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Efficacy and Safety of Sofosbuvir Plus Ribavirin in Chronic Genotype 1, 2 and 3 Hepatitis C Virus (HCV) and Human Immunodeficiency Virus (HIV) Co-infected Adults

A Phase 3, Open-label Study to Investigate the Efficacy and Safety of GS-7977 Plus Ribavirin in Chronic Genotype 1, 2 and 3 Hepatitis C Virus (HCV) and Human Immunodeficiency Virus (HIV) Co-infected Subjects

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01667731
Enrollment
224
Registered
2012-08-17
Start date
2012-07-31
Completion date
2014-02-28
Last updated
2014-11-21

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Hepatitis C, Human Immunodeficiency Virus

Keywords

Hepatitis C, Chronic, HCV, HIV, Human Immunodeficiency Virus, Co-Infected

Brief summary

This study will evaluate the efficacy, safety, and tolerability of sofosbuvir (SOF; GS-7977) plus ribavirin (RBV) in adults with chronic genotypes 1, 2, and 3 HCV infection who are coinfected with HIV-1.

Interventions

DRUGSOF

Sofosbuvir (SOF) 400 mg tablet administered orally once daily

DRUGRBV

Ribavirin (RBV) tablets administered orally in a divided daily dose according to package insert weight-based dosing recommendations (\< 75kg = 1000 mg and ≥ 75 kg = 1200 mg)

Sponsors

Gilead Sciences
Lead SponsorINDUSTRY

Study design

Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* Willing and able to provide written informed consent * Male or female, age ≥ 18 years with chronic HCV and HIV-1 infection * HCV RNA \> 1 x 10\^4 IU/mL at screening * Infection with HCV genotype 1, 2 or 3 as determined at screening * HIV-1 infection confirmed with positive ELISA or Western blot at screening * Medical records must be sufficient to be categorized on interferon (IFN) eligibility or prior treatment history with PEG/RBV. * Confirmation of chronic HCV infection * Ability to determine presence/absence of cirrhosis. * HIV antiretroviral therapy (ARV) criteria of one of the following: * ARV untreated with a CD4 T-cell count \> 500 cells/mm\^3 * On a stable, protocol-approved, ARV for \> 8 weeks prior to screening with a CD4 T-cell count \> 200 cells/mm\^3 and a documented undetectable plasma HIV-1 RNA level for ≥ 8 weeks preceding the screening visit * Approved HIV antiretroviral medications based on drug interaction studies * Not been treated with any investigational drug or device within 30 days of the screening visit * Females if confirmed that she is not pregnant or nursing of non-childbearing potential or of childbearing potential but has a negative serum pregnancy test at screening and agrees to use protocol approved method of birth control from screening through 6 months after the last dose of RBV * Males who agree to consistently and correctly use a condom while their female partner agrees to use protocol approved method of birth control from screening through 7 months after the last dose of RBV * Must be of generally good health as determined by the investigator. * Liver imaging within 6 months of baseline/Day 1 is required in cirrhotic patients only, to exclude hepatocellular carcinoma (HCC)

Exclusion criteria

* Non-genotype 1/2/3 or mixed genotype at screening * Genotype 1 with prior treatment for HCV * Poor control with ARV regimen * Prior exposure to a direct-acting antiviral targeting the HCV nonstructural protein (NS)5B polymerase * Chronic liver disease of a non-HCV etiology (eg, hemochromatosis, Wilson's disease, α1 antitrypsin deficiency, cholangitis) * A new AIDS-defining condition diagnosed within 30 days prior to screening * Active, serious infection (other than HIV or HCV) requiring parenteral antibiotics, antivirals or antifungals within 30 days prior to baseline * Infection with hepatitis B virus (HBV) * Contraindication to RBV therapy * Chronic use of systemically administered immunosuppressive agents (eg, prednisone equivalent \> 10 mg/day) * History of solid organ transplantation or malignancy diagnosed or treated within 5 years * Current or prior history of clinical hepatic decompensation or other significant gastrointestinal disorder

Design outcomes

Primary

MeasureTime frameDescription
Percentage of Participants With Sustained Virologic Response (SVR) at 12 Weeks After Discontinuation of Therapy (SVR12)Posttreatment Week 12SVR12 was defined as HCV RNA \< the lower limit of quantitation (LLOQ; ie, 25 IU/mL) at 12 weeks after stopping study treatment.
Incidence of Adverse Events Leading to Permanent Discontinuation of Study Drug(s)Up to 24 weeksThe percentage of participants discontinuing any study drug due to an adverse event was summarized.

