Human Immunodeficiency VirusNCT02344680
Liver Fibrosis in Zambian HIV-HBV Co-infected Patients
An observational study of Human Immunodeficiency Virus and HBV, run by University of Alabama at Birmingham at 1 site in Zambia.
Trial summary
A cohort of adults with HIV-HBV co-infection will be created in Lusaka, Zambia, to describe the short and long-term (up to 10 years of follow-up) HBV and liver outcomes, including the effectiveness of current therapies, and to identify the risk factors for major endpoints of interest, including HCC and HBV functional… Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Human Immunodeficiency Virus, HBV, Fibrosis, Liver
- What is being tested?
- Anti-HIV Agents
- How many people
- 349 participants
- Where
- 1 siteZambia
- Study dates
- Oct 2015to 28 May 2026
- Phase
- Observational
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
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 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Study population: 400 adults with HIV-HBV coinfection
Who may be able to join
- Age 18 years or older
- Living with HIV infection
- Living with active HBV infection, defined as any single positive HBsAg assay
- Naïve to antiretroviral therapy or currently participating in HIV/HBV co-infection in IeDEA-SA
Who cannot join
- Unable or unwilling to provide informed consent
- Planning to relocate out of Lusaka district
Trial locations and contacts
1 site in 1 country.
Zambia1 site
Centre for Infectious Disease Research in Zambia (CIDRZ)
Lusaka, Lusaka Province, 34681
About this study
Official title: Liver Fibrosis in Zambian HIV-HBV Co-infected Patients: a Long-term Prospective Cohort Study
A cohort of adults with HIV-HBV co-infection will be created in Lusaka, Zambia, to describe the short and long-term (up to 10 years of follow-up) HBV and liver outcomes, including the effectiveness of current therapies, and to identify the risk factors for major endpoints of interest, including HCC and HBV functional cure. This cohort will also create a pool of potential participants for in-depth mechanistic studies and clinical trials of novel HBV cure drugs.
Read the detailed description
Among people with HIV in Africa, liver disease is a neglected area of investigation but is anticipated to become increasingly common as patients live longer due to antiretroviral therapy. In Lusaka, Zambia, we previously (NCT02060162, clinicaltrials.gov) described that HIV-HBV co-infection was the most important liver risk factor. However, in that study, only very short-term outcomes could be assessed. Building on these preliminary results and addressing the need to study HIV-HBV during a longer duration of follow-up, the current protocol will focus exclusively on people with HIV-HBV in Zambia. Zambia is an ideal site for this research as it has ~12% HIV prevalence and 6% HBsAg-positivity among adults nationwide. In fact, ~70% of people with HIV-HBV globally reside in Africa. In the proposed study, we will obtain consent from people with HIV-HBV to participate in an observational cohort study with up to 10 years of follow-up. Standard of care antiviral therapies will be received by participants. More in-depth analysis of liver and HBV viral and serological outcomes will occur. Screening for liver cancer will also occur. This study will provide useful clinical and epidemiological information to health policymakers in Zambia and beyond. It will also provide a platform for the training of health workers in Zambia in HBV clinical management.
- Conditions
- Human Immunodeficiency Virus, HBV, Fibrosis, Liver, Cirrhosis, Liver, Hepatocellular Carcinoma, Hepatitis Delta Virus
- Being tested
- Anti-HIV Agents
- Medical subject headings
- Acquired Immunodeficiency Syndrome, Liver Cirrhosis, Carcinoma, Hepatocellular, Hepatitis D, Hepatitis, Alcoholic
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Anti-HIV AgentsDrug
Also called Anti-retroviral therapy
| Study group | Role | What they receive |
|---|---|---|
| Adults with HIV-HBV co-infection | Adults with HIV-HBV co-infection who are receiving antiretroviral therapy Receives: Drug: Anti-HIV Agents |
What is being measured
The primary outcome is the main question the study is designed to answer.
