy for an infection within 2 weeks prior to study entry.

Ages Eligible for Study
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Minimum Age: 13 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment


Arms and Interventions

| Intervention/Treatment |
| --- |
|Drug: Interferon alfa-2b|nan|
|Drug: Zidovudine|nan|
|Drug: Zalcitabine|nan|
|Drug: Didanosine|nan|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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AIDS-Related Opportunistic Infections, Interferon Alfa-2b, Zalcitabine, Didanosine, Drug Therapy, Combination, Acquired Immunodeficiency Syndrome, Zidovudine, Hepatitis C