Secondary

MeasureTime frameDescription
Change From Baseline in HCV RNA at Week 2Baseline; Week 2
Change From Baseline in HCV RNA at Week 4Baseline; Week 4
Change From Baseline in HCV RNA at Week 6Baseline; Week 6
Percentage of Participants With Sustained Virologic Response at 4 and 24 Weeks After Discontinuation of Therapy (SVR4 and SVR24)Posttreatment Weeks 4 and 24SVR4 and SVR24 were defined as HCV RNA \< LLOQ at 4 and 24 weeks following the last dose of study drug, respectively.
Percentage of Participants Experiencing On-treatment Virologic FailureUp to 24 weeksOn-treatment virologic failure was defined as: 1. Viral breakthrough: HCV RNA ≥ LLOQ after having previously had HCV RNA \< LLOQ while on treatment, confirmed with 2 consecutive values (second confirmation value may have been posttreatment) or with a last available on-treatment measurement and no subsequent follow-up values, or 2. Viral rebound: \> 1 log10 IU/mL increase in HCV RNA from nadir while on treatment, confirmed with 2 consecutive values (second confirmation value may have been posttreatment) or with a last available on-treatment measurement and no subsequent follow-up values, or 3. Nonresponse: HCV RNA persistently ≥ LLOQ through 8 weeks of treatment
Percentage of Participants Experiencing Viral RelapseUp to Posttreatment Week 24Viral relapse was defined as having achieved undetectable HCV RNA levels (HCV RNA \< LLOQ) at end of treatment, but did not achieve an SVR.
Change From Baseline in HCV RNA at Week 8Baseline; Week 8
Change From Baseline in HCV RNA at Week 1Baseline; Week 1

Countries

Puerto Rico, United States

Participant flow

Recruitment details

Participants were enrolled at a total of 34 study sites in the United States. The first participant was screened on 20 July 2012. The last participant observation occurred on 10 February 2014.

Pre-assignment details

330 participants were screened.

Participants by arm

ArmCount
SOF+RBV 12 Wk GT 2 TN
SOF 400 mg tablet once daily + RBV tablets (1000-1200 mg daily based on weight) for 12 weeks (treatment naive, genotype 2)
26
SOF+RBV 12 Wk GT 3 TN
SOF 400 mg tablet once daily + RBV tablets (1000-1200 mg daily based on weight) for 12 weeks (treatment naive, genotype 3)
42
SOF+RBV 24 Wk GT 2 TE
SOF 400 mg tablet once daily + RBV tablets (1000-1200 mg daily based on weight) for 24 weeks (treatment experienced, genotype 2)
24
SOF+RBV 24 Wk GT 3 TE
SOF 400 mg tablet once daily + RBV tablets (1000-1200 mg daily based on weight) for 24 weeks (treatment experienced, genotype 3)
17
SOF+RBV 24 Wk GT 1 TN
SOF 400 mg tablet once daily + RBV tablets (1000-1200 mg daily based on weight) for 24 weeks (treatment naive, genotype 1)
114
Total223

Withdrawals & dropouts

PeriodReasonFG000FG001FG002FG003FG004
Overall StudyDeath01000
Overall StudyEfficacy Failure1120124
Overall StudyEnrolled but not treated00001
Overall StudyLost to Follow-up23112
Overall StudySubject Withdrew Consent20101

