Towards a Functional Cure for HBV - The COMMIT Cohort Study (COMMIT)
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ClinicalTrials.gov Identifier: NCT03645044 |
Recruitment Status :
Recruiting
First Posted : August 24, 2018
Last Update Posted : September 26, 2019
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Condition or disease |
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Hiv HBV Coinfection |
A) Aims and Objectives. Effective antiviral treatments of HBV are available, but treatment is lifelong in most so comes at considerable cost and with some toxicity. An effective therapeutic strategy to achieve a cure for HBV remains an unmet need. This project examines the key steps to HBV cure in the setting of HIV-HBV co-infection. Seroconversion is key to the cure. Seroconversion is the process where detectable antibody (specific protective protein produced by the immune system) against virus proteins (antigens) are developed in the blood. This proposed Asian HIV-HBV co-infection cohort (where treatment initiation is later and hence at lower cluster of differentiation 4 (CD4) counts) will provide a unique opportunity to test our hypothesis that following initiation of antiviral therapy, HB surface and "e" antigen loss is more frequent (i) early in treatment and (ii) with lower CD4 cell counts, and that predictors of losing HB surface and 'e" antigen (Ag) and gaining antibody (Ab) against them are directly associated with B-cell functions.
B) Key Questions. Primary objective: to determine the rates & clinical determinants of HBsAg and HBeAg loss and seroconversion in HIV-HBV co-infected patients commencing HBV-active antiretroviral (ART). We will test the hypotheses that: (i) seroconversion occurs predominantly in the early phase of treatment (≤12 months) with HBV active ART and (ii) seroconversion is more frequent in HIV-HBV co-infected individuals commencing treatment with lower CD4+ T cell counts (≤100 cells/mm3) compared to those with higher counts (>100 cells/mm3).
Secondary objectives: (i) identify predictive biomarkers of HBsAg loss/seroconversion and (ii) examine predictors of HBeAg loss/seroconversion in this setting
C) Research Design. This is a large prospective, observational cohort study of treatment-naïve HIV-HBV co-infected patients (n=150). Clinical sites are - (1) HIV-Netherland-Australia-Thailand (HIV-NAT)/Thai Red Cross AIDS Research Centre, Bangkok, Thailand; (2) Y.R. Gaitonde Centre for AIDS Research and Education (YRG CARE), Chennai, India; and (3) Clinical Investigation Centre (CIC), University of Malaya, Infectious Diseases Directorate, Kuala Lumpur, Malaysia. Participants will be followed for 2 years, with study visits at baseline (study entry/initiation of treatment), months 3, 6, 12, 18, and 24 of follow-up. Clinical and laboratory information/data and blood samples will be collected at study visits.
Study Type : | Observational |
Estimated Enrollment : | 150 participants |
Observational Model: | Cohort |
Time Perspective: | Prospective |
Official Title: | Towards a Functional Cure for HBV: Exploiting Lessons From HIV-HBV Co-infection: The COMMIT Cohort Study |
Actual Study Start Date : | May 24, 2018 |
Estimated Primary Completion Date : | June 2021 |
Estimated Study Completion Date : | December 2022 |
- HBsAg loss/seroconversion on ART [ Time Frame: 24 months ]Frequency of HBsAg loss/seroconversion in early (first 12 months) compared to later stage
- HBeAg loss/seroconversion on ART [ Time Frame: 24 months ]Frequency of HBeAg loss/seroconversion in early (first 12 months) compared to later stage
- HBsAg epitope profiles [ Time Frame: 24 months ]HBsAg epitope profiles at study entry and after 2 years of antiviral therapy in HBsAg responders and non-responders
- Differential B cell gene expression [ Time Frame: 24 months ]Differential B cell gene expression (genetic testing) in HBsAg responders and non-responders after 2 years of antiviral therapy
- B-cell activating factor (BAFF) levels [ Time Frame: 24 months ]Levels of BAFF in plasma at study entry and after 2 years of antiviral therapy in HBsAg responders and non-responders
- HBeAg and HBsAg specific memory B cells [ Time Frame: 24 months ]Proportion of HBeAg and HBsAg specific memory B cells at study entry and after 2 years of antiviral therapy
- B cell subtypes [ Time Frame: 24 months ]Percentage of B cell subtypes at study entry and after 2 years of antiviral therapy
Biospecimen Retention: Samples With DNA

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Ages Eligible for Study: | 18 Years and older (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Sampling Method: | Non-Probability Sample |
Inclusion Criteria:
- Male or female, aged 18 years and older
- HIV antibody positive
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Chronically-infected with HBV, as defined by:
i. Positive Hepatitis B surface antigen HBsAg) or HBV DNA result with a subsequent positive HBsAg or HBV DNA result at least 6 months after first positive result (the 2nd HBsAg test may be taken at the baseline visit) ii. HBsAg positive with the absence of immunoglobulin M antibodies to HBV core at screening
- Current or ever hepatitis C virus (HCV) antibody negative
- Hepatitis D virus (HDV) negative
- ART naïve or within 7-10 days of ART start at sites where immediate ART start (test and treat) is practice
- Provide signed and dated informed consent form.
- Willing to comply with all study procedures and be available for the duration of the study.
Exclusion Criteria:
- Hepatitis C virus (HCV) antibody positive
- Hepatitis delta antibody positive
- Anything that would place the individual at increased risk or preclude the individual's full compliance with or completion of the study.

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): NCT03645044
Contact: Jennifer Audsley, PhD | +61383443266 | jennifer.audsley@unimelb.edu.au |
India | |
YRGCare | Not yet recruiting |
Chennai, India | |
Contact: Nagalingeswaran Kumarasamy, MD +91 44 71026610 info@yrgcare.org | |
Malaysia | |
Clinical Investigation Centre (CIC), University of Malaya, Infectious Diseases Directorate | Not yet recruiting |
Kuala Lumpur, Malaysia | |
Contact: Iskandar Azwa, MD +603-7949-3641 iskandar.azwa@gmail.com | |
Thailand | |
HIV-NAT/Thai Red Cross AIDS Research Centre | Recruiting |
Bangkok, Thailand | |
Contact: Anchalee Avihingsanon, MD, PhD +66 (0) 2652 3040 anchalee.a@hivnat.org) |
Principal Investigator: | Joe Sasadeusz, MBBS, PhD | University of Melbourne |
Responsible Party: | Joe Sasadeusz, Infectious Diseases physician, University of Melbourne |
ClinicalTrials.gov Identifier: | NCT03645044 |
Other Study ID Numbers: |
COMMIT study (NMHRC 1123988) |
First Posted: | August 24, 2018 Key Record Dates |
Last Update Posted: | September 26, 2019 |
Last Verified: | September 2019 |
Individual Participant Data (IPD) Sharing Statement: | |
Plan to Share IPD: | No |
Studies a U.S. FDA-regulated Drug Product: | No |
Studies a U.S. FDA-regulated Device Product: | No |
HBV sAg loss/seroconversion HBV "e" antigen (eAg) loss/seroconversion antiretroviral therapy |
Coinfection Infection Virus Diseases Parasitic Diseases |