Reduction in Liver Fibrosis Stage
Based on transient elastography, we calculated the number and proportion of participants with at least significant fibrosis at their first measure who regressed to minimal-no fibrosis during follow-up. This outcome excluded participants with no-minimal fibrosis at enrollment.
Measured: From baseline to 10 years of follow-up
Secondary outcomes (3)
Prevalence of Significant Liver Fibrosis (Metavir F2 or Greater)
Proportion of participants with median liver stiffness based on transient elastography of >=7 kPa
Measured: At enrollment
Prevalence of Persistent HBV Viremia: Measure HBV DNA at Month 24
Proportion of participants with measure of HBV DNA above detection at month 24
Measured: Month 24
Incidence of Hepatocellular Carcinoma
Number of new cases of hepatocellular carcinoma during follow-up
Measured: From baseline to 10 years of follow-up
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted26 Jan 2015 (estimated)
- Study startOct 2015
- Primary completion28 May 2026
- Study completion28 May 2026
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (36)Papers the sponsor has linked to this study.
- Other trials for Human Immunodeficiency VirusStudies of the same condition, open and under way.
- More trials run by University of Alabama at BirminghamThe 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
- Observational model
- Cohort
- Time perspective
- Prospective
- Enrolment
- 349 participants (actual)
Sponsor and investigators
- Lead sponsor
- University of Alabama at Birmingham
- Sponsor type
- University, hospital or other
- Collaborators
- Fogarty International Center of the National Institute of Health, National Institutes of Health (NIH)
- Responsible party
- Principal investigator, Michael Vinikoor, University of Alabama at Birmingham
- Investigators
- Michael J Vinikoor, MD, Principal investigator, University of Alabama at Birmingham
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02344680
- Sponsor's protocol ID
- IRB-150819001
- Other IDs
- K01TW009998
- Status last verified
- May 2026
- First submitted
- 12 Jan 2015
- Last updated
- 2 Jul 2026
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
Publications
Weber R, Sabin CA, Friis-Moller N, Reiss P, El-Sadr WM, Kirk O, Dabis F, Law MG, Pradier C, De Wit S, Akerlund B, Calvo G, Monforte Ad, Rickenbach M, Ledergerber B, Phillips AN, Lundgren JD. Liver-related deaths in persons infected with the human immunodeficiency virus: the D:A:D study. Arch Intern Med. 2006 Aug 14-28;166(15):1632-41. doi: 10.1001/archinte.166.15.1632.
PubMed 16908797Central Statistical Office (CSO) MoH, Tropical Diseases Research Centre, University of Zambia, and Macro International Inc. Zambia Demographic and Health Survey 2007. Calverton, Maryland, USA: CSO and Macro International Inc., 2009.
Kapembwa KC, Goldman JD, Lakhi S, Banda Y, Bowa K, Vermund SH, Mulenga J, Chama D, Chi BH. HIV, Hepatitis B, and Hepatitis C in Zambia. J Glob Infect Dis. 2011 Jul;3(3):269-74. doi: 10.4103/0974-777X.83534.
PubMed 21887060Hamers RL, Zaaijer HL, Wallis CL, Siwale M, Ive P, Botes ME, Sigaloff KC, Hoepelman AI, Stevens WS, Rinke de Wit TF; PharmAccess African Studies to Evaluate Resistance (PASER). HIV-HBV coinfection in Southern Africa and the effect of lamivudine- versus tenofovir-containing cART on HBV outcomes. J Acquir Immune Defic Syndr. 2013 Oct 1;64(2):174-82. doi: 10.1097/QAI.0b013e3182a60f7d.
PubMed 23892239Martin-Carbonero L, Teixeira T, Poveda E, Plaza Z, Vispo E, Gonzalez-Lahoz J, Soriano V. Clinical and virological outcomes in HIV-infected patients with chronic hepatitis B on long-term nucleos(t)ide analogues. AIDS. 2011 Jan 2;25(1):73-9. doi: 10.1097/QAD.0b013e328340fde2.
