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Hepatitis CCTN 0064NCT02641158

Assessing Long-term CTN 0049 Outcomes, HCV Prevalence and Progression Along the HCV Care Continuum Among HIV/HCV Co-infected Substance Users in the U.S.

A study testing Care Facilitation Group in people with Hepatitis C and HIV, run by Columbia University at 11 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Primary Objective: This study will evaluate the effectiveness of an HCV Care Facilitation intervention in moving HIV/HCV co-infected substance users forward along the HCV care continuum (compared with a Control group). Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Hepatitis C, HIV, AIDS
What is being tested?
Care Facilitation Group
Could I receive a placebo?
No, everyone receives an active treatment
How many people
422 participants
Where
11 sitesUnited States
Study dates
Dec 2015to 9 May 2018
Phase
Interventional
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 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • By virtue of participating individuals being recruited from the CTN-0049 cohort, they will be:
  • HIV-infected and
  • 18 years of age or older
  • Be able to communicate in English
  • Additionally, to be eligible for Component 1 they must:
  • provide informed consent, which includes being willing to provide sufficient locator information and to be tested for anti-HCV antibodies and, if antibody positive, tested for active HCV infection
Show all 14Show fewer
  • sign a HIPAA form / medical record release form to facilitate medical record abstraction
  • Finally, to continue on to Component 2, they must:
  • provide sufficient locator information
  • report living in the vicinity and being able to return for follow-up visits
  • complete the baseline assessments
  • complete the blood draw
  • test as HCV antibody positive via study Component 1 and,
  • agree to be randomized in Component 2

Who cannot join

  • Individuals will be excluded from participation if they:
  • have significant cognitive or developmental impairment
  • are terminated via Site Principal Investigator decision/discretion with agreement from study Lead Investigator
  • are currently in jail, prison or any inpatient overnight facility as required by court of law or have a pending legal action which may prevent an individual from completing the study
  • Additionally, individuals may participate in Component 1, but will be excluded from Component 2 if they:
  • are currently on HCV therapy/medications at baseline
  • have completed a course of HCV medications in the last 12 weeks based on self-report.
  • It should be noted that pregnancy is not an exclusion criterion. Therefore, sites may enroll pregnant women and/or follow-up with already enrolled women who become pregnant after enrollment in the study provided that they have local IRB approval to do so.

Trial locations and contacts

11 sites in 1 country.

11 sites in 1 country

United States11 sites
  • Grady Memorial Hospital / Ponce de Leon Center

    Atlanta, Georgia, 30322

  • Johns Hopkins Hospital / Moore Clinic

    Baltimore, Maryland, 21287

  • University Hospital at University of Alabama at Birmingham

    Birmingham, Alabama, 35294

  • Boston University Medical Center

    Boston, Massachusetts, 02118

  • John H. Stroger Jr. Hospital of Cook County

    Chicago, Illinois, 60612

  • University of Texas Southwestern

    Dallas, Texas, 75390

  • Jackson Health System Adult HIV Outpatient Clinics / University of Miami

    Miami, Florida, 33136

  • Mount Sinai - St. Luke's Roosevelt Hospital Center

    New York, New York, 10025

  • Hahnemann University Hospital

    Philadelphia, Pennsylvania, 19102

  • University of Pittsburgh Medical Center Presbyterian / Pittsburgh AIDS Center for Treatment

    Pittsburgh, Pennsylvania, 15213

  • Los Angeles BioMedical Research Institute at Harbor-UCLA Medical Center

    Torrance, California, 90502

Other trials in United States

About this study

Official title: CTN 0064: Assessing Long-term CTN 0049 Outcomes, HCV Prevalence and Progression Along the HCV Care Continuum Among HIV/HCV Co-infected Substance Users in the U.S.

Primary Objective: This study will evaluate the effectiveness of an HCV Care Facilitation intervention in moving HIV/HCV co-infected substance users forward along the HCV care continuum (compared with a Control group).

Primary Hypothesis: The number of steps achieved along the HCV care continuum will differ between the two study groups over the 14-month follow-up period.

