Hepatitis BNCT00782158
Hepatitis B and HIV Co-Infection in Patients in Uganda
An observational study of Hepatitis B and HIV Infections, run by National Institute of Allergy and Infectious Diseases (NIAID) at 2 sites in Uganda.
Trial summary
This study will determine the amount of liver scarring (fibrosis) or liver damage in people infected with 1) hepatitis B virus (HBV, a virus that can infect the liver); 2) HIV (the virus that causes AIDS); 3) both HBV and HIV; and 4) neither HBV nor HIV. Read more about this study
- Who is it for?
- Ages 18 to 99 years
- Conditions the study is for
- Hepatitis B, HIV Infections
- How many people
- 6,303 participants
- Where
- 2 sitesUganda
- Study dates
- 27 Oct 2008to 14 Dec 2018
- Phase
- Observational
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 99 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Willing and able to provide individual informed consent
- Currently being followed at the RHSP or IDI Adult Infectious Disease Clinic
- Persons aged 18 years and older
Who cannot join
- Age less than 18 years
- Women who are pregnant
- Participants with a cardiac device (i.e., pacemaker)
- Participants not willing to allow storage of samples
- Participants not able to follow study instructions
Trial locations and contacts
2 sites in 1 country.
Uganda2 sites
Infectious Diseases Institute
Kampala
International Ctr for Excellence in Research and Rakai Health Sciences Program
Rakai
About this study
Official title: Hepatitis B and HIV Co-Infection in Uganda
This study will determine the amount of liver scarring (fibrosis) or liver damage in people infected with 1) hepatitis B virus (HBV, a virus that can infect the liver); 2) HIV (the virus that causes AIDS); 3) both HBV and HIV; and 4) neither HBV nor HIV. Liver fibrosis and liver damage can have many causes, including alcohol, certain medicines, exposure to some contaminated foods and infections with viruses that affect the liver (such as HBV). About 25 million people in sub-Saharan Africa are infected with HIV and about 50 million with chronic HBV, yet very little information is available on how many people are infected with both viruses and the medical implications of co-infection.
Participants in Uganda s Rakai Health Sciences Program (RHSP) or Infectious Diseases Institute (IDI) clinic who are 18 years of age or older may be eligible for this study.
Read more
People enrolled in the study come to the clinic for at least one visit and may be asked to return yearly. During the visit, participants undergo the following procedures:
- Questionnaire and a short interview about their health and quality of life.
- Physical examination and blood draw. The blood is tested for HBV and other factors that may suggest liver disease. Blood drawn at previous clinic visits or from other studies may also be tested.
- Liver evaluation using a FibroScan, a medical device that uses elastic waves to measure liver stiffness in a process similar to ultrasound scanning. For this test, the subjects lies flat on the back with the arm extended out. The tip of the machine s probe is covered with gel and placed on the skin between the ribs at the level of the right lobe of the liver. The machine produces a little tap on the skin that sends a wave out and checks how fast the wave moves. The speed of the wave indicates the amount of scarring in the liver.
Read the detailed description
While there are around 25 million HIV-infected persons in sub-Saharan Africa, there are also an estimated 50 million with chronic hepatitis B virus (HBV) infection. Yet data from Africa on the prevalence and clinical implications of HIV/HBV co-infection are sparse or unavailable. The scale-up of' HIV treatment with antiretroviral medication (ARVs) in Africa, should result in substantial reductions in morbidity and mortality. In developed countries, however, improved survival with highly active antiretroviral therapy (HAART) has been associated with notable increases in mortality due to liver disease among HIV-infected persons. Also, persons co-infected with hepatitis viruses have significantly higher liver-related toxicity with ARVs compared to persons infected with HIV alone. Our protocol will investigate predictors of liver disease among co-infected participants. The proposed study directly addresses the problem of HIV/HBV co-infection by examining the association of HBV viral markers with the development of significant liver fibrosis (defined by transient elastography). In addition to strengthening the clinical research capacity of our Ugandan colleagues, completion of our study aims will provide needed information for understanding the complex interaction of HBV and HIV, for projecting the future burden of liver disease related to the HIV epidemic, for clinical management of HBV infection in the setting of co-infection with HIV, and for optimizing the benefits while mitigating the potential deleterious consequences of antiretroviral programs in Africa.
Serological screening will be performed on up to 11,000 subjects in order to identify up to 2,400 subjects to be recruited into the clinical protocol. All people who choose to participate in the study will be asked to come to the clinic for at least 1 visit. If continuing funding is obtained, participants may be asked to return for additional yearly follow-up visits.
