Abdominal Obesity Metabolic SyndromeMETAFIBNCT02353767
Evaluation of Liver Fibrosis in HIV-infected Patients With Metabolic Syndrome
An observational study of Abdominal Obesity Metabolic Syndrome and HIV, run by Institut de Médecine et d'Epidémiologie Appliquée - Fondation Internationale Léon M'Ba.
Trial summary
This study aims to estimate the prevalence of bridging liver fibrosis and cirrhosis (METAVIR score ≥ F2) according to METAVIR score in HIV infected patients not chronically infected by viral hepatitis but exhibiting a metabolic syndrome according to the IDF definition (International Diabetes Foundation). Read more about this study
- Who is it for?
- Ages 18 to 90 years
- Conditions the study is for
- Abdominal Obesity Metabolic Syndrome, HIV, Liver Fibrosis
- What is being tested?
- Noninvasive evaluation of liver fibrosis and steatosis
- Type of treatment
- Surgery or procedure
- How many people
- 478 participants
- Where
- No sites listed yet
- Study dates
- Jan 2011to Feb 2013
- Phase
- Observational
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 90 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Study population: Eligible patients followed in the Infectious Diseases department of Saint-Antoine hospital.
Who may be able to join
- For all patients:
- >18 years of age
- HIV-1 infection for a minimum of 5 years confirmed by Western Blot or ELISA
- Signed and full comprehension of informed consent
- Affiliation to Sécurité Sociale
- Specific to Cases :
Show all 11Show fewer
- Presence of metabolic syndrome according to the International Diabetes Foundation (IDF)
- Matched Criteria specific to controls :
- Same age ± 7 years
- Same duration of HIV-1 infection ± 3 years
- Same criterion of HIV-1 viral load (according to 3 thresholds: 50 - 500, 501 - 1000 or > 1000 c/mL)
Who cannot join
- Chronic hepatitis B (HBs-Ag positive or isolated positive antiHBc-Ab with positive HBV-DNA)
- Chronic hepatitis C (positive antiHCV-Ab)
- Active IV or oral drug use and/or ongoing substitution therapy
- Other known chronic hepatitis : auto-immune hepatitis, primary or secondary biliary cirrhosis, hemochromatosis, Wilson disease, alpha 1 anti-trypsin deficit, primary or secondary sclerosing cholangitis, biliary obstruction, liver vascular disease associated with HIV infection, biliary or liver cancer
- CD4 < 50/mm3
- Any current opportunistic infection
- Serious condition influencing vital status
- Pregnancy
About this study
This study aims to estimate the prevalence of bridging liver fibrosis and cirrhosis (METAVIR score ≥ F2) according to METAVIR score in HIV infected patients not chronically infected by viral hepatitis but exhibiting a metabolic syndrome according to the IDF definition (International Diabetes Foundation).
Read the detailed description
HIV-associated morbidity and mortality has been considerably modified ever since the availability of potent antiretroviral treatment in 1996. Recent studies have shown the impact of treatment, with the decreased frequency of AIDS-related diseases coinciding with the preponderance of non-AIDS related pathologies.
Consequently, diseases of hepatic origin have become a key problem in the therapeutic course of HIV-infected patients, representing a major source of significant morbidity and mortality. Liver-related diseases comprise of various etiologies, including co-infection with chronic viral hepatitis and excessive alcohol consumption. When excluding these particular diseases, fibrotic patients exhibit an elevated prevalence of metabolic syndrome, regardless of lipodystrophy. Directly linked to metabolic syndrome, non-alcoholic hepatic steatosis has the capacity to induce necro-inflammatory lesions with an increased risk of evolving into cirrhosis and its complications thereto (i.e. hepatocellular carcinoma, liver decompensation, and end-stage liver disease). In the context of HIV, very little data is available concerning the link between metabolic syndrome and hepatic fibrosis, despite the increasing risk of developing such disease during extended life-span, the long-term disruption of glycolipid metabolism induced by antiretroviral treatment, and the presence of various social risk-factors (i.e. increasing trends in weight gain and decreased physical activity).
The principal objective of the present study is to then characterize the prevalence and determinants associated with hepatic fibrosis among HIV-infected patients, without co-infection with other hepatitis viruses, and who present symptoms of metabolic syndrome according to the AHA 2009 definition. In order to more appropriately answer this research question, we will conduct a nested, matched case-control study including 300 HIV-infected patients per group. We will also aim to identify risk-factors of liver fibrosis other than metabolic syndrome, to study agreement in 4 non-invasive scores of liver fibrosis and 3 non-invasive score of steatosis, and to evaluate the performance of the Controlled Attenuation Parameter (CAP) method for use in diagnosing hepatic steatosis.
All patients in this study will be recruited in a clinical center situated in the infectious disease unit at Saint-Antoine Hospital, where 3400 HIV-infected patients have regular consultations. Patients will be identified from an in-house informatics platform, serving as a surveillance tool for metabolic syndrome, among other diseases, with the intention of increasing better-adapted clinical and therapeutic care. Each patient presenting with metabolic syndrome will be matched with a control patient on the following characteristics: age (±5 years), duration of HIV-infection (±2 years), HIV-RNA viral load (in categories of <50-500, 501-1000, or >1000 copies/mL), and gender. Patients with abnormal transaminases will be excluded from this study.
