B/F/TAF Switch Study for HIV-HBV Coinfection

Hepatitis B Clinical Trial

— BEST-HBV  

Official title:

Efficacy, Safety, and Tolerability of Bictegravir/Emtricitabine/Tenofovir Alafenamide in Adults With HIV-HBV Coinfection

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03797014
• Other study ID #: HP00083844
• Status: Completed
• Phase: Phase 4
• Start date: April 30, 2019
• Est. completion date: May 5, 2023

Study information

• Verified date: October 2023
• Source: University of Maryland, Baltimore
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The primary objective of this study is to evaluate the efficacy and safety of fixed dose combination (FDC) bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) in adults coinfected with both HIV-1 and hepatitis B. As this is a switch study, all eligible subjects enrolled will be switched from their current antiretroviral regimen to B/F/TAF will be followed on treatment for 48 weeks.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 28
• Est. completion date: May 5, 2023
• Est. primary completion date: November 22, 2022
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

1. Age 18 years or older at enrollment.

2. Documented HIV-1 infection and currently on a stable regimen for at least 3 months if on an INSTI-based regimen (6 months if on a non-INSTI-based regimen) preceding the screening visit with documented plasma HIV-1 RNA = 50 copies/mL for at least 3 months preceding the screening visit.

3. No known history of resistance to tenofovir alafenamide (TAF), emtricitabine (FTC), or Bictegravir (BIC).

4. Documented chronic hepatitis B infection, based on any of the following: a. Positive HBsAg result or nucleic acid test for HBV DNA (including qualitative, quantitative, and genotype testing) or positive HBeAg on two occasions at least 6 months apart (any combination of these tests performed 6 months apart is acceptable); or b. Negative immunoglobulin M (IgM) antibodies to HBV core antigen (anti-HBc IgM) AND a positive results on one of the following tests: HBsAg, HBeAg, or nucleic acid test for HBV DNA (including qualitative, quantitative, and genotype testing) prior to or at screening.

5. No current or prior regimen containing three active anti-HBV agents (i.e. cannot be on tenofovir alafenamide (TDF)/emtricitabine (FTC)/entecavir or TDF/lamivudine (3TC)/entecavir).

6. Must have a primary care provider(s) for medical management.

7. Females of childbearing potential must agree to utilize protocol recommended highly effective contraceptive methods or be non-heterosexually active or practice sexual abstinence from screening and throughout the duration of the study. Female subjects who utilize hormonal contraceptive as one of their birth control methods must have used the same method for at least 3 months prior to study drug dosing.

8. Male subjects must be willing to abstain from heterosexual intercourse or use a condom throughout the study period.

9. Stated willingness to comply with all study procedures and availability for the duration of the study.

10. Written informed consent must be obtained before any study procedure is performed.

Exclusion Criteria:

1. Females who are pregnant or breastfeeding.

2. Any known allergies to any of the components of B/F/TAF.

3. Treatment with another investigational drug within three months of enrollment.

4. Abnormal hematological and biochemical parameters at screening, including:

1. Absolute neutrophil count (ANC) < 750 cells/mm3.

2. Platelets < 50,000/mm3.

3. Hemoglobin < 8.5 g/dL.

4. AST or ALT of > 5 times upper limit of normal (ULN).

5. Estimated GFR < 30 mL/min/1.73 m2.

6. Total bilirubin > 1.5 times ULN.

5. Previous or current history of malignancy, other than cutaneous Kaposi's sarcoma, basal cell carcinoma, or resected, non-invasive cutaneous squamous cell carcinoma. Note: Those with a history of malignancy who are in remission for two or more years may be included in the study.

6. An opportunistic illness indicative of stage 3 HIV diagnosed within the 30 days prior to screening.

7. Subjects experiencing decompensated cirrhosis (e.g. ascites, encephalopathy, or variceal bleeding).

8. Acute hepatitis in the 30 days prior to study entry.

9. Active tuberculosis infection.

10. Subjects receiving ongoing therapy with any medications contraindicated for co-administration with B/F/TAF FDC, including but not limited to the following medications: dofetilide, phenobarbital, phenytoin, carbamazepine, oxcarbamazepine, rifampin, rifapentine, cisapride, St. John's Wort, and Echinaceae.

11. Current alcohol or substance use that in the opinion of the investigator may interfere with subject study compliance.

12. Any other clinical conditions that in the opinion of the investigator would make the subject unsuitable for the study or unable to comply with the dosing requirements.

Related Conditions & MeSH terms

• Coinfection
• Hepatitis
• Hepatitis B
• HIV-1-infection

Intervention

Drug:
• B/F/TAF
Fixed dose combination B/F/TAF (50 mg/ 200 mg/ 25 mg/ tablet) administered orally once daily without regards to food.

Locations

Country	Name	City	State
United States	Institute of Human Virology Clinical Research Unit	Baltimore	Maryland
United States	Newlands Health	Philadelphia	Pennsylvania

Sponsors (2)

Lead Sponsor	Collaborator
University of Maryland, Baltimore	Gilead Sciences

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	HIV-1 RNA at Week 24	Proportion of participants with HIV-1 RNA <50 copies/mL at Week 24 by US FDA Snapshot Algorithm	Week 24
Primary	HBV DNA at Week 24	Proportion of participants with plasma HBV DNA <29 IU/mL at Week 24 as defined by Missing=Failure Approach	Week 24
Secondary	HIV-1 RNA at Week 48	Proportion of participants with HIV-1 RNA <50 copies/mL at Week 48 by US FDA Snapshot Algorithm	Week 48
Secondary	HBV DNA at Week 48	Proportion of participants with plasma HBV DNA <29 IU/mL at Week 48 as defined by Missing=Failure Approach	Week 48
Secondary	CD4 Cell Count Change at Week 24	Change from baseline in CD4 cell count at Week 24	Baseline; Week 24
Secondary	CD4 Cell Count Change at Week 48	Change from baseline in CD4 cell count at Week 48	Baseline; Week 48
Secondary	ALT Normalization at Week 24	Proportion of participants with normal ALT at Week 24	Week 24
Secondary	ALT Normalization at Week 48	Proportion of participants with normal ALT at Week 48	Week 48
Secondary	HBeAg Loss at Week 48	Proportion of participants with hepatitis B envelop antigen (HBeAg) loss at Week 48 visit.	Week 48
Secondary	HBsAg Loss at Week 48	Proportion of participants with hepatitis B surface antigen (HBsAg) loss at Week 48 visit.	Week 48