PubMed 21076274Tuma P, Medrano J, Resino S, Vispo E, Madejon A, Sanchez-Piedra C, Rivas P, Labarga P, Martin-Carbonero L, Barreiro P, Soriano V. Incidence of liver cirrhosis in HIV-infected patients with chronic hepatitis B or C in the era of highly active antiretroviral therapy. Antivir Ther. 2010;15(6):881-6. doi: 10.3851/IMP1630.
PubMed 20834100Kirk GD, Bah E, Montesano R. Molecular epidemiology of human liver cancer: insights into etiology, pathogenesis and prevention from The Gambia, West Africa. Carcinogenesis. 2006 Oct;27(10):2070-82. doi: 10.1093/carcin/bgl060. Epub 2006 May 5.
PubMed 16679307Stabinski 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 21555823Crane M, Iser D, Lewin SR. Human immunodeficiency virus infection and the liver. World J Hepatol. 2012 Mar 27;4(3):91-8. doi: 10.4254/wjh.v4.i3.91.
PubMed 22489261Puoti M, Manno D, Nasta P, Carosi G. Hepatitis B virus and HIV coinfection in low-income countries: unmet needs. Clin Infect Dis. 2008 Feb 1;46(3):367-9. doi: 10.1086/525532. No abstract available.
PubMed 18171305Hoffmann CJ, Charalambous S, Martin DJ, Innes C, Churchyard GJ, Chaisson RE, Grant AD, Fielding KL, Thio CL. Hepatitis B virus infection and response to antiretroviral therapy (ART) in a South African ART program. Clin Infect Dis. 2008 Dec 1;47(11):1479-85. doi: 10.1086/593104.
PubMed 18937580Hawkins C, Christian B, Ye J, Nagu T, Aris E, Chalamilla G, Spiegelman D, Mugusi F, Mehta S, Fawzi W. Prevalence of hepatitis B co-infection and response to antiretroviral therapy among HIV-infected patients in Tanzania. AIDS. 2013 Mar 27;27(6):919-927. doi: 10.1097/QAD.0b013e32835cb9c8.
PubMed 23196935Wandeler G, Gsponer T, Bihl F, Bernasconi E, Cavassini M, Kovari H, Schmid P, Battegay M, Calmy A, Egger M, Furrer H, Rauch A; Swiss HIV Cohort Study. Hepatitis B virus infection is associated with impaired immunological recovery during antiretroviral therapy in the Swiss HIV cohort study. J Infect Dis. 2013 Nov 1;208(9):1454-8. doi: 10.1093/infdis/jit351. Epub 2013 Jul 30.
PubMed 23901088Easterbrook P, Sands A, Harmanci H. Challenges and priorities in the management of HIV/HBV and HIV/HCV coinfection in resource-limited settings. Semin Liver Dis. 2012 May;32(2):147-57. doi: 10.1055/s-0032-1316476. Epub 2012 Jul 3.
PubMed 22760654Kelly P, Saloojee H, Chen JY, Chung RT. Noncommunicable diseases in HIV infection in low- and middle-income countries: gastrointestinal, hepatic, and nutritional aspects. J Acquir Immune Defic Syndr. 2014 Sep 1;67 Suppl 1(0 1):S79-86. doi: 10.1097/QAI.0000000000000260.
PubMed 25117963
Study at a glance
From the registry record, last updated by the sponsor on 2 Jul 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Liver Fibrosis in Zambian HIV-HBV Co-infected Patients: a Long-term Prospective Cohort Study
- ClinicalTrials.gov ID
- NCT02344680
- Acronym / sponsor ID
- IRB-150819001
- Conditions
- Human Immunodeficiency Virus, HBV, Fibrosis, Liver, Cirrhosis, Liver, Hepatocellular Carcinoma, Hepatitis Delta Virus
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 349 participants (actual)
- Lead sponsor
- University of Alabama at BirminghamUniversity, hospital or other
- Collaborators
- Fogarty International Center of the National Institute of Health, National Institutes of Health (NIH)
- Study start
- Oct 2015 (actual)
- Primary completion
- 28 May 2026 (actual)
- Study completion
- 28 May 2026 (actual)
- First posted
- 26 Jan 2015 (estimated)
- Results
- Posted 2 Jul 2026
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
A cohort of adults with HIV-HBV co-infection will be created in Lusaka, Zambia, to describe the short and long-term (up to 10 years of follow-up) HBV and liver outcomes, including the effectiveness of current therapies, and to identify the risk factors for major endpoints of interest, including HCC and HBV functional cure. This cohort will also create a pool of potential participants for in-depth mechanistic studies and clinical trials of novel HBV cure drugs.
