Effect of Boceprevir on HCV-specific T Cell Responses (Boce-Par)
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Purpose
Analysis of HCV-specific T cell responses in patients treated with boceprevir to assess whether therapy can induce restoration of the T cell function and to what extent this recovery can be achieved
| Condition | Intervention |
|---|---|
|
Chronic Hepatitis C |
Drug: Boceprevir |
| Study Type: | Observational |
| Study Design: | Time Perspective: Prospective |
| Official Title: | Effect of Boceprevir Therapy on HCV-specific T Cell Responses: Perspectives of Immune Monitoring and Immune Therapy |
- Levels of HCV-specific T cell functions before, during and after therapy to measure functional restoration induced by therapy [ Time Frame: 2 years ] [ Designated as safety issue: No ]Capacity of expansion, cytokine production (IFN-γ, IL-2 and TNF-α) and cytotoxicity expressed by HCV-specific T cells will be analyzed longitudinally at different time points before, during and after therapy
- Correlation of quality and intensity of pre-treatment HCV-specific T cell responses with outcome of therapy [ Time Frame: 2 years ] [ Designated as safety issue: No ]To assess whether different levels of efficiency of pre-treatment antiviral T cell responses can predict response to treatment.
Biospecimen Retention: Samples With DNA
Sera and peripheral blood lymphomononuclear cells
| Estimated Enrollment: | 30 |
| Study Start Date: | October 2011 |
| Estimated Study Completion Date: | October 2013 |
| Estimated Primary Completion Date: | October 2012 (Final data collection date for primary outcome measure) |
| Groups/Cohorts | Assigned Interventions |
|---|---|
Chronic hepatitis C
|
Drug: Boceprevir
In the experimental arm boceprevir (800 mg orally three times daily), PEG-IFN and ribavirin will be given for 24 weeks after the lead-in; the patients who will have undetectable HCV-RNA at week 8 will stop treatment at week 28; those who will be HCV-RNA positive at any visit between week 8 and 24 will receive an additional 20 weeks of PEG + RBV. Treatment will be discontinued if HCV-RNA is positive at week 24. Immunological analysis will be performed longitudinally at the following time points: week -4, 0, 4 (end of lead-in), 8, 12, 24, 48, week 24 of follow-up. HCV-RNA will be quantified at the same time points and viremia will be correlated with immunological data. Other Name: Peginterferon alfa-2b and ribavirin
|
Detailed Description:
Reconstitution of the antiviral T cell function may represent a component of the anti-viral effect of protease inhibitors. If T cell responsiveness is restored under therapy, potentiation of anti-viral T cell functions by exogenous T cell stimulation might be exploited to complement and to further improve response to available therapies. Monitoring the T cell function might also be useful to predict more accurately response to therapy.
To address these issues, phenotype and function of HCV-specific T cells will be analyzed longitudinally before, during and after therapy in naïve genotype 1 chronic hepatitis C patients treated with peginterferon plus ribavirin or with peginterferon and ribavirin plus boceprevir. To analyze the global CD4 and CD8 reactivity against all structural and non-structural HCV proteins a wide panel of peptides corresponding to the whole HCV genome of genotype 1 will be employed. To further analyze CD8 reactivity, HLA-A2/peptide tetramers will be used in HLA-A2 positive patients to directly quantify ex vivo HCV-specific CD8 cells circulating in the peripheral blood.The T cell function will be analyzed as capacity of expansion in vitro, cytokine production and cytotoxicity.
Eligibility| Ages Eligible for Study: | 18 Years to 70 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
| Sampling Method: | Probability Sample |
Naïve genotype 1 chronic hepatitis C patients
Inclusion Criteria:
Subjects must meet all of the following inclusion criteria to be eligible for participation in this study.
- Male or female, aged from 18 to 70 years old, inclusive.