Baseline characteristics

CharacteristicTotalSOF+RBV 24 Wk GT 1 TNSOF+RBV 24 Wk GT 3 TESOF+RBV 24 Wk GT 2 TESOF+RBV 12 Wk GT 3 TNSOF+RBV 12 Wk GT 2 TN
Age, Continuous49 years
STANDARD_DEVIATION 8.7
48 years
STANDARD_DEVIATION 8.4
54 years
STANDARD_DEVIATION 7
54 years
STANDARD_DEVIATION 4.9
48 years
STANDARD_DEVIATION 9.6
51 years
STANDARD_DEVIATION 9.7
Ethnicity (NIH/OMB)
Hispanic or Latino
54 Participants25 Participants5 Participants5 Participants11 Participants8 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
169 Participants89 Participants12 Participants19 Participants31 Participants18 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants
HCV Genotype
Genotype 1
114 participants114 participants0 participants0 participants0 participants0 participants
HCV Genotype
Genotype 2
50 participants0 participants0 participants24 participants0 participants26 participants
HCV Genotype
Genotype 3
59 participants0 participants17 participants0 participants42 participants0 participants
HCV RNA Category
< 6 log10 IU/mL
50 participants22 participants2 participants5 participants15 participants6 participants
HCV RNA Category
≥ 6 log10 IU/mL
173 participants92 participants15 participants19 participants27 participants20 participants
HCV RNA (log10 IU/mL)6.5 log10 IU/mL
STANDARD_DEVIATION 0.75
6.6 log10 IU/mL
STANDARD_DEVIATION 0.83
6.4 log10 IU/mL
STANDARD_DEVIATION 0.47
6.5 log10 IU/mL
STANDARD_DEVIATION 0.82
6.2 log10 IU/mL
STANDARD_DEVIATION 0.59
6.5 log10 IU/mL
STANDARD_DEVIATION 0.59
IL28b Status
CC
75 participants30 participants10 participants10 participants15 participants10 participants
IL28b Status
CT
111 participants57 participants7 participants10 participants22 participants15 participants
IL28b Status
Missing
1 participants1 participants0 participants0 participants0 participants0 participants
IL28b Status
TT
36 participants26 participants0 participants4 participants5 participants1 participants
Liver Cirrhosis
No
201 participants109 participants11 participants20 participants36 participants25 participants
Liver Cirrhosis
Yes
22 participants5 participants6 participants4 participants6 participants1 participants
Race/Ethnicity, Customized
American Indian/Alaska Native/First Nations
1 participants0 participants1 participants0 participants0 participants0 participants
Race/Ethnicity, Customized
Asian
3 participants1 participants0 participants1 participants1 participants0 participants
Race/Ethnicity, Customized
Black or African American
52 participants37 participants1 participants6 participants2 participants6 participants
Race/Ethnicity, Customized
Hawaiian or Other Pacific Islander
2 participants1 participants0 participants0 participants0 participants1 participants
Race/Ethnicity, Customized
Other
9 participants5 participants0 participants0 participants3 participants1 participants
Race/Ethnicity, Customized
White
156 participants70 participants15 participants17 participants36 participants18 participants
Sex: Female, Male
Female
38 Participants21 Participants3 Participants1 Participants8 Participants5 Participants
Sex: Female, Male
Male
185 Participants93 Participants14 Participants23 Participants34 Participants21 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
deaths
Total, all-cause mortality
— / —— / —— / —
other
Total, other adverse events
57 / 6837 / 41106 / 114
serious
Total, serious adverse events
5 / 681 / 418 / 114

Outcome results

Primary

Incidence of Adverse Events Leading to Permanent Discontinuation of Study Drug(s)

The percentage of participants discontinuing any study drug due to an adverse event was summarized.