Detailed description
Among people with HIV in Africa, liver disease is a neglected area of investigation but is anticipated to become increasingly common as patients live longer due to antiretroviral therapy. In Lusaka, Zambia, we previously (NCT02060162, clinicaltrials.gov) described that HIV-HBV co-infection was the most important liver risk factor. However, in that study, only very short-term outcomes could be assessed. Building on these preliminary results and addressing the need to study HIV-HBV during a longer duration of follow-up, the current protocol will focus exclusively on people with HIV-HBV in Zambia. Zambia is an ideal site for this research as it has ~12% HIV prevalence and 6% HBsAg-positivity among adults nationwide. In fact, ~70% of people with HIV-HBV globally reside in Africa. In the proposed study, we will obtain consent from people with HIV-HBV to participate in an observational cohort study with up to 10 years of follow-up. Standard of care antiviral therapies will be received by participants. More in-depth analysis of liver and HBV viral and serological outcomes will occur. Screening for liver cancer will also occur. This study will provide useful clinical and epidemiological information to health policymakers in Zambia and beyond. It will also provide a platform for the training of health workers in Zambia in HBV clinical management.
Study design
- Observational model
- Cohort
- Time perspective
- Prospective
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Adults with HIV-HBV co-infection | – | Drug: Anti-HIV AgentsAdults with HIV-HBV co-infection who are receiving antiretroviral therapy |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- 400 adults with HIV-HBV coinfection
Key inclusion criteria (4 listed)
- Age 18 years or older
- Living with HIV infection
- Living with active HBV infection, defined as any single positive HBsAg assay
- Naïve to antiretroviral therapy or currently participating in HIV/HBV co-infection in IeDEA-SA
Key exclusion criteria (2 listed)
- Unable or unwilling to provide informed consent
- Planning to relocate out of Lusaka district
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Anti-HIV AgentsAlso: Anti-retroviral therapy | Drug | Adults with HIV-HBV co-infection |
Primary outcome
Reduction in Liver Fibrosis Stage
Time frame: From baseline to 10 years of follow-up
Based on transient elastography, we calculated the number and proportion of participants with at least significant fibrosis at their first measure who regressed to minimal-no fibrosis during follow-up. This outcome excluded participants with no-minimal fibrosis at enrollment.
3 secondary outcomes
Prevalence of Significant Liver Fibrosis (Metavir F2 or Greater)
Time frame: At enrollment
Prevalence of Persistent HBV Viremia: Measure HBV DNA at Month 24
Time frame: Month 24
Incidence of Hepatocellular Carcinoma
Time frame: From baseline to 10 years of follow-up
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 2 Jul 2026.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Background: PubMed 16908797Weber R, Sabin CA, Friis-Moller N, Reiss P, El-Sadr WM, Kirk O, Dabis F, Law MG, Pradier C, De Wit S, Akerlund B, Calvo G, Monforte Ad, Rickenbach M, Ledergerber B, Phillips AN, Lundgren JD. Liver-related deaths in persons infected with the human immunodeficiency virus: the D:A:D study. Arch Intern Med. 2006 Aug 14-28;166(15):1632-41. doi: 10.1001/archinte.166.15.1632.
- BackgroundCentral Statistical Office (CSO) MoH, Tropical Diseases Research Centre, University of Zambia, and Macro International Inc. Zambia Demographic and Health Survey 2007. Calverton, Maryland, USA: CSO and Macro International Inc., 2009.
