Efficacy and Safety of PegIntron Plus Ribavirin for Treatment of Chronic Hepatitis C in HIV-Infected Subjects (Study P04469)(TERMINATED)

Study Overview
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Brief Summary
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In this study, adult Indonesian subjects with human immunodeficiency virus (HIV) coinfected with chronic hepatitis C (CHC) will be given peginterferon alfa-2b (PEG-IFN) plus ribavirin (RBV) combination therapy. The efficacy rate (sustained virologic response, end of treatment virologic response, and sustained biochemical response), the subject morbidity rate as caused by other opportunistic infection (eg, bacterial pneumonia, tuberculosis, and other bacterial infection), and the safety and tolerability of this combination therapy will be examined.

Official Title
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Efficacy and Safety of PegIntron Plus Ribavirin for Treatment of Chronic Hepatitis C Infection in HIV-Infected Persons Not Previously Treated With Interferon

Conditions
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Hepatitis C, Chronic, Hepacivirus, HIV Infections

Intervention / Treatment
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* Biological: Peginterferon alfa-2b (SCH 054031)
* Drug: Ribavirin (SCH 018908)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Previously untreated chronic hepatitis C with HCV-RNA positive in plasma. Must have finished the detoxification phase of a drug rehabilitation program and abstained for at least 6 weeks from using abused substance (alcohol, I.V. drugs and inhaled drugs) before starting therapy. Liver transaminases (alanine aminotransferase [ALT]) 1.5-fold above the upper limit of normal. Controlled HIV infection with a viral load <10,000 copies/mL and a CD4 cell (T-cell) count >200 x 10^6 cells/L, in response to a stable antiretroviral treatment (ART) or without ART if it is not required. Compensated liver disease with protocol-specified minimum hematologic, biochemical, and serologic criteria at the Entry visit. Alpha-fetoprotein value within normal limits obtained within one year prior to entry. Results above the upper limit of normal but <=50 ng/mL require both of the following: Alpha-fetoprotein value <=50 ng/mL obtained within 3 months prior to entry in the study and Ultrasound obtained within 3 months prior to entry in the study or that is negative for evidence of hepatocellular carcinoma. Liver biopsy (optional) within 12 months prior to study entry with a pathology report confirming that the histologic diagnosis is consistent with chronic hepatitis. Women of childbearing potential must be using an acceptable method of birth control or be surgically sterilized. Reconfirmation that sexually active males must be practicing acceptable methods of contraception during the treatment period and for 6 months after discontinuation of therapy. Subjects must be free of any clinically significant diseases other than hepatitis or HIV infection that would interfere with study evaluations. Exclusion Criteria: Suspected hypersensitivity to interferon, PEG-interferon, or ribavirin. HIV therapy using didanosine (ddI) and stavudine (d4T) in their HIV medications, due to the potentiality of the resulting lactic acidosis. Participation in any other clinical trial within 30 days of entry to this protocol. Treatment with any investigational drug within 30 days of entry to this protocol. Subjects with organ transplants other than cornea and hair transplant. Any cause for the liver disease based on subject history and biopsy (where applicable) other than chronic hepatitis C, including but not limited to coinfection with hepatitis B virus (HBV); hemochromatosis (iron deposition >2+ in liver parenchyma); alpha-1 antitrypsin deficiency; Wilson's disease; autoimmune hepatitis; alcoholic liver disease; obesity-induced liver disease. Hemophilia or any other condition that would prevent the subject from having a liver biopsy, including anticoagulant therapy. Hemoglobinopathies (eg, Thalassemia) Evidence of advanced liver disease such as history or presence of ascites, bleeding varices, and encephalopathy. Any known preexisting medical condition that could interfere with the subject's participation in and completion of the protocol such as preexisting psychiatric condition, especially severe depression, or a history of severe psychiatric disorder. Significant cardiovascular dysfunction within the past 6 months (eg, angina, congestive heart failure, recent myocardial infarction, severe hypertension, or significant arrhythmia). Subjects with electrocardiogram (ECG) showing clinically significant abnormalities. Poorly controlled diabetes mellitus. Chronic pulmonary disease (eg, chronic obstructive pulmonary disease). Immunologically mediated disease. Any medical condition requiring, or likely to require during the course of the study, chronic systemic administration of steroids. Clinical gout. Clinically significant retinal abnormalities. Alcohol consumption of >20 gr/day. Women who are pregnant or nursing. Subjects who have not observed the designated washout periods for any of the prohibited medications.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 75 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
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: PEG-IFN + RBV<br>PEG-IFN + RBV therapy in previously untreated chronic HCV subjects coinfected with HIV | Biological: Peginterferon alfa-2b (SCH 054031)<br>* Subjects will be given peginterferon alfa-2b (PEG-IFN) subcutaneously, at a dose of 1.5 ug/kg weekly. Treatment duration will be 48 weeks for subjects with Hepatitis C Virus (HCV) genotype 1 and 24 weeks for subjects with HCV genotype 2 or 3 and baseline Hepatitis C Virus-ribonucleic acid (HCV-RNA) below 800,000 IU/mL.<br>* Other names: PegIntron;Drug: Ribavirin (SCH 018908)<br>* Subjects will be given ribavirin 800 mg/day orally(PO) when body weight is <65 kg, 1000 mg/day when body weight is between 65 kg and 85 kg, and 1200 mg/day when body weight is >85 kg. Treatment duration will be 48 weeks for subjects with HCV genotype 1 and 24 weeks for subjects with HCV genotype 2 or 3 and baseline HCV-RNA below 800,000 IU/mL.<br>* Other names: Rebetol;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of Participants Who Achieved Sustained Virologic Response (SVR) | Treatment duration for genotype 1 participants was 48 weeks. Treatment duration for genotypes 2 & 3 participants who had baseline hepatitis c virus ribonucleic acid [HCV-RNA] <800,000 IU/mL was 24 weeks. SVR was defined as plasma HCV RNA level below lower level of quanitation at the end of 24 weeks follow-up (week 48 or 72). The study was terminated due to low enrollment. This analysis was not performed. | Week 48 or Week 72 (depending on duration of treatment) | 
| Number of Participants Who Achieved Virologic Response (VR) | Treatment duration for genotype 1 participants was 48 weeks. Treatment duration for genotypes 2 & 3 participants who had baseline hepatitis c virus ribonucleic acid [HCV-RNA] <800,000 IU/mL was 24 weeks. The study was terminated due to low enrollment. This analysis was not performed. | 24 Weeks or 48 Weeks (depending on duration of treatment, which was either 24 or 48 weeks) | 
| Number of Participants Who Achieved Sustained Biochemical Response (SBR) | Treatment duration for genotype 1 participants was 48 weeks. Treatment duration for genotypes 2 & 3 participants who had baseline hepatitis c virus ribonucleic acid [HCV-RNA] <800,000 IU/mL was 24 weeks. SBR was defined as the presence of normal alanine aminotransferase (ALT) values at the end of 24 weeks follow-up (week 48 or 72). The study was terminated due to low enrollment. This analysis was not performed. | Week 48 or Week 72 (depending on duration of treatment, which was either 24 or 48 weeks) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of Participants Experiencing Opportunistic Infection | The study was terminated due to low enrollment. This analysis was not performed. | Throughout the study (up to 72 weeks) | 
| Number of Participants Who Died |  | Throughout the study (up to 72 weeks) | 
| Number of Participants Experiencing Adverse Events | An adverse event was defined as any untoward medical occurrence in a subject administered a pharmaceutical product, biologic (at any dose), or medical device, which did not necessarily have a causal relationship with the treatment. | Throughout the study (up to 72 weeks) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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HIV