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出境医 / 临床实验 / Immunology of HIV and Alcoholic Hepatitis

Immunology of HIV and Alcoholic Hepatitis

Study Description
Brief Summary:
This is prospective, longitudinal cohort study involving HIV-positive, antiretroviral (ART)-treated, heavy alcohol drinking participants who have and do not have alcoholic hepatitis.

Condition or disease Intervention/treatment
HIV/AIDS Alcoholic Hepatitis Other: Alcoholic Hepatitis Group Other: Heavy Drinking Controls without Hepatitis

Detailed Description:
The primary objective of this study is to determine the relationships between alcohol consumption and HIV-related pathogenic processes (microbial translocation, immune activation, inflammation, HIV replication, and hepatitis). Two study groups will be assembled and followed longitudinally over one year to address this objective. Group 1 will include HIV-positive, ART-treated, heavy alcohol drinkers who have alcoholic hepatitis. Group 2 will include HIV-positive, ART-treated, heavy alcohol drinkers who do not have alcoholic hepatitis. Both groups will undergo similar study procedures and follow-up.
Study Design
Layout table for study information
Study Type : Observational
Actual Enrollment : 0 participants
Observational Model: Case-Control
Time Perspective: Prospective
Official Title: Effects of Alcoholic Hepatitis on Immunological and Virological Profiles in HIV-Positive Patients
Actual Study Start Date : July 1, 2020
Actual Primary Completion Date : September 30, 2020
Actual Study Completion Date : September 30, 2020
Arms and Interventions
Group/Cohort Intervention/treatment
With alcoholic hepatitis
HIV-positive patients receiving antiretroviral therapy and who are heavy drinkers with high bilirubin and AST levels.
Other: Alcoholic Hepatitis Group
Alcoholic hepatitis is defined as having a total bilirubin level >3mg/dL and AST level>50U/L

Without alcoholic hepatitis
HIV-positive patients receiving antiretroviral therapy and who are heavy drinkers without high bilirubin and AST levels.
Other: Heavy Drinking Controls without Hepatitis
Normal levels of AST, ALT and total bilirubin and without evidence of cirrhosis or hepatosplenomegaly

Outcome Measures
Primary Outcome Measures :
  1. Immune activation - Levels of sCD14, sCD163 [ Time Frame: One year ]
    Levels of sCD14, sCD163


Biospecimen Retention:   Samples Without DNA
PBMC, plasma, serum

Eligibility Criteria
Layout table for eligibility information
Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Sampling Method:   Non-Probability Sample
Study Population
40 patients with HIV infection who are receiving antiretroviral therapy and who are heavy drinkers.
Criteria

Inclusion Criteria:

  • Both Groups: Age equal to or greater than 18 years
  • HIV infection documented by any licensed rapid HIV test or HIV enzyme or chemiluminescence immunoassay (E/CIA) test kit at any time prior to study entry and confirmed by a licensed Western blot, a second antibody test by a method other than the initial rapid HIV and/or E/CIA, or by at least one detectable HIV-1 RNA level
  • Receipt of stable antiretroviral therapy of any kind for at least 90 days prior to the baseline study visit
  • The most recent HIV-1 RNA level must be <200 copies/mL obtained as part of routine clinical care within 90 days prior to the main study visit
  • NOTE: There is no CD4 cell count eligibility criterion for this study.
  • Current alcoholism defined as >40g/day and >60g/day of alcoholic intake on average for a minimum of six months and within 90 days of the baseline visit in women and men, respectively
  • For Group 1 (Alcoholic Hepatitis Group), the presence of alcoholic hepatitis is defined by

    • Per most recently obtained routine clinical care laboratories, a total bilirubin > 3mg/dL and AST >50U/L, both within 90 days of the baseline study visit
    • For Group 1, participants who have become alcohol abstinent within 14 days of the baseline visit will still be allowed to participate
  • For Group 2 (Heavy drinking controls without hepatitis):

    • The most recent AST, ALT, and total bilirubin levels must be within normal limits. However, if the bilirubin level is increased due to suspected Gilbert's syndrome or due to current use of atazanavir, then the participant will be eligible.
    • There must not be evidence of current hepatosplenomegaly by examination or imaging obtained previously
    • There must not be stigmata of cirrhosis (spider angiomata, jaundice, encephalopathy, palmar erythema, ascites, intestinal varices).