- Conditions
- Hepatitis B, HIV Infections
- Keywords
- HIV, Hepatitis B, Coinfection, Liver Fibrosis, Transient Elastography
- Medical subject headings
- Hepatitis B, HIV Infections, Coinfection, Liver Cirrhosis
What is being measured
The primary outcome is the main question the study is designed to answer.
Liver fibrosis and hepatoxicity
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted31 Oct 2008 (estimated)
- Study start27 Oct 2008
- Study completion14 Dec 2018
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (3)Papers the sponsor has linked to this study.
- Other trials for Hepatitis BStudies of the same condition, open and under way.
- More trials run by National Institute of Allergy and Infectious Diseases (NIAID)The sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Time perspective
- Other
- Enrolment
- 6,303 participants (actual)
Sponsor and investigators
- Sponsor type
- US National Institutes of Health
- Responsible party
- Sponsor
- Investigators
- Steven J Reynolds, M.D., Principal investigator, National Institute of Allergy and Infectious Diseases (NIAID)
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00782158
- Sponsor's protocol ID
- 999909016
- Other IDs
- 09-I-N016
- Status last verified
- 14 Dec 2018
- First submitted
- 29 Oct 2008
- Last updated
- 5 Dec 2019
- Results posted
- No
Publications
Stabinski L, Reynolds SJ, Ocama P, Laeyendecker O, Ndyanabo A, Kiggundu V, Boaz I, Gray RH, Wawer M, Thio C, Thomas DL, Quinn TC, Kirk GD; Rakai Health Sciences Program. High prevalence of liver fibrosis associated with HIV infection: a study in rural Rakai, Uganda. Antivir Ther. 2011;16(3):405-11. doi: 10.3851/IMP1783.
PubMed 21555823Auerbach BJ, Reynolds SJ, Lamorde M, Merry C, Kukunda-Byobona C, Ocama P, Semeere AS, Ndyanabo A, Boaz I, Kiggundu V, Nalugoda F, Gray RH, Wawer MJ, Thomas DL, Kirk GD, Quinn TC, Stabinski L; Rakai Health Sciences Program. Traditional herbal medicine use associated with liver fibrosis in rural Rakai, Uganda. PLoS One. 2012;7(11):e41737. doi: 10.1371/journal.pone.0041737. Epub 2012 Nov 27.
PubMed 23209545Redd AD, Wendel SK, Grabowski MK, Ocama P, Kiggundu V, Bbosa F, Boaz I, Balagopal A, Reynolds SJ, Gray RH, Serwadda D, Kirk GD, Quinn TC, Stabinski L. Liver stiffness is associated with monocyte activation in HIV-infected Ugandans without viral hepatitis. AIDS Res Hum Retroviruses. 2013 Jul;29(7):1026-30. doi: 10.1089/aid.2013.0004. Epub 2013 May 8.
PubMed 23548102
Study at a glance
From the registry record, last updated by the sponsor on 5 Dec 2019. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Hepatitis B and HIV Co-Infection in Uganda
- ClinicalTrials.gov ID
- NCT00782158
- Acronym / sponsor ID
- 999909016
- Conditions
- Hepatitis B, HIV Infections
- Keywords
- HIV, Hepatitis B, Coinfection, Liver Fibrosis, Transient Elastography
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 6,303 participants (actual)
- Lead sponsor
- National Institute of Allergy and Infectious Diseases (NIAID)US National Institutes of Health
- Study start
- 27 Oct 2008
- Study completion
- 14 Dec 2018
- First posted
- 31 Oct 2008 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study will determine the amount of liver scarring (fibrosis) or liver damage in people infected with 1) hepatitis B virus (HBV, a virus that can infect the liver); 2) HIV (the virus that causes AIDS); 3) both HBV and HIV; and 4) neither HBV nor HIV. Liver fibrosis and liver damage can have many causes, including alcohol, certain medicines, exposure to some contaminated foods and infections with viruses that affect the liver (such as HBV). About 25 million people in sub-Saharan Africa are infected with HIV and about 50 million with chronic HBV, yet very little information is available on how many people are infected with both viruses and the medical implications of co-infection.
Participants in Uganda s Rakai Health Sciences Program (RHSP) or Infectious Diseases Institute (IDI) clinic who are 18 years of age or older may be eligible for this study.
People enrolled in the study come to the clinic for at least one visit and may be asked to return yearly. During the visit, participants undergo the following procedures:
- Questionnaire and a short interview about their health and quality of life.
