A Study to Assess the Safety, Tolerability and Efficacy of TMC435 Along With Pegylated Interferon Alpha-2a (Pegasys) and Ribavirin (Copegus) Triple Therapy in Chronic Hepatitis C Genotype-1 Infected Patients Co-infected With Human Immunodeficiency Virus-Type 1

• Number of patients with sustained virologic response, SVR24 [ Time Frame: Week 24 (for the 12 Week treatment), Week 36 (for the 12 Week treatment followed by 12 Week follow up treatment), Week 60 (for the 12 Week treatment followed by 36 Week follow up treatment) ] [ Designated as safety issue: No ]
• Number of patients with undetectable hepatitis C virus (HCV) ribonucleic acid (RNA) less than 25 IU per mL undetectable, and/or HCV RNA levels less than 25 IU per mL [ Time Frame: Week 4, Week 12, Week 24, Week 36 and Week 48 ] [ Designated as safety issue: No ]
• Number of HCV patients on-treatment failure [ Time Frame: Week 12 (for the 12 Week treatment), Week 24 (for the 12 Week treatment followed by 12 Week follow up treatment), Week 48 (for the 12 Week treatment followed by 36 Week follow up treatment) ] [ Designated as safety issue: No ]
  Patients are considered as an on-treatment failure if, at actual end of treatment, there is confirmed detectable HCV RNA levels.
• Number of HCV patients with viral breakthrough [ Time Frame: Up to Week 48 ] [ Designated as safety issue: No ]
  Confirmed increase of more than 1 log10 IU per mL in HCV RNA level from the lowest level reached, or a confirmed HCV RNA level of more than 100 IU per mL in patients whose HCV RNA levels had previously been below the limit of quantification (less than 25 IU per mL detectable) or undetectable (less than 25 IU per mL undetectable), while on study therapy.
• Number of HCV patients with viral relapse [ Time Frame: Up to Week 72 ] [ Designated as safety issue: No ]
  Patients are considered to have a viral relapse if, at actual end of treatment, HCV RNA levels are less than 25 IU per mL undetectable; and during the follow-up period, HCV RNA levels are more than or equal to 25 IU per mL.
• Number of patients with normalized alanine aminotransferase levels at the end of treatment and at SVR assessments [ Time Frame: Week 12, Week 24, Week 36, Week 60, Week 72 ] [ Designated as safety issue: No ]
• Number of patients with virologic response defined as a plasma HIV viral load less than 50 HIV RNA copies per mL [ Time Frame: Baseline (Day 1) to Weeks 2, 4, 8, 12, 16, 20, 24, 28, 36, 42, 48, 52, 60 and 72. ] [ Designated as safety issue: No ]
• Number of patients with virologic response defined as a plasma HIV viral load less than 200 HIV RNA copies per microliter [ Time Frame: Baseline (Day 1) to Weeks 2, 4, 8, 12, 16, 20, 24, 28, 36, 42, 48, 52, 60 and 72. ] [ Designated as safety issue: No ]
• Number of patients with virologic response defined as a plasma HIV viral load less than 400 HIV RNA copies per microliter [ Time Frame: Baseline (Day 1) to Weeks 2, 4, 8, 12, 16, 20, 24, 28, 36, 42, 48, 52, 60 and 72. ] [ Designated as safety issue: No ]
• Number of HIV patients with virologic failure [ Time Frame: Baseline (Day 1) to Weeks 2, 4, 8, 12, 16, 20, 24, 28, 36, 42, 48, 52, 60 and 72. ] [ Designated as safety issue: No ]
• Mean change from baseline in log10 plasma HIV viral load [ Time Frame: Baseline (Day 1) to Weeks 2, 4, 8, 12, 16, 20, 24, 28, 36, 42, 48, 52, 60 and 72. ] [ Designated as safety issue: No ]
• Mean change from baseline in CD4+ cell count (absolute and percentage) [ Time Frame: Baseline (Day 1) to Weeks 2, 4, 8, 12, 16, 20, 24, 28, 36, 42, 48, 52, 60 and 72. ] [ Designated as safety issue: No ]
• Number of patients with adverse events [ Time Frame: Up to Week 72 ] [ Designated as safety issue: Yes ]

