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CompletedNCT00399672Updated Nov 30, 2016

Evaluation of a Multi-disciplinary Approach for the Treatment of Hepatitis C in IDUs (HI-LO Study)

An interventional study of Interferon injections and ribavirin and Interferon injections and ribavirin in Hepatitis C Virus Infection, sponsored by University of British Columbia. Completed at 1 site in Canada. Open to participants aged 19 Years and older. Per ClinicalTrials.gov, last updated 2016-11-30.

Sponsored by University of British Columbia · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
370
Allocation
Non-randomized
Ages
19 Years and older
Sex
All
01

Study summary

Although injection drug users (IDUs) account for over 70% of new cases of HCV infection/year, there is no consensus on how to approach their medical care. In some Canadian centres, patients must be free of recreational drug use for as long as 6 months before being considered for HCV therapy. This is not consistent with current North American guidelines. Over the past 5 years, we have developed a successful program for the treatment of HIV infection in this population, based on a multi-disciplinary comprehensive program including directly observed therapy (DOT). Even though the duration of therapy for HCV is shorter than for HIV (as little as 6 months vs. life-long), we must address issues of administration of a weekly injection (interferon), twice daily pills (ribavirin) and the risk of significant side effects (including anxiety and depression) to successfully expand our program to treat this disease. Further, it may be that even if the program is successful, its benefits will be negated by HCV re-infection due to continued risk behaviors for its transmission.

Read the detailed description

We will determine the HCV infection status of potential study subjects within a cohort of 2,000 IDUs receiving care in our centres (Appendix 1). For those who carry HCV antibodies (expected n = 1800), a test for HCV viremia and genotype will be performed. By these evaluations, we expect up to 600 individuals to be viremic and carry HCV genotype 2 or 3. Within this group, 200 consecutive patients (100/study strategy) will receive therapy for HCV, based on their eligibility to do so according to Provincial guidelines for the reimbursement of medications. Patient allocation will be according to the study site where they regularly receive care. At two sites, patients will be enrolled in a DOT program with on-site full-time nursing and counseling support (high intensity, 50 patients/site). At the other two sites, patients will receive medication on a weekly basis and will have access to part-time nursing and counseling support (low intensity, 50 patients/site). Medical follow-up will be according to current clinical standards, and the primary endpoint of the study will be the rate of sustained virologic response (SVR) six months after completion of treatment. Within the study described above, we will use standardized methodologies to calculate the total health care costs related to the treatment of HCV infection. We will also assess the effect of treatment on the quality of life (QoL) of study participants.

02

Conditions studied

  • Hepatitis C Virus Infection

Keywords

  • HCV
  • injection drug users
  • ribavirin
  • pegylated interferon
  • illicit drug users
03

In context

Hepatitis A

2,709 studies on the registry are indexed under Hepatitis A; 142 are open to participants now.

This study's enrollment of 370 is above the median of 100 across 1,886 interventional studies indexed under Hepatitis A.

Browse Hepatitis A studies →

Lead sponsor

University of British Columbia is the lead sponsor of 1,309 studies on the registry; 253 are open to participants now.

Of its 6 completed or terminated interventional studies of FDA-regulated products, 1 (17%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
19 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Age > 19 years;
  • Serum HCV-RNA pos;
  • HCV genotype 2 or 3;
  • HBsAg neg;
  • serum ALT > 1.5x upper limit normal > 3 months;
  • Illicit drug use in the past year;
  • Agreement from each participant of childbearing age to practice contraception;
  • Absence of other contraindications to the initiation of therapy as determined by the health care team;
  • Ability to provide informed consent.

Exclusion criteria

Exclusion Criteria:

  • Any cause for chronic liver disease other than HCV (including alcohol use >350 g/wk);
  • Pregnant or breastfeeding women;
  • Active HBV infection;
  • Hemolytic anemia;
  • Decompensated cirrhosis or portal hypertension or PT-INR > 1.3 or Child-Hugh class > A;
  • Active suicidal ideation, psychosis, mania or hypomania;
  • Serum creatinine > 180 µg/mL;
  • Hemoglobin \< 120 g/L in men or 110 g/L in women;
  • Platelets \< 90 x 109/L;
  • Neutrophils \< 1.5 x 109/L;
  • Active autoimmune disease;
  • NYHA disease > grade 2;
  • Psoriasis requiring systemic therapy;
  • Active malignancy apart from non melanoma skin cancer;
  • Use of systemic immunosuppressant agents;
  • Prior treatment of HCV with interferon or ribavirin;
  • HIV positive with CD4 count \<300 cells/mm3 or receiving didanosine (due to interaction with ribavirin);
  • Life expectancy \< 2 years.
05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Non-randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
370 participants (actual)

Study arms

  • Active comparator
    1

    The 4 participating sites are designated either High Intensity or Low Intensity. High Intensity sites have access to: full time specialist physicians, access to full time nurses and counselors. All weekly pegylated interferon injections will be administered by clinic staff and ribavirin will be dispensed in weekly medication pack.

    Drug: Interferon injections and ribavirin

  • Active comparator
    2

    The 4 participating sites are designated either High Intensity or Low Intensity. In the Low intensity group, all patients will have access to: full time primary care physicians, specialist physicians and access to part time nurse or counselor by appointment. Patients will be offered the option of self or nurse administered pegylated interferon injections on an appointment basis. Ribavirin will be dispensed biweekly. The treatment medication cannot be stored at the clinic; it must be the subjects responsibility.

    Drug: Interferon injections and ribavirin

Interventions

  • DrugInterferon injections and ribavirin

    Weekly pegylated interferon injections will be administered by clinic staff and ribavirin will be dispensed in weekly medication pack.

  • DrugInterferon injections and ribavirin

    Patients will be offered the option of self or nurse administered pegylated interferon injections on an appointment basis. Ribavirin will be dispensed biweekly. The treatment medication cannot be stored at the clinic; it must be the subjects responsibility.

06

What researchers measure

Primary outcomes

  1. Rate of sustained virologic response (SVR) six months after completion of treatment.

Secondary outcomes

  1. Adherence to therapy

  2. Cost

  3. Quality of life

07

Study locations

1 site
  • Pender Community Health Centre
    Vancouver, British Columbia V6B 1R3, Canada
08

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Nov 30, 2016, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT00399672
Lead sponsor
University of British Columbia
Collaborators
Canadian Institutes of Health Research (CIHR)
Responsible party
Sponsor
First posted
Nov 15, 2006
Start date
Jun 2007
Primary completion
Aug 2010
Completion
Dec 2012
Last update
Nov 30, 2016

Study contacts

Brian Conway, MD
principal investigator · University of British Columbia

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Nov 2016. You cannot join it, but the record below documents what was studied.

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