- Willing and able to provide written informed consent
- Chronic HCV infection for at least 6 month prior to baseline (Day 1) in subjects currently positive for HCV-RNA and anti-HCV antibody documented by:
- A positive anti-HCV antibody test, positive HCV-RNA assay, or HCV genotype test at least 6 month prior to baseline (Day 1) or
- A liver biopsy performed prior to baseline (Day 1) with evidence of chronic HCV infection
- Subjects must have liver biopsy results (performed no more than two years prior the screening) indicating the absence of cirrhosis
- HCV infection limited to genotype 1
- Detectable plasma HCV-RNA at screening
- BMI between 18 and 36 Kg/m2
- Eligible subjects must also be HCV treatment-naïve, defined as no prior exposure to PEG-INF and ribavirin, and must be eligible to standard of care therapy with PEG/RBV
- Subjects must have the following laboratory parameters at screening:
ALT and AST ≤ 5 x upper limit of normal range (ULN) Hemoglobin (Hb) ≥ 12 g/dl WBC ≥ 2.500 cells/μL with absolute neutrophil count ≥ 1500 cells/μL If a woman of childbearing potential, must have negative serum β-human chorionic gonadotropin (β-HCG) pregnancy test documented at the screening visit and a negative serum or urine pregnancy test before the first dose of study drug to ensure that they are not pregnant at the time of starting treatment A female subjects of childbearing potential and nonvasectomized male subjects with a female partners of childbearing potential must agree that they and their partner will use effective contraception (two separate forms of contraception simultaneously, one of which must be a male condom with spermicide) from screening throughout the duration of study treatment and for at least 7 months
Exclusion Criteria:
- Pregnant women or women who may wish to become pregnant during the course of the study
- Male with a female who is pregnant or is planning to become pregnant within seven month the study of anticipated last dose of ribavirin
- Evidence of infection or co-infection with a no-genotype 1 HCV-strain
- History of hemoglobinopathy
- History of sarcoidosis
- History of invasive malignancy diagnosed or treated within 5 years.
- Untreated or significant psychiatric illnesses including severe depression, schizophrenia, psychosis, history of a suicide attempt
- Co-infection with HBV or HIV
- Chronic use of systemic immunosuppressive agents
- Presence of autoimmune disorders; subjects with treated hypothyroidism with normal TSH may be enrolled
- History of significant cardiac disease
- Clinical evidence of chronic pulmonary disease
- Known cirrhosis
- History of solid organ transplantation
- Suspicion of hepatocellular carcinoma
- Chronic liver disease of a non-HCV etiology
- Ongoin alcohol abuse
- History of clinical relevant drug abuse
- Positive urine screen for cocaine, opiate etc, or methadone use
Contacts and Locations| Contact: Carlo Ferrari, MD | +390521703622 | cafer@tin.it |
| Contact: Alessandra Orlandini, MD | +390521782839 | aorlandini@ao.pr.it |
| Italy | |
| Unit of Infectious Diseases and Hepatology | Not yet recruiting |
| Parma, Italy, 43126 | |
| Contact: Carlo Ferrari, MD +390521703622 cafer@tin.it | |
| Contact: Alessandra Orlandini, MD +390521702839 aorlandini@ao.pr.it | |
| Principal Investigator: Carlo Ferrari, MD | |
| Principal Investigator: | Carlo Ferrari, MD | Azienda Ospedaliero-Universitaria di Parma |
More Information
No publications provided
| Responsible Party: | Carlo Ferrari, Azienda Ospedaliero-Universitaria di Parma |
| ClinicalTrials.gov Identifier: | NCT01403181 History of Changes |
| Other Study ID Numbers: | AZOSPA |
| Study First Received: | July 26, 2011 |
| Last Updated: | July 26, 2011 |
| Health Authority: | Italy: Ethics Committee |
Keywords provided by Azienda Ospedaliero-Universitaria di Parma:
|
HCV T cells cytokines cytotoxicity proliferation |
Additional relevant MeSH terms:
|
Hepatitis Hepatitis A Hepatitis, Chronic Hepatitis C Hepatitis C, Chronic Liver Diseases Digestive System Diseases Hepatitis, Viral, Human Virus Diseases Enterovirus Infections Picornaviridae Infections |
RNA Virus Infections Flaviviridae Infections Ribavirin Peginterferon alfa-2b Antiviral Agents Anti-Infective Agents Therapeutic Uses Pharmacologic Actions Antimetabolites Molecular Mechanisms of Pharmacological Action |
ClinicalTrials.gov processed this record on May 23, 2013