Read more

Secondary Objectives:

Component 1 (Long-term CTN 0049 follow-up):

Using the CTN 0064 baseline data (self-report, medical record abstraction and biological data), the following CTN 0049 primary and secondary outcomes in participants who consented to the CTN 0064 protocol will be re-analyzed to evaluate latent and/or enduring effects of the CTN 0049 interventions:

  1. HIV virological suppression
  2. HIV primary care visit attendance
  3. All-cause mortality
Read the detailed description

The CTN 0064 study leverages the existing research infrastructure and cohort of the CTN 0049 (NCT01612169) randomized, controlled trial (RCT). CTN 0049 ("Project HOPE -- Hospital Visit as Opportunity for Prevention and Engagement for HIV-Infected Drug Users") is a three-group RCT that evaluated the most effective strategy to achieve HIV virologic suppression among HIV-infected substance users who were recruited from hospital settings. Between July 2012 and January 2014, a total of 801 HIV-infected hospitalized patients were recruited from 11 participating sites throughout the U.S. and randomized to one of the following three groups: 1) Patient Navigator intervention, 2) Patient Navigator plus Contingency Management intervention, and 3) Treatment as Usual. All CTN 0049 participants provided informed consent and completed baseline computer assisted personal interviews or CAPI (computer assisted personal interview: focusing on drug use, mental health, demographics and socio-economic factors, HIV care and drug treatment history) and blood draws (for HIV viral load and CD4 count). The two intervention groups received up to 11 patient navigation sessions over a 6-month period to actively assist participants in linking to HIV primary care and substance use treatment. Participants in all three groups completed follow-up assessments consisting of CAPI, blood draws, urine collection and breath analysis at approximately 6 and 12 months post-randomization. Medical records were reviewed to document receipt of HIV care and treatment during the study period. CTN 0064 will leverage the CTN 0049 research infrastructure and cohort by utilizing the 11 participating CTN 0049 research teams to recruit their randomized participants into the CTN 0064 study.

CTN 0064 has two main components: Component 1 is the baseline assessment for CTN 0064. It will also serve as a long-term follow-up assessment for CTN 0049 for those who consent to participate in CTN 0064. Participants whose HCV antibody test result is positive in this baseline assessment will be invited to enroll in Component 2. Component 2 is an RCT that will assess the effectiveness of a Care Facilitation intervention (compared to Control) in moving HIV/HCV co-infected substance users forward along the HCV care continuum. The study's primary objective is based on Component 2 and will be operationalized as movement through a series of (potentially non-sequential) pre-defined, clinical steps along the HCV care continuum (including the ultimate step, sustained virologic response to treatment at 12 weeks post treatment completion [SVR12]) (AASLD/IDSA/IAS-USA). Secondary objectives will be to assess: 1) success at each step in the HCV care continuum, 2) engagement in HIV care and substance use treatment, and 3) HIV viral suppression as well as 4) to examine other long-term outcomes of the CTN 0049 cohort.

All adults who were randomized into the CTN 0049 study and who provided consent to be contacted about future studies (hereafter, referred to as the "CTN 0049 cohort") will be invited to enroll in the CTN 0064 study. All participants will provide informed consent and complete Component 1, consisting of: 1) a computer assisted personal interview or CAPI (capturing history of HIV care, HCV testing and care, substance use and substance use treatment; mental health; demographics; and socio-economic factors), 2) HCV antibody screening via rapid HCV test (and, if HCV antibody positive, HCV RNA testing via venipuncture), 3) associated pre-/post-HCV test information and counseling, 4) blood specimen collection via venipuncture, and 5) drug/alcohol toxicology screening (via urine evaluation). The blood specimens of all participants will be assessed for HIV viral load and CD4 count. The blood specimens for the subset of participants who screen as HCV antibody positive will be assessed for HCV RNA to determine if their HCV infection is active.

Participants who screen as HCV antibody positive will be randomized into Component 2 and assigned to one of two groups: 1) HCV Care Facilitation intervention or 2) Control. The Care Facilitation intervention group will receive up to 12 sessions during a 6-month intervention period. Follow-up visits with both groups will be conducted at approximately 6 and 12 months post-randomization. These visits will consist of CAPI, blood specimen collection, and drug/alcohol toxicology screening. Medical records will be reviewed to document HCV testing, receipt and use of HCV clinical evaluation, care and treatment (as applicable); and HIV care and treatment before and during the study period.

Being tested
Control Group, Care Facilitation Group
Keywords
HIV, Hepatitis C, Substance users, Drug users
Medical subject headings
Hepatitis C, Acquired Immunodeficiency Syndrome, Substance-Related Disorders, Drug Misuse

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Control GroupOther

    After screening HCV antibody positive, participants will receive an appointment and reminder card to return for their HCV RNA results. If HCV RNA positive, study staff will attempt to make an appointment for the participant's next step in the HCV continuum. If a participant attends the "next step" visit, the participant would be subject to whatever is the local standard of care at that clinic/agency from that point forward.

  • Care Facilitation GroupBehavioural

    The same will occur for intervention participants, yet an HCV care facilitator will motivate them to return for their HCV RNA results; appointment reminders will be made prior to the "next step" visit; follow-up contact will be made for missed appointments; and the HCV care facilitator will coordinate and link the participant to available community resources (e.g., mental health, housing agencies) by scheduling appointments, arranging transportation, and helping to complete any clinic registration (or other) paperwork that agencies may require to access services.