The purpose of this study is to evaluate the safety and tolerability of TMC435 along with pegylated interferon alpha-2a (PegIFNα-2a) and ribavirin (RBV) triple therapy in hepatitis C virus genotype-1 infected subjects, co-infected with human immunodeficiency virus-type 1, and to evaluate the number of patients with sustained virologic response (SVR) at 12 weeks after the planned end of treatment.

This is an open-label (all the people know the identity of the intervention), single arm (study will be conducted in a single group) clinical study, to evaluate the safety, tolerability and efficacy of TMC435 along with pegylated interferon alpha-2a (PegIFNα-2a) and ribavirin (RBV) triple therapy in adult chronic hepatitis C (CHC) genotype-1 infected patients who are co-infected with human immunodeficiency virus-type 1 (HIV-1). The study consists of 3 phases, screening phase (Week -6), treatment phase, and a follow-up phase (up to 24 weeks). In the treatment phase, patients will be classified based on their experience with previous hepatitis C virus (HCV) treatment as follows: 1) HCV treatment-naive (patients who never received medication for the treatment of HCV); 2) prior HCV relapsers (patients who received at least 24 weeks of a PegIFNα-2a and RBV-based therapy and relapsed within 1 year after the last medication intake); and 3) prior HCV non-responders (can be further classified as, null responders: patients having at least 1 prior documented course of PegIFNα-2a and RBV therapy for at least 12 consecutive weeks; or partial responders: patients having at least 20 consecutive weeks which has not been discontinued due to intolerability to PegIFNα-2a and RBV therapy). All patients will receive TMC435 once daily along with PegIFNα-2a and RBV for 12 weeks. Patients who are continuing treatment only with PegIFNα-2a and RBV will follow until 24 or 48 weeks. Pharmacokinetics will be measured after collection of blood samples. Safety evaluations for adverse events, clinical laboratory tests, electrocardiogram, vital signs, physical examinations, and specific toxicities will be performed throughout the study. The total duration of treatment is approximately of 24 weeks.

• Drug: TMC435
  TMC435 150 mg will be administered once daily for 12 weeks along with peginterferon alpha-2a and ribavirin.
• Drug: Pegylated interferon alpha-2a
  Pegylated interferon alpha-2a 180 microgram will be administered as subcutaneous injection of 0.5 mL until 24 to 48 weeks.
• Drug: Ribavirin
  Ribavirin 1000 or 1200 mg twice daily will be administered each day until 24 to 48 weeks.

Inclusion Criteria:

• A liver biopsy required within 3 years prior to screening unless the patient has a contraindication for a liver biopsy
• Patients with bridging fibrosis or cirrhosis and without a liver biopsy result within 2 years prior screening must have an ultrasound taken within 2 months prior to the screening visit or during screening with no findings suspicious for hepatocellular carcinoma (HCC)
• Genotype-1 hepatitis C virus (HCV) infection
• Plasma HCV ribonucleic acid (RNA) of more than 10,000 IU per mL
• Documented human immunodeficiency virus-type 1 (HIV-1) infection at least 6 months prior to screening

Exclusion Criteria:

• Patient showing evidence of hepatic decompensation (ie, history or current evidence of ascites, bleeding varices or hepatic encephalopathy, albumin serum concentration less than 3.3 gm per dL, prolonged prothrombin time [PT] expressed as international normalized ratio [INR] more than 1.5)
• Any liver disease of non-HCV etiology
• Co-infection with hepatitis B virus (hepatitis B surface antigen [HBsAg] positive)
• An acute HIV-1 infection; or HIV-2 infection
• Change in antiretroviral (ARV) regimen within the last 4 weeks prior screening