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Trial record 29 of 223 for:    "Hepatitis B" | "Tenofovir"

Use of TDF in Patients With Inactive Chronic Hepatitis B Infection

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ClinicalTrials.gov Identifier: NCT02600117
Recruitment Status : Enrolling by invitation
First Posted : November 9, 2015
Last Update Posted : April 10, 2019
Sponsor:
Collaborator:
Gilead Sciences
Information provided by (Responsible Party):
Florence Wong, University Health Network, Toronto

Brief Summary:
Recent evidence suggests that patients with inactive chronic hepatitis B (CHB) may develop the same types of liver complications that patients in the active state of hepatitis B virus (HBV) infection experience. Treatment guidelines for patients in the active state of HBV infection indicate that HBsAg clearance is associated with definitive remission of the activity of chronic HBV & improved long-term outcome. Clinical data showed that HBsAg clearance is achievable, in a small population of patients on continuous treatment with potent oral antivirals (OAVs), such as tenofovir disoproxil fumarate (TDF). It is possible the same OAVs can have the same effect in patients with inactive CHB, but in a shorter treatment duration. The purpose of this study is to find out if TDF is effective in controlling HBV DNA & promoting seroconversion from HBsAg-positive to HBsAb-positive in patients with inactive CHB.

Condition or disease Intervention/treatment Phase
Hepatitis B, Chronic Drug: Tenofovir disoproxil fumarate Phase 3

Detailed Description:

Hepatitis B virus (HBV) infection is a major worldwide health problem. The course of the majority of patients with inactive chronic hepatitis B is usually benign; therefore, the current treatment guidelines recommend not treating these patients. However, recent evidence suggests that the prognosis of these inactive carrier is not exactly benign. For instance, patients may develop liver cancer despite their inactive carrier state. Also, approximately 20-30% of patients with inactive chronic hepatitis B may undergo spontaneous reactivation of hepatitis over time. Multiple episodes of reactivation or sustained reactivation can cause progressive liver damage and even liver decompensation. However, until there are data to support that treatment with oral antivirals can alter the outcome of these patients, they will remain untreated. Potent oral antivirals have been shown to suppress HBV DNA and normalize liver enzymes in patients with active chronic hepatitis B infection. With continued long-term treatment, some of these patients have gone on to clear hepatitis B surface antigen and develop hepatitis B surface antibody. Therefore, it is possible that the same oral antivirals can have the same effect in patients with inactive chronic hepatitis B, but in a shorter duration of treatment. This study will explore the possible use of tenofovir disoproxil fumarate in controlling HBV DNA and promoting hepatitis B surface antigen seroconversion in patients with inactive chronic hepatitis B.

After completion of all initial investigations, patients will be started on TDF 300mg daily. Patients will be reviewed at 6 monthly intervals as per standard of care. At each clinic visit, patients will have blood tests including complete blood count, renal function, electrolytes, liver enzyme and liver function tests, as well as HBV serology including quantitative HBsAg and HBV DNA. Patients will also receive an abdominal ultrasound, fibroscan and fibrotest on an annual basis. Treatment will be stopped when sAg+ve seroconverts to sAb+ve or at the end of 3 years whichever comes earlier.


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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 50 participants
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: The Use of Tenofovir Disoproxil Fumarate (TDF) in the Management of Patients With Inactive Chronic Hepatitis B (CHB) Infection
Study Start Date : November 2015
Estimated Primary Completion Date : May 2022
Estimated Study Completion Date : October 2022

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Tenofovir disoproxil fumarate
300 mg, orally, once a day for 3 years or when sAg+ve seroconverts to sAb+ve whichever comes earlier
Drug: Tenofovir disoproxil fumarate
300 mg, oral, once a day
Other Name: Viread




Primary Outcome Measures :
  1. Seroconversion from hepatitis B surface antigen positive to hepatitis B surface antibody positive [ Time Frame: Three years ]
    Positive hepatitis B surface antibody result will indicate recovery from chronic hepatitis B virus infection.



Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 75 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • All patients with inactive chronic hepatitis B, defined as someone who has HBV DNA ≤ log4, eAg-ve, eAb+, HBsAg+ve and normal ALT persistently for >6 months

Exclusion Criteria:

  • Patients older than 75 years of age
  • Presence of hepatoma at entry
  • Presence of decompensated cirrhosis defined by a history of variceal bleed, ascites, or hepatic encephalopathy
  • Presence of abnormal renal function defined as serum creatinine of>110µmol/L
  • co-infection with HIV

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02600117


Locations
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Canada, Ontario
University Health Network - Toronto General Hospital
Toronto, Ontario, Canada, M5G 2C4
Sponsors and Collaborators
University Health Network, Toronto
Gilead Sciences
Investigators
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Principal Investigator: Florence Wong, MD University Health Network -Toronto General Hospital

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Responsible Party: Florence Wong, MD, Hepatologist, Professor-Division of Gastroenterology,Department of Medicine, University of Toronto, University Health Network, Toronto
ClinicalTrials.gov Identifier: NCT02600117     History of Changes
Other Study ID Numbers: IN-CA-174-1708
First Posted: November 9, 2015    Key Record Dates
Last Update Posted: April 10, 2019
Last Verified: April 2019
Additional relevant MeSH terms:
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Hepatitis B
Hepatitis B, Chronic
Tenofovir
Hepatitis A
Hepatitis
Liver Diseases
Digestive System Diseases
Hepatitis, Viral, Human
Virus Diseases
Enterovirus Infections
Picornaviridae Infections
RNA Virus Infections
Hepadnaviridae Infections
DNA Virus Infections
Hepatitis, Chronic
Antiviral Agents
Anti-Infective Agents
Reverse Transcriptase Inhibitors
Nucleic Acid Synthesis Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
Anti-Retroviral Agents
Anti-HIV Agents