Study groups in NCT02641158
Study groupRoleWhat they receive
Control GroupOtherNot described
Receives: Other: Control Group
Care Facilitation GroupExperimentalNot described
Receives: Behavioral: Care Facilitation Group

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Forward movement along the HCV care continuum assessed as the difference between the number of steps completed pre- and post-randomization (among Component 2 participants)

    The primary outcome is a count variable: total # of completed steps along the HCV care continuum by 14 months post-randomization (this is the outside window for the 12-month follow-up visit) minus the total number of steps completed within 12 months prior to baseline. Participants' final step on the HCV care continuum will be assessed the last time they are observed in medical records within the 14-month-long follow-up period. Because the entire sample has HIV, we include 2 HIV-related steps:

    1. Receipt of HCV RNA result -- result received within 3 months of baseline
    2. HIV primary care visit -- completion of 1 visit with an HIV primary care provider
    3. Initiated HIV ART
    4. HCV evaluation
    5. HCV treatment offered and declined or prescription process initiated
    6. HCV treatment initiated
    7. Course of HCV treatment completed
    8. SVR12 (sustained virologic response) achieved at 12 or more weeks after treatment completion

    Measured: 14 months post-randomization (this is the outside window for the 12-month follow-up visit)

Secondary outcomes (3)
  1. HIV viral suppression

    Suppression binary defined as viral load <=200 copies/ml (yes) vs. viral load >200 copies/ml or all-cause mortality (no)

    Measured: Assessed at the CTN 0064 baseline visit

  2. HIV care visit attendance

    Measured: Assessed in the 6-month time period before the CTN 0064 baseline visit

  3. All-cause mortality

    Measured: Time period will vary by participant between 9 months and 4 years depending when they were randomized into CTN 0049 and when they complete the CTN 0064 baseline assessment.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted29 Dec 2015 (estimated)
  2. Study startDec 2015
  3. Primary completion9 May 2018
  4. Study completion9 May 2018

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
422 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02641158
Sponsor's protocol ID
AAAP8757
Other IDs
U10DA013720
Acronym
CTN 0064
Status last verified
Jul 2020
First submitted
13 Dec 2015
Last updated
22 Jul 2020
Results posted
No
Data monitoring committee
Yes
Individual data sharing
Yes: Information about the study and the de-identified study data will be available at https://datashare.nida.nih.gov/ within 18 months of the date the data are locked, as per the procedures of the National Drug Abuse Treatment Clinical Trials Network.

Publications

  • Gutkind S, Starbird LE, Murphy SM, Teixeira PA, Gooden LK, Matheson T, Feaster DJ, Jain MK, Masson CL, Perlman DC, Del Rio C, Metsch LR, Schackman BR. Cost of Hepatitis C care facilitation for HIV/Hepatitis C Co-infected people who use drugs. Drug Alcohol Depend. 2022 Mar 1;232:109265. doi: 10.1016/j.drugalcdep.2022.109265. Epub 2022 Jan 10.

    PubMed 35042101
  • Metsch LR, Feaster DJ, Gooden LK, Masson C, Perlman DC, Jain MK, Matheson T, Nelson CM, Jacobs P, Tross S, Haynes L, Lucas GM, Colasanti JA, Rodriguez A, Drainoni ML, Osorio G, Nijhawan AE, Jacobson JM, Sullivan M, Metzger D, Vergara-Rodriguez P, Lubelchek R, Duan R, Batycki JN, Matthews AG, Munoz F, Jelstrom E, Mandler R, Del Rio C. Care Facilitation Advances Movement Along the Hepatitis C Care Continuum for Persons With Human Immunodeficiency Virus, Hepatitis C, and Substance Use: A Randomized Clinical Trial (CTN-0064). Open Forum Infect Dis. 2021 Jun 27;8(8):ofab334. doi: 10.1093/ofid/ofab334. eCollection 2021 Aug.

    PubMed 34377726

Questions about this trial

What is this clinical trial studying?

A study testing Care Facilitation Group in people with Hepatitis C and HIV, run by Columbia University at 11 sites in United States.

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 14 inclusion and 8 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 22 Jul 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 11 sites in United States. 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?

Forward movement along the HCV care continuum assessed as the difference between the number of steps completed pre- and post-randomization (among Component 2 participants) (time frame: 14 months post-randomization (this is the outside window for the 12-month follow-up visit)). 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 NCT02641158, which also lists 2 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 22 Jul 2020.

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