HIV Clinical Trial
Official title:
Neurobehavioral Deficits in HIV/HCV Infection Pre/Post Anti-HCV Therapy
This study will evaluate the impact of standard hepatitis C virus treatment on brain deficits in people who are infected with both HIV and the hepatitis C virus.
The World Health Organization estimates at least 3% of the world's population is infected
with chronic hepatitis C virus (HCV), and up to one third of all HIV infected people are
coinfected with HCV. HCV can damage the liver cells and cause liver diseases such as
cirrhosis and hepatocellular carcinoma. People infected with HCV can also suffer from
neurocognitive deficits, including problems with information processing, slowing of muscular
processes related to thinking, and difficulty focusing on complex things. These
neurocognitive deficits are similar to those found in HIV infected individuals, and previous
research indicates that people infected with both HIV and HCV have greater overall cognitive
impairments. This study aims to determine the impact of anti-HCV treatment on
neurocognitive, neuropsychiatric, and neuroimaging factors in people infected with HCV and
people coinfected with both HCV and HIV. The study also aims to measure whether possible
neurocognitive improvements from anti-HCV treatment are related to a physical health
outcome, measured as a sustained virologic response, and whether adherence to the medication
schedule laid out for the participants influences possible positive effects on either
neurocognitive or physical health.
Two kinds of participants will be recruited for this study: those infected with HCV and
those infected with both HCV and HIV. These two groups will be compared to determine how
comorbid HCV and HIV infection affects treatment outcomes. The treatment specified for HCV
is pegylated interferon alfa and ribavirin (PEG-IFN/RBV), considered standard care for
patients with chronic HCV. Participants will continue to see their doctors as regularly
scheduled, and any other prescribed medications or advice concerning HCV treatment will be
noted by researchers. All participants will be tested at baseline, after 12 weeks of
treatment, and 12 weeks after the completion of treatment. A subset from each group of
participants will undergo additional neuroimaging tests. Participation in this study will
last for varied amounts of time depending on the recommended treatments for HCV. Based on
each virus' genotype and rapid virologic response, the treatment period for HCV may last 24
or 48 weeks, with further extensions of 12 to 24 weeks in some cases.
During the three testing sessions, each lasting 5 hours, participants' health, cognitive
functioning, and medication adherence will be measured. Testing will include self-report
measures, intelligence tests, tasks designed to assess cognitive functioning, and motor
functioning tasks. Urine tests screening for narcotics will also be collected. In addition
to self-report measures, caps to pill bottles storing HCV medication will automatically
record every time the cap is removed to measure adherence to the medication schedule.
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