AIDS, Cirrhosis, HIV Infection
Conditions
Brief summary
An international investigation to evaluate if, and if so how long, autologous bone marrow hematopoietic stem cell transplantation can safely restore liver functions for HIV infected patients who have decompensated liver cirrhosis.
Detailed description
An international investigation to evaluate if, and if so how long, autologous bone marrow (ABM) hematopoietic stem cell transplantation (HSCT) can safely restore liver functions for HIV infected patients who have decompensated liver cirrhosis.
Interventions
Harvest and apheresis of bone marrow cells from HIV infected patients with cirrhosis under general anesthesia, using bone marrow collection system and transplanting the patients' hematopoietic stem cells back to the patients
Sponsors
Study design
Eligibility
Inclusion criteria
Outpatients or inpatients that are treated for HIV infection at AIDS Clinical Center of National Center for Global Health and Medicine who meet all criteria following: * have cirrhosis with 7 or higher Child-Pugh Score in Child-Pugh Score B * able to consent and willing to participate in the study * under good control for HIV infection
Exclusion criteria
Cases applicable to ANY condition of the following: * Hepatocellular carcinoma (HCC), except for cases having been completely treated without history of recurrence * Malignant tumors other than HCC * Alcoholic liver disease (ALD) * Hemoglobin under 8g/dL or Platelets under 20/ml at the registration * Esophageal or gastric varices with a risk of bursting, except for cases with only cured history of such conditions * Cases that cannot obtain the informed consent to autologous blood transfusion * Pregnancy * Renal dysfunction with 2mg/dL or higher serum creatinine * Performance Status 3 or 4 (assessment excludes hemophilic arthritis related daily life limitations) * Cases not fit for general anesthesia * Other conditions considered not suitable for the study by doctors
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Post-transplantation prognosis for cirrhosis | 24 weeks | Evaluate statistical significance between pre-transplantation and 24 weeks after in: * Child-Pugh score * albumin * serum fibrosis markers * Transient Elastography (TM) * ascites imagery * SF-36v2(TM) Health Survey. Because advanced liver cirrhosis is a progressive condition itself, treatment efficacy is defined by improvement and no change in the indicators listed. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Duration of the treatment efficacy | After 24 weeks up to 48 weeks | Using the same evaluation modules as of the primary outcomes, investigate and assess the autologous bone marrow transplantation effectivity chronologically after the primal 24 weeks up to 48 weeks to evaluate the duration of the treatment efficacy. |
Countries
Japan