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Zidovudine Levels in HIV Infected Patients Being Treated for HCV



Zidovudine Levels in HIV Infected Patients Being Treated for HCV

For Condition: HIV Infections,HCV Infections
Status: Recruiting
Sponsor(s): National Institute of Allergy and Infectious Diseases (NIAID) ,
Synopsis: This study will test the amount of anti-HIV drugs in the blood cells of HIV infected patients who are also being treated for hepatitis C virus (HCV) infection.
Details: An estimated 50,000 people in Puerto Rico are infected with HCV. HIV and HCV have similar routes of transmission, and HCV co-infection occurs in 8% to 23% of HIV infected patients. Researchers have shown that treatment for HCV with Rebetron (ribavirin plus interferon alfa-2b) significantly decreases HCV viral load without affecting HIV viral load. However, measurements of intracellular levels of the active forms of zidovudine (ZDV-MP and ZDV-TP) were not performed. Such measurements are needed to provide a more rational basis for dosing in HIV/HCV co-infected patients. This study will investigate the intracellular exposure to active ZDV metabolites prior to and after treatment with Rebetron or treatment with PEG-Intron (pegylated interferon) and ribavirin. Participants in this study will remain on their usual antiretroviral regimen; no changes may be made to that regimen for the first 4 weeks of the study. Upon study entry, participants will have intracellular pharmacokinetic studies. During Week 2, participants will start either Rebetron or PEG-Intron plus ribavirin therapy, will have intracellular pharmacokinetic studies, and will undergo liver biopsy. Additional intracellular pharmacokinetic studies will be performed at Weeks 12 and 24. Rebetron or PEG-Intron plus ribavirin will be given for 48 weeks. A second liver biopsy will be performed 24 weeks after discontinuing Rebetron or PEG-Intron plus ribavirin therapy. Participants will be followed for 72 weeks.
Eligibility:
Study Type:
  Interventional, Treatment, Non-Randomized, Open Label, Uncontrolled, Single Group Assignment, Pharmacokinetics Study
Minimum Age/Maximum Age: 21 Years/60 Years
Genders: Both
Protocol Entry Criteria: Inclusion Criteria - HCV infection - HIV-1 infection - CD4 cell count > 200 cells/mm³ within 30 days prior to study entry - HIV RNA < 400 copies/ml within 90 days of study entry - Use of zidovudine, lamivudine, and any PI and/or NNRTI - ANC value >= 1,500 ml³ within 30 days of study entry - Weight > 50 kg (110 lbs) for women and > 60 kg (132 lbs) for men - Acceptable methods of contraception - Ability and willingness to complete the Baseline Adherence Questionnaire - Documentation of adherence confirmed by the Baseline Adherence Questionnaire and certified by the study officials Exclusion Criteria - Previous ribavirin therapy - More than 2 months of interferon therapy - Current use of any NRTI other than ZDV and 3TC - Hepatitis B surface antigen positive - Infectious, autoimmune, tumoral, biliary, or vascular liver disease - Alcohol consumption of more than 50 g/day - Current use of intravenous drugs - Hemoglobin levels < 10 gm/dl - Methadone use - Chemotherapy - Certain medications - Acute opportunistic or bacterial infection requiring therapy at the time of enrollment - Hemoglobinopathy (e.g., thalassemia) or any other cause of tendency to hemolysis - Psychiatric disorders, severe depression, history of suicide attempts, or suicidal ideation - Renal disease requiring dialysis - Significant coronary diseases or two or more risk factors for coronary diseases, such as > 55 years old, hypertension, and cholesterol > 250 mg/dl - Any clinically significant diseases (other than HIV and HCV infection) that, in the opinion of study officials, would compromise the outcome of this study - Pregnancy - Participation in blinded clinical trial
Total Enrollment: 16

Location and Contact Information:

Overall Study Official:
JoseRodriguez,  Principal Investigator,  MSC-UPR

UPR Adult ACTU *Recruiting*
San Juan,  ,  00936-5067
Puerto Rico
Recruiting Daniel  Casiano 787-767-9195


Additional Information:
Study ID Numbers:
  1R01AIA9141-01A1;  5R01AI049141-02
Study Start Date: September 2001
Record last reviewed: April 2004
Additional information available at: clinicaltrials.gov
Clinicaltrials.gov Reference link: NCT00059358

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