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Aim of the study is to assess the efficacy and safety of 24 weeks of oral Sofosbuvir/Ledipasvir fixed-dose combination (FDC) in subjects with HCV genotype 1 infection and HIV co-infection, who have previously failed a NS3/4A protease inhibitor plus Pegylated interferon /ribavirin regimen or stopped prematurely their treatment for intolerance.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Sofosbuvir/Ledipasvir | Experimental | Non-cirrhotic patients will receive SOF/LDV Fixed Dose Combination (FDC) for 12 weeks. Cirrhotic patients will receive SOF/LDV Fixed Dose Combination (FDC) for 24 weeks. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Sofosbuvir/Ledipasvir fixed dose | Drug | SOF 400 mg/LDV 90 mg FDC tablet administered orally once daily |
|
| Measure | Description | Time Frame |
|---|---|---|
| Sustained virologic response 12 weeks after discontinuation of therapy (SVR12), i.e. at week 36. | 12 weeks post-treatment |
| Measure | Description | Time Frame |
|---|---|---|
| Adverse clinical and biological events that occur during the treatment and up to 24 weeks after the end of the treatment | up to 24 weeks after the end of the treatment | |
| Number and causes of poor adherence and treatment interruptions | at 1,2,3,4,8,12,16, 20, 24 weeks during treatment, 4, 8,14,18,24 weeks after treatment discontinuationeeks after discontinuation of drugs |
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Inclusion Criteria:
Confirmed HIV infection
Infection with HCV genotype 1 only, confirmed at screen visit, with a HCV-RNA ≥ 1000 InternationalUnit(IU)/mL at screen visit
Treatment-experienced subjects with:
previous virological failure to tritherapy with Peginterferon/Ribavirin and protease inhibitor,
or premature discontinuation of previous tritherapy with Peginterferon/Ribavirin and protease inhibitor due to intolerance to Peginterferon or protease inhibitor
Anti-HCV treatment stopped for at least the last 3 months
Patients on a stable (for more than 1 month) antiretroviral treatment consisting of an emtricitabine/tenofovir or lamivudine/tenofovir standard of care backbone plus efavirenz or raltegravir or rilpivirine or enfuvirtide. Alternative combinations of the above listed medications may be allowed.
Dendritic cells 4 > 100/mm3 and > 15% at screen visit
HIV-RNA < 50cp/ml for more than 3 months at screen visit
Any liver fibrosis grade, with the assessment of the presence or not of cirrhosis at screening, cirrhosis being defined as a METAVIR score of F4 on the liver puncture biopsy and/or with hepatic impulse elastometry ≥ 14,5 kilopascal (kPa):
Previous liver biopsy exhibiting cirrhosis lesions (METAVIR F4),
Female patients with child-bearing potential, and their heterosexual partners must use adequate contraception from the date of screening until 90 days after administration of the last dose of study drug. Male participants must agree to consistently and correctly use a condom, while their female partner must use adequate contraception from the date of screening until 90 days after administration of the last dose of study drug
Body weight ≥40 kg and ≤125 kg
Informed and signed consent for the main study and the Pharmacokinetic (PK ) sub-study (for the participating patients)
Patients with Health insurance
Non inclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Eric Rosenthal | Hôpital de Nice | Principal Investigator |
| Eric Bellissant | Centre de Méthodologie et de Gestion, CHU de Rennes | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Centre de Méthodologie et de Gestion de Rennes | Rennes | France |
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| SVR rate 24 weeks (i.e. W48) after the end of treatment and according to the HCV sub-type | Week 48 |
| Number of patients with HCV resistance mutations to Sofosbuvir and/or Ledipasvir | from Day(D)0 to Week (W)24 |
| HCV viral load | at Day 0, Week 1, 2, 4, 8, 12, 16, 20, week 24, and 4, 8, 12, 18 and 24 weeks after the end of the treatment |
| Plasma HIV RNA levels | at Day 0, Week 4, 8, 12, 16, 20, 24, 36 and Week 48 |
| Assess drug-drug interactions between HCV et HIV drugs | Describe pharmacokinetic parameters of HIV drugs at Day 0 and Week 4 Describe pharmacokinetic parameters of Sofosbuvir and Ledipasvir at Week 4 | Day 0 and Week 4 |
| Patient's reported outcomes evaluation | Day 0, Week 12, Week 24 and Week 36 |
| ID | Term |
|---|---|
| D006526 | Hepatitis C |
| ID | Term |
|---|---|
| D000086982 | Blood-Borne Infections |
| D003141 | Communicable Diseases |
| D007239 | Infections |
| D006525 | Hepatitis, Viral, Human |
| D014777 | Virus Diseases |
| D018178 | Flaviviridae Infections |
| D012327 | RNA Virus Infections |
| D006505 | Hepatitis |
| D008107 | Liver Diseases |
| D004066 | Digestive System Diseases |
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| ID | Term |
|---|---|
| D000069474 | Sofosbuvir |
| C586541 | ledipasvir |
| ID | Term |
|---|---|
| D014542 | Uridine Monophosphate |
| D014500 | Uracil Nucleotides |
| D011742 | Pyrimidine Nucleotides |
| D011743 | Pyrimidines |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
| D009711 | Nucleotides |
| D009706 | Nucleic Acids, Nucleotides, and Nucleosides |
| D012265 | Ribonucleotides |
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