Exclusion Criteria:

  • Inability to complete written, informed consent
  • Incarceration at the time of screening or main study visit
  • Abstinence from alcohol >2 weeks prior to the baseline study visit
  • Liver disease considered to be due to any etiology besides alcohol use
  • Diagnosed disease or process associated with increased systemic inflammation (including, but not limited to, systemic lupus erythematosus, inflammatory bowel diseases, other collagen vascular/autoimmune diseases)
  • Known active hepatitis B (defined as hepatitis B surface antigen positive with quantifiable HBV DNA viral load) or active hepatitis C (defined as quantifiable hepatitis C RNA viral load)
  • Fever, defined as T ≥ 38.0C within 48 hours prior to any study visit
  • Therapy for acute infection or other serious medical illnesses within 7 days of study visit
  • Malignancy requiring active treatment or had completed treatment within 90 days of any study visit (excluding skin-limited Kaposi sarcoma)
  • Pregnancy or breastfeeding within 14 days of any study visit
  • Receipt of investigational agents, cytotoxic chemotherapy, systemic or topical glucocorticoids (of any dose), or anabolic steroids (including physiologic testosterone replacement therapy) within 14 days of study visit
  • Active illicit drug use (besides marijuana) via any intake route (inhalation, smoking, injection)
Contacts and Locations

Locations
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United States, Indiana
Infectious Diseases Research Center
Indianapolis, Indiana, United States, 46202
Sponsors and Collaborators
Indiana University
Tracking Information
First Submitted Date May 14, 2019
First Posted Date May 15, 2019
Last Update Posted Date January 22, 2021
Actual Study Start Date July 1, 2020
Actual Primary Completion Date September 30, 2020   (Final data collection date for primary outcome measure)
Current Primary Outcome Measures
 (submitted: May 14, 2019)
Immune activation - Levels of sCD14, sCD163 [ Time Frame: One year ]
Levels of sCD14, sCD163
Original Primary Outcome Measures Same as current
Change History
Current Secondary Outcome Measures Not Provided
Original Secondary Outcome Measures Not Provided
Current Other Pre-specified Outcome Measures Not Provided
Original Other Pre-specified Outcome Measures Not Provided
 
Descriptive Information
Brief Title Immunology of HIV and Alcoholic Hepatitis
Official Title Effects of Alcoholic Hepatitis on Immunological and Virological Profiles in HIV-Positive Patients
Brief Summary This is prospective, longitudinal cohort study involving HIV-positive, antiretroviral (ART)-treated, heavy alcohol drinking participants who have and do not have alcoholic hepatitis.
Detailed Description The primary objective of this study is to determine the relationships between alcohol consumption and HIV-related pathogenic processes (microbial translocation, immune activation, inflammation, HIV replication, and hepatitis). Two study groups will be assembled and followed longitudinally over one year to address this objective. Group 1 will include HIV-positive, ART-treated, heavy alcohol drinkers who have alcoholic hepatitis. Group 2 will include HIV-positive, ART-treated, heavy alcohol drinkers who do not have alcoholic hepatitis. Both groups will undergo similar study procedures and follow-up.
Study Type Observational
Study Design Observational Model: Case-Control
Time Perspective: Prospective
Target Follow-Up Duration Not Provided
Biospecimen Retention:   Samples Without DNA
Description:
PBMC, plasma, serum
Sampling Method Non-Probability Sample
Study Population 40 patients with HIV infection who are receiving antiretroviral therapy and who are heavy drinkers.
Condition
  • HIV/AIDS
  • Alcoholic Hepatitis
Intervention
  • Other: Alcoholic Hepatitis Group
    Alcoholic hepatitis is defined as having a total bilirubin level >3mg/dL and AST level>50U/L
  • Other: Heavy Drinking Controls without Hepatitis
    Normal levels of AST, ALT and total bilirubin and without evidence of cirrhosis or hepatosplenomegaly
Study Groups/Cohorts
  • With alcoholic hepatitis
    HIV-positive patients receiving antiretroviral therapy and who are heavy drinkers with high bilirubin and AST levels.
    Intervention: Other: Alcoholic Hepatitis Group
  • Without alcoholic hepatitis
    HIV-positive patients receiving antiretroviral therapy and who are heavy drinkers without high bilirubin and AST levels.
    Intervention: Other: Heavy Drinking Controls without Hepatitis
Publications * Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruitment Information
Recruitment Status Withdrawn
Actual Enrollment
 (submitted: January 20, 2021)
0
Original Estimated Enrollment
 (submitted: May 14, 2019)
40
Actual Study Completion Date September 30, 2020
Actual Primary Completion Date September 30, 2020   (Final data collection date for primary outcome measure)
Eligibility Criteria

