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NCT Number: NCT02282709

Effect of ASV and DCV Therapy on the Quality of Immune Status in Chronic HCV Patients

Rationale: Chronic HCV infection is characterised by a weak HCV specific CD8+ T cell response, due to continuous pressure of high viral load. Treatment of chronic HCV patients with ASV and DCV will result in a significant drop in HCV viral load. At present, no information is available on the immunological effects of treatment with ASV and DCV, nor on the early effects of viral load reduction caused by a compound that is thought not to possess direct immunomodulatory effects. This information will be crucial for a better understanding of the mechanisms that may limit the effectiveness of treatment, occurrence of viral rebound or relapses during, at the end of treatment or during the follow up period.

Objective: To evaluate in detail the functionality of immune cells in blood in chronic HCV patients before, during and after treatment with ASV and DCV, in an IFN-free regimen.

Study design: This is an investigator-initiated single center open label study with one arm of 12 patients.

Study population: Adult chronic HCV patients with genotype 1b, who are previous non-responders to the treatment.

Intervention (if applicable): All patients will be treated with twice daily a 200 mg oASV and once daily a 60 mg DCV for 24 weeks.

Main study parameters/endpoints:

1. Phenotype and function of blood leukocytes during treatment; frequency of HCV-specific T cells, NK cells and monocytes 2. Gene expression levels of leukocyte populations before, during and after treatment 3. Gene expression levels of the type I IFN signaling pathway on whole blood samples 4. Serum cytokines levels using multiplex platforms

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Key information

Conditions

Chronic Hepatitis C Blood-Borne Infections Chronic Disease Communicable Diseases Digestive System Diseases Disease Attributes Flaviviridae Infections Hepatitis Hepatitis C Hepatitis C, Chronic Hepatitis, Chronic Hepatitis, Viral, Human Infections Liver Diseases Pathologic Processes Pathological Conditions, Signs and Symptoms RNA Virus Infections Virus Diseases

Age range

18 year–70 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 3

Primary location

Erasmus Medical Center

Rotterdam, 3015 CE, Netherlands

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Patients between 18 and 70 years of age, with a chronic hepatitis C - genotype 1b infection
  • Patients are non-responders to previous treatment with peginterferon or conventional interferon plus ribavirin combination therapy
  • High viral load (>400,000 IU/ml)
  • Indication for antiviral therapy of hepatitis C according to current clinical guidelines
  • Written informed consent

Exclusion criteria

  • Decompensated cirrhosis (Child-Pugh Grade B or C)
  • Hepatic imaging (ultrasound, CT or MRI) with the evidence of hepatocellular carcinoma within the last 3 months.
  • Females who are pregnant or breast-feeding
  • History or other evidence of severe illness, malignancy or any other condition which would make the patient, in the opinion of the investigators, unsuitable for the study
  • Co-infections with human immunodeficiency virus (HIV) or Hepatitis B virus (HBV)
  • Presence of contra-indications for antiviral therapy with ASV and DCV:
  • Interfering substance abuse, such as high alcohol intake (indicator: 28 drinks/ week)
  • Any exposure to NS3 protease inhibitors or NS5A polymerase inhibitors
  • Treatment with peginterferon/ ribavirin within 6 months before start of therapy
  • Any other condition which in the opinion of the investigator would make the patient unsuitable for enrollment, or could interfere with the patient participating and completing in the study

Treatment and study plan

Daclatasvir

Drug

60 mg once daily

Asunaprevir

Drug

100 mg BID

Primary outcomes

  1. HCV-specific T cell phenotype and function (a composite measure of (I) HCV-specific T-cell frequency and (II) phenotypic expression of memory markers and (III) inhibitory receptor markers

    Time frame: 1 year

  2. NK cell phenotype and function (a composite measure of (I) NK cell frequency and (II) expression of activation and inhibitory markers (III) IFN-y production upon IL-12/IL-18 stimulation and (IV) Perforin granzyme production

    Time frame: 1 year

Secondary outcomes

  1. Gene expression levels of the type I IFN signaling pathway on whole blood samples measured by multiplex

    Time frame: 1 year

  2. Gene expression levels of leukocyte populations before, during and after treatment measured by microarray

    Time frame: 2 years

  3. Serum cytokines levels using multiplex platforms LUMINEX -100

    Time frame: 1 year

Sponsors and collaborators

Lead sponsor

Foundation for Liver Research

Other

Registry information

Acronym: ImmunoDual

Important dates

Study start
2014
Primary completion
2015
Study completion
2015
First posted
Nov 4, 2014
Registry last updated
Oct 19, 2015

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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