Time frame: Up to 24 weeks

Population: Safety Analysis Set: participants who were enrolled and received at least 1 dose of study drug

ArmMeasureValue (NUMBER)
SOF+RBV 12 Wk GT 2 TNIncidence of Adverse Events Leading to Permanent Discontinuation of Study Drug(s)4.4 percentage of participants
SOF+RBV 12 Wk GT 3 TNIncidence of Adverse Events Leading to Permanent Discontinuation of Study Drug(s)2.4 percentage of participants
SOF+RBV 24 Wk GT 2 TEIncidence of Adverse Events Leading to Permanent Discontinuation of Study Drug(s)2.6 percentage of participants
Primary

Percentage of Participants With Sustained Virologic Response (SVR) at 12 Weeks After Discontinuation of Therapy (SVR12)

SVR12 was defined as HCV RNA \< the lower limit of quantitation (LLOQ; ie, 25 IU/mL) at 12 weeks after stopping study treatment.

Time frame: Posttreatment Week 12

Population: Full Analysis Set: participants who were enrolled and received at least 1 dose of study drug

ArmMeasureValue (NUMBER)
SOF+RBV 12 Wk GT 2 TNPercentage of Participants With Sustained Virologic Response (SVR) at 12 Weeks After Discontinuation of Therapy (SVR12)88.5 percentage of participants
SOF+RBV 12 Wk GT 3 TNPercentage of Participants With Sustained Virologic Response (SVR) at 12 Weeks After Discontinuation of Therapy (SVR12)66.7 percentage of participants
SOF+RBV 24 Wk GT 2 TEPercentage of Participants With Sustained Virologic Response (SVR) at 12 Weeks After Discontinuation of Therapy (SVR12)91.7 percentage of participants
SOF+RBV 24 Wk GT 3 TEPercentage of Participants With Sustained Virologic Response (SVR) at 12 Weeks After Discontinuation of Therapy (SVR12)94.1 percentage of participants
SOF+RBV 24 Wk GT 1 TNPercentage of Participants With Sustained Virologic Response (SVR) at 12 Weeks After Discontinuation of Therapy (SVR12)76.3 percentage of participants
Secondary

Change From Baseline in HCV RNA at Week 1

Time frame: Baseline; Week 1

Population: Participants in the Full Analysis Set with available data were analyzed.

ArmMeasureValue (MEAN)Dispersion
SOF+RBV 12 Wk GT 2 TNChange From Baseline in HCV RNA at Week 1-4.69 log10 IU/mLStandard Deviation 0.471
SOF+RBV 12 Wk GT 3 TNChange From Baseline in HCV RNA at Week 1-4.52 log10 IU/mLStandard Deviation 0.464
SOF+RBV 24 Wk GT 2 TEChange From Baseline in HCV RNA at Week 1-4.63 log10 IU/mLStandard Deviation 0.68
SOF+RBV 24 Wk GT 3 TEChange From Baseline in HCV RNA at Week 1-4.78 log10 IU/mLStandard Deviation 0.354
SOF+RBV 24 Wk GT 1 TNChange From Baseline in HCV RNA at Week 1-4.42 log10 IU/mLStandard Deviation 0.958
Secondary

Change From Baseline in HCV RNA at Week 2

Time frame: Baseline; Week 2

Population: Participants in the Full Analysis Set with available data were analyzed.

ArmMeasureValue (MEAN)Dispersion
SOF+RBV 12 Wk GT 2 TNChange From Baseline in HCV RNA at Week 2-5.11 log10 IU/mLStandard Deviation 0.574
SOF+RBV 12 Wk GT 3 TNChange From Baseline in HCV RNA at Week 2-4.84 log10 IU/mLStandard Deviation 0.579
SOF+RBV 24 Wk GT 2 TEChange From Baseline in HCV RNA at Week 2-5.15 log10 IU/mLStandard Deviation 0.813
SOF+RBV 24 Wk GT 3 TEChange From Baseline in HCV RNA at Week 2-5.06 log10 IU/mLStandard Deviation 0.467
SOF+RBV 24 Wk GT 1 TNChange From Baseline in HCV RNA at Week 2-5.00 log10 IU/mLStandard Deviation 0.829
Secondary

Change From Baseline in HCV RNA at Week 4

Time frame: Baseline; Week 4

Population: Participants in the Full Analysis Set with available data were analyzed.