Inclusion Criteria:

  • Both Groups: Age equal to or greater than 18 years
  • HIV infection documented by any licensed rapid HIV test or HIV enzyme or chemiluminescence immunoassay (E/CIA) test kit at any time prior to study entry and confirmed by a licensed Western blot, a second antibody test by a method other than the initial rapid HIV and/or E/CIA, or by at least one detectable HIV-1 RNA level
  • Receipt of stable antiretroviral therapy of any kind for at least 90 days prior to the baseline study visit
  • The most recent HIV-1 RNA level must be <200 copies/mL obtained as part of routine clinical care within 90 days prior to the main study visit
  • NOTE: There is no CD4 cell count eligibility criterion for this study.
  • Current alcoholism defined as >40g/day and >60g/day of alcoholic intake on average for a minimum of six months and within 90 days of the baseline visit in women and men, respectively
  • For Group 1 (Alcoholic Hepatitis Group), the presence of alcoholic hepatitis is defined by

    • Per most recently obtained routine clinical care laboratories, a total bilirubin > 3mg/dL and AST >50U/L, both within 90 days of the baseline study visit
    • For Group 1, participants who have become alcohol abstinent within 14 days of the baseline visit will still be allowed to participate
  • For Group 2 (Heavy drinking controls without hepatitis):

    • The most recent AST, ALT, and total bilirubin levels must be within normal limits. However, if the bilirubin level is increased due to suspected Gilbert's syndrome or due to current use of atazanavir, then the participant will be eligible.
    • There must not be evidence of current hepatosplenomegaly by examination or imaging obtained previously
    • There must not be stigmata of cirrhosis (spider angiomata, jaundice, encephalopathy, palmar erythema, ascites, intestinal varices).

Exclusion Criteria:

  • Inability to complete written, informed consent
  • Incarceration at the time of screening or main study visit
  • Abstinence from alcohol >2 weeks prior to the baseline study visit
  • Liver disease considered to be due to any etiology besides alcohol use
  • Diagnosed disease or process associated with increased systemic inflammation (including, but not limited to, systemic lupus erythematosus, inflammatory bowel diseases, other collagen vascular/autoimmune diseases)
  • Known active hepatitis B (defined as hepatitis B surface antigen positive with quantifiable HBV DNA viral load) or active hepatitis C (defined as quantifiable hepatitis C RNA viral load)
  • Fever, defined as T ≥ 38.0C within 48 hours prior to any study visit
  • Therapy for acute infection or other serious medical illnesses within 7 days of study visit
  • Malignancy requiring active treatment or had completed treatment within 90 days of any study visit (excluding skin-limited Kaposi sarcoma)
  • Pregnancy or breastfeeding within 14 days of any study visit
  • Receipt of investigational agents, cytotoxic chemotherapy, systemic or topical glucocorticoids (of any dose), or anabolic steroids (including physiologic testosterone replacement therapy) within 14 days of study visit
  • Active illicit drug use (besides marijuana) via any intake route (inhalation, smoking, injection)
Sex/Gender
Sexes Eligible for Study: All
Ages 18 Years and older   (Adult, Older Adult)
Accepts Healthy Volunteers No
Contacts Contact information is only displayed when the study is recruiting subjects
Listed Location Countries United States
Removed Location Countries  
 
Administrative Information
NCT Number NCT03951662
Other Study ID Numbers NIAAA 1UH2AA026218
Has Data Monitoring Committee Yes
U.S. FDA-regulated Product
Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
IPD Sharing Statement
Plan to Share IPD: No
Responsible Party Samir K Gupta, MD, MS, Indiana University
Study Sponsor Indiana University
Collaborators Not Provided
Investigators Not Provided
PRS Account Indiana University
Verification Date January 2021

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