- Physical examination and blood draw. The blood is tested for HBV and other factors that may suggest liver disease. Blood drawn at previous clinic visits or from other studies may also be tested.
- Liver evaluation using a FibroScan, a medical device that uses elastic waves to measure liver stiffness in a process similar to ultrasound scanning. For this test, the subjects lies flat on the back with the arm extended out. The tip of the machine s probe is covered with gel and placed on the skin between the ribs at the level of the right lobe of the liver. The machine produces a little tap on the skin that sends a wave out and checks how fast the wave moves. The speed of the wave indicates the amount of scarring in the liver.
Detailed description
While there are around 25 million HIV-infected persons in sub-Saharan Africa, there are also an estimated 50 million with chronic hepatitis B virus (HBV) infection. Yet data from Africa on the prevalence and clinical implications of HIV/HBV co-infection are sparse or unavailable. The scale-up of' HIV treatment with antiretroviral medication (ARVs) in Africa, should result in substantial reductions in morbidity and mortality. In developed countries, however, improved survival with highly active antiretroviral therapy (HAART) has been associated with notable increases in mortality due to liver disease among HIV-infected persons. Also, persons co-infected with hepatitis viruses have significantly higher liver-related toxicity with ARVs compared to persons infected with HIV alone. Our protocol will investigate predictors of liver disease among co-infected participants. The proposed study directly addresses the problem of HIV/HBV co-infection by examining the association of HBV viral markers with the development of significant liver fibrosis (defined by transient elastography). In addition to strengthening the clinical research capacity of our Ugandan colleagues, completion of our study aims will provide needed information for understanding the complex interaction of HBV and HIV, for projecting the future burden of liver disease related to the HIV epidemic, for clinical management of HBV infection in the setting of co-infection with HIV, and for optimizing the benefits while mitigating the potential deleterious consequences of antiretroviral programs in Africa.
Serological screening will be performed on up to 11,000 subjects in order to identify up to 2,400 subjects to be recruited into the clinical protocol. All people who choose to participate in the study will be asked to come to the clinic for at least 1 visit. If continuing funding is obtained, participants may be asked to return for additional yearly follow-up visits.
Study design
- Time perspective
- Other
Who may qualify
- Ages
- 18 to 99 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (3 listed)
Key exclusion criteria (5 listed)
- Age less than 18 years
- Women who are pregnant
- Participants with a cardiac device (i.e., pacemaker)
- Participants not willing to allow storage of samples
- Participants not able to follow study instructions
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
Liver fibrosis and hepatoxicity
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 5 Dec 2019.
- Background: PubMed 21555823Stabinski L, Reynolds SJ, Ocama P, Laeyendecker O, Ndyanabo A, Kiggundu V, Boaz I, Gray RH, Wawer M, Thio C, Thomas DL, Quinn TC, Kirk GD; Rakai Health Sciences Program. High prevalence of liver fibrosis associated with HIV infection: a study in rural Rakai, Uganda. Antivir Ther. 2011;16(3):405-11. doi: 10.3851/IMP1783.
- Background: PubMed 23209545Auerbach BJ, Reynolds SJ, Lamorde M, Merry C, Kukunda-Byobona C, Ocama P, Semeere AS, Ndyanabo A, Boaz I, Kiggundu V, Nalugoda F, Gray RH, Wawer MJ, Thomas DL, Kirk GD, Quinn TC, Stabinski L; Rakai Health Sciences Program. Traditional herbal medicine use associated with liver fibrosis in rural Rakai, Uganda. PLoS One. 2012;7(11):e41737. doi: 10.1371/journal.pone.0041737. Epub 2012 Nov 27.
- Background: PubMed 23548102Redd AD, Wendel SK, Grabowski MK, Ocama P, Kiggundu V, Bbosa F, Boaz I, Balagopal A, Reynolds SJ, Gray RH, Serwadda D, Kirk GD, Quinn TC, Stabinski L. Liver stiffness is associated with monocyte activation in HIV-infected Ugandans without viral hepatitis. AIDS Res Hum Retroviruses. 2013 Jul;29(7):1026-30. doi: 10.1089/aid.2013.0004. Epub 2013 May 8.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Steven J Reynolds, M.D. principal investigator
National Institute of Allergy and Infectious Diseases (NIAID)
2 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Hepatitis B and HIV Infections, run by National Institute of Allergy and Infectious Diseases (NIAID) at 2 sites in Uganda.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 5 Dec 2019. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 2 sites in Uganda. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Liver fibrosis and hepatoxicity. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT00782158, which also lists 3 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 5 Dec 2019.