ArmMeasureValue (MEAN)Dispersion
SOF+RBV 12 Wk GT 2 TNChange From Baseline in HCV RNA at Week 4-5.04 log10 IU/mLStandard Deviation 0.71
SOF+RBV 12 Wk GT 3 TNChange From Baseline in HCV RNA at Week 4-4.86 log10 IU/mLStandard Deviation 0.602
SOF+RBV 24 Wk GT 2 TEChange From Baseline in HCV RNA at Week 4-5.16 log10 IU/mLStandard Deviation 0.82
SOF+RBV 24 Wk GT 3 TEChange From Baseline in HCV RNA at Week 4-5.06 log10 IU/mLStandard Deviation 0.467
SOF+RBV 24 Wk GT 1 TNChange From Baseline in HCV RNA at Week 4-5.12 log10 IU/mLStandard Deviation 0.957
Secondary

Change From Baseline in HCV RNA at Week 6

Time frame: Baseline; Week 6

Population: Participants in the Full Analysis Set with available data were analyzed.

ArmMeasureValue (MEAN)Dispersion
SOF+RBV 12 Wk GT 2 TNChange From Baseline in HCV RNA at Week 6-5.13 log10 IU/mLStandard Deviation 0.593
SOF+RBV 12 Wk GT 3 TNChange From Baseline in HCV RNA at Week 6-4.86 log10 IU/mLStandard Deviation 0.602
SOF+RBV 24 Wk GT 2 TEChange From Baseline in HCV RNA at Week 6-5.16 log10 IU/mLStandard Deviation 0.82
SOF+RBV 24 Wk GT 3 TEChange From Baseline in HCV RNA at Week 6-5.06 log10 IU/mLStandard Deviation 0.467
SOF+RBV 24 Wk GT 1 TNChange From Baseline in HCV RNA at Week 6-5.20 log10 IU/mLStandard Deviation 0.785
Secondary

Change From Baseline in HCV RNA at Week 8

Time frame: Baseline; Week 8

Population: Participants in the Full Analysis Set with available data were analyzed.

ArmMeasureValue (MEAN)Dispersion
SOF+RBV 12 Wk GT 2 TNChange From Baseline in HCV RNA at Week 8-5.13 log10 IU/mLStandard Deviation 0.593
SOF+RBV 12 Wk GT 3 TNChange From Baseline in HCV RNA at Week 8-4.83 log10 IU/mLStandard Deviation 0.589
SOF+RBV 24 Wk GT 2 TEChange From Baseline in HCV RNA at Week 8-5.16 log10 IU/mLStandard Deviation 0.82
SOF+RBV 24 Wk GT 3 TEChange From Baseline in HCV RNA at Week 8-5.06 log10 IU/mLStandard Deviation 0.467
SOF+RBV 24 Wk GT 1 TNChange From Baseline in HCV RNA at Week 8-5.20 log10 IU/mLStandard Deviation 0.785
Secondary

Percentage of Participants Experiencing On-treatment Virologic Failure

On-treatment virologic failure was defined as: 1. Viral breakthrough: HCV RNA ≥ LLOQ after having previously had HCV RNA \< LLOQ while on treatment, confirmed with 2 consecutive values (second confirmation value may have been posttreatment) or with a last available on-treatment measurement and no subsequent follow-up values, or 2. Viral rebound: \> 1 log10 IU/mL increase in HCV RNA from nadir while on treatment, confirmed with 2 consecutive values (second confirmation value may have been posttreatment) or with a last available on-treatment measurement and no subsequent follow-up values, or 3. Nonresponse: HCV RNA persistently ≥ LLOQ through 8 weeks of treatment

Time frame: Up to 24 weeks

Population: Full Analysis Set

ArmMeasureValue (NUMBER)
SOF+RBV 12 Wk GT 2 TNPercentage of Participants Experiencing On-treatment Virologic Failure3.8 percentage of participants
SOF+RBV 12 Wk GT 3 TNPercentage of Participants Experiencing On-treatment Virologic Failure0 percentage of participants
SOF+RBV 24 Wk GT 2 TEPercentage of Participants Experiencing On-treatment Virologic Failure0 percentage of participants
SOF+RBV 24 Wk GT 3 TEPercentage of Participants Experiencing On-treatment Virologic Failure0 percentage of participants
SOF+RBV 24 Wk GT 1 TNPercentage of Participants Experiencing On-treatment Virologic Failure0.9 percentage of participants
Secondary

Percentage of Participants Experiencing Viral Relapse

Viral relapse was defined as having achieved undetectable HCV RNA levels (HCV RNA \< LLOQ) at end of treatment, but did not achieve an SVR.