- Background: PubMed 21887060Kapembwa KC, Goldman JD, Lakhi S, Banda Y, Bowa K, Vermund SH, Mulenga J, Chama D, Chi BH. HIV, Hepatitis B, and Hepatitis C in Zambia. J Glob Infect Dis. 2011 Jul;3(3):269-74. doi: 10.4103/0974-777X.83534.
- Background: PubMed 23892239Hamers RL, Zaaijer HL, Wallis CL, Siwale M, Ive P, Botes ME, Sigaloff KC, Hoepelman AI, Stevens WS, Rinke de Wit TF; PharmAccess African Studies to Evaluate Resistance (PASER). HIV-HBV coinfection in Southern Africa and the effect of lamivudine- versus tenofovir-containing cART on HBV outcomes. J Acquir Immune Defic Syndr. 2013 Oct 1;64(2):174-82. doi: 10.1097/QAI.0b013e3182a60f7d.
- Background: PubMed 21076274Martin-Carbonero L, Teixeira T, Poveda E, Plaza Z, Vispo E, Gonzalez-Lahoz J, Soriano V. Clinical and virological outcomes in HIV-infected patients with chronic hepatitis B on long-term nucleos(t)ide analogues. AIDS. 2011 Jan 2;25(1):73-9. doi: 10.1097/QAD.0b013e328340fde2.
- Background: PubMed 20834100Tuma P, Medrano J, Resino S, Vispo E, Madejon A, Sanchez-Piedra C, Rivas P, Labarga P, Martin-Carbonero L, Barreiro P, Soriano V. Incidence of liver cirrhosis in HIV-infected patients with chronic hepatitis B or C in the era of highly active antiretroviral therapy. Antivir Ther. 2010;15(6):881-6. doi: 10.3851/IMP1630.
- Background: PubMed 16679307Kirk GD, Bah E, Montesano R. Molecular epidemiology of human liver cancer: insights into etiology, pathogenesis and prevention from The Gambia, West Africa. Carcinogenesis. 2006 Oct;27(10):2070-82. doi: 10.1093/carcin/bgl060. Epub 2006 May 5.
- 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 22489261Crane M, Iser D, Lewin SR. Human immunodeficiency virus infection and the liver. World J Hepatol. 2012 Mar 27;4(3):91-8. doi: 10.4254/wjh.v4.i3.91.
- Background: PubMed 18171305Puoti M, Manno D, Nasta P, Carosi G. Hepatitis B virus and HIV coinfection in low-income countries: unmet needs. Clin Infect Dis. 2008 Feb 1;46(3):367-9. doi: 10.1086/525532. No abstract available.
- Background: PubMed 18937580Hoffmann CJ, Charalambous S, Martin DJ, Innes C, Churchyard GJ, Chaisson RE, Grant AD, Fielding KL, Thio CL. Hepatitis B virus infection and response to antiretroviral therapy (ART) in a South African ART program. Clin Infect Dis. 2008 Dec 1;47(11):1479-85. doi: 10.1086/593104.
- Background: PubMed 23196935Hawkins C, Christian B, Ye J, Nagu T, Aris E, Chalamilla G, Spiegelman D, Mugusi F, Mehta S, Fawzi W. Prevalence of hepatitis B co-infection and response to antiretroviral therapy among HIV-infected patients in Tanzania. AIDS. 2013 Mar 27;27(6):919-927. doi: 10.1097/QAD.0b013e32835cb9c8.
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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.
Michael J Vinikoor, MD principal investigator
University of Alabama at Birmingham
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Human Immunodeficiency Virus and HBV, run by University of Alabama at Birmingham at 1 site in Zambia.
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 4 inclusion and 2 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 2 Jul 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Zambia. 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?
Yes. Results are posted in the registry (first posted 2 Jul 2026). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
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?
Reduction in Liver Fibrosis Stage (time frame: From baseline to 10 years of follow-up). 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 NCT02344680, which also lists 36 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 2 Jul 2026.