Time frame: Up to Posttreatment Week 24

Population: Participants in the Full Analysis Set with available data were analyzed.

ArmMeasureValue (NUMBER)
SOF+RBV 12 Wk GT 2 TNPercentage of Participants Experiencing Viral Relapse0 percentage of participants
SOF+RBV 12 Wk GT 3 TNPercentage of Participants Experiencing Viral Relapse28.6 percentage of participants
SOF+RBV 24 Wk GT 2 TEPercentage of Participants Experiencing Viral Relapse4.2 percentage of participants
SOF+RBV 24 Wk GT 3 TEPercentage of Participants Experiencing Viral Relapse5.9 percentage of participants
SOF+RBV 24 Wk GT 1 TNPercentage of Participants Experiencing Viral Relapse22.1 percentage of participants
Secondary

Percentage of Participants With Sustained Virologic Response at 4 and 24 Weeks After Discontinuation of Therapy (SVR4 and SVR24)

SVR4 and SVR24 were defined as HCV RNA \< LLOQ at 4 and 24 weeks following the last dose of study drug, respectively.

Time frame: Posttreatment Weeks 4 and 24

Population: Full Analysis Set

ArmMeasureGroupValue (NUMBER)
SOF+RBV 12 Wk GT 2 TNPercentage of Participants With Sustained Virologic Response at 4 and 24 Weeks After Discontinuation of Therapy (SVR4 and SVR24)SVR2488.5 percentage of participants
SOF+RBV 12 Wk GT 2 TNPercentage of Participants With Sustained Virologic Response at 4 and 24 Weeks After Discontinuation of Therapy (SVR4 and SVR24)SVR488.5 percentage of participants
SOF+RBV 12 Wk GT 3 TNPercentage of Participants With Sustained Virologic Response at 4 and 24 Weeks After Discontinuation of Therapy (SVR4 and SVR24)SVR2466.7 percentage of participants
SOF+RBV 12 Wk GT 3 TNPercentage of Participants With Sustained Virologic Response at 4 and 24 Weeks After Discontinuation of Therapy (SVR4 and SVR24)SVR471.4 percentage of participants
SOF+RBV 24 Wk GT 2 TEPercentage of Participants With Sustained Virologic Response at 4 and 24 Weeks After Discontinuation of Therapy (SVR4 and SVR24)SVR495.8 percentage of participants
SOF+RBV 24 Wk GT 2 TEPercentage of Participants With Sustained Virologic Response at 4 and 24 Weeks After Discontinuation of Therapy (SVR4 and SVR24)SVR2491.7 percentage of participants
SOF+RBV 24 Wk GT 3 TEPercentage of Participants With Sustained Virologic Response at 4 and 24 Weeks After Discontinuation of Therapy (SVR4 and SVR24)SVR494.1 percentage of participants
SOF+RBV 24 Wk GT 3 TEPercentage of Participants With Sustained Virologic Response at 4 and 24 Weeks After Discontinuation of Therapy (SVR4 and SVR24)SVR2488.2 percentage of participants
SOF+RBV 24 Wk GT 1 TNPercentage of Participants With Sustained Virologic Response at 4 and 24 Weeks After Discontinuation of Therapy (SVR4 and SVR24)SVR2475.4 percentage of participants
SOF+RBV 24 Wk GT 1 TNPercentage of Participants With Sustained Virologic Response at 4 and 24 Weeks After Discontinuation of Therapy (SVR4 and SVR24)SVR480.7 percentage of participants

Source: ClinicalTrials.gov · Data processed: Mar 14, 2026