This study will bring about a clearer understanding of the frequency and importance of liver fibrosis risk in patients with metabolic syndrome, which will allow us to determine the more important elements of surveillance necessary in the prevention and development of hepatic lesions. Accordingly, this study will add more pertinent information regarding treatment guidelines specific to this patient population.
- Conditions
- Abdominal Obesity Metabolic Syndrome, HIV, Liver Fibrosis
- Being tested
- Noninvasive evaluation of liver fibrosis and steatosis
- Medical subject headings
- Abdominal obesity metabolic syndrome, Liver Cirrhosis
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Noninvasive evaluation of liver fibrosis and steatosisProcedure or surgery
Transient elastography (using the Fibroscan, CAP Fibroscan) and biomarker panels (FibroTest, Fibromètre, Hepascore, Steatotest, Nashtest)
| Study group | Role | What they receive |
|---|---|---|
| Cases | Presence of metabolic syndrome according to the International Diabetes Foundation (IDF) Receives: Procedure: Noninvasive evaluation of liver fibrosis and steatosis | |
| Controls | * age ± 7 years from cases
* duration of HIV-1 infection ± 3 years from cases
* HIV-1 viral load matched to cases according to 3 thresholds: 50 - 500, 501 - 1000 or > 1000 copies/mL Receives: Procedure: Noninvasive evaluation of liver fibrosis and steatosis |
What is being measured
The primary outcome is the main question the study is designed to answer.
Liver fibrosis
Liver fibrosis as measured by Fibroscanner
Measured: One time
Secondary outcomes (2)
Liver steatosis
Sub group of patients who had IRM measurements
Measured: One time
Hand osteoarthritis
Sub group of patients who had an X-Ray of their hands
Measured: One time
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted3 Feb 2015 (estimated)
- Study startJan 2011
- Primary completionFeb 2013
- Study completionFeb 2013
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (4)Papers the sponsor has linked to this study.
- Other trials for Abdominal Obesity Metabolic SyndromeStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Case-control
- Time perspective
- Cross-sectional
- Enrolment
- 478 participants (actual)
Sponsor and investigators
- Lead sponsor
- Institut de Médecine et d'Epidémiologie Appliquée - Fondation Internationale Léon M'Ba
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02353767
- Sponsor's protocol ID
- IMEA 42
- Acronym
- METAFIB
- Status last verified
- Jan 2015
- First submitted
- 29 Jan 2015
- Last updated
- 3 Feb 2015
- Results posted
- No
- Data monitoring committee
- No
Publications
Lewden C, May T, Rosenthal E, Burty C, Bonnet F, Costagliola D, Jougla E, Semaille C, Morlat P, Salmon D, Cacoub P, Chene G; ANRS EN19 Mortalite Study Group and Mortavic1. Changes in causes of death among adults infected by HIV between 2000 and 2005: The "Mortalite 2000 and 2005" surveys (ANRS EN19 and Mortavic). J Acquir Immune Defic Syndr. 2008 Aug 15;48(5):590-8. doi: 10.1097/QAI.0b013e31817efb54.
PubMed 18645512Worm SW, Friis-Moller N, Bruyand M, D'Arminio Monforte A, Rickenbach M, Reiss P, El-Sadr W, Phillips A, Lundgren J, Sabin C; D:A:D study group. High prevalence of the metabolic syndrome in HIV-infected patients: impact of different definitions of the metabolic syndrome. AIDS. 2010 Jan 28;24(3):427-35. doi: 10.1097/QAD.0b013e328334344e.
PubMed 19910787Fonquernie F, Lacombe K, Vincensini JP, Boccara F, Clozel S, Ayouch Boda A, Bollens D, Campa P, Pacanowski J, Meynard JL, Meyohas MC, Girard PM. How to improve the quality of a disease management program for HIV-infected patients using a computerized data system. The Saint-Antoine Orchestra program. AIDS Care. 2010 May;22(5):588-96. doi: 10.1080/09540120903280893.
PubMed 20401768Tomi AL, Sellam J, Lacombe K, Fellahi S, Sebire M, Rey-Jouvin C, Miquel A, Bastard JP, Maheu E, Haugen IK, Felson DT, Capeau J, Girard PM, Berenbaum F, Meynard JL. Increased prevalence and severity of radiographic hand osteoarthritis in patients with HIV-1 infection associated with metabolic syndrome: data from the cross-sectional METAFIB-OA study. Ann Rheum Dis. 2016 Dec;75(12):2101-2107. doi: 10.1136/annrheumdis-2016-209262. Epub 2016 Mar 31.
PubMed 27034453
Study at a glance
From the registry record, last updated by the sponsor on 3 Feb 2015. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Evaluation of Liver Fibrosis in HIV-infected Patients With Metabolic Syndrome
- ClinicalTrials.gov ID
- NCT02353767
- Acronym / sponsor ID
- METAFIB / IMEA 42
- Conditions
- Abdominal Obesity Metabolic Syndrome, HIV, Liver Fibrosis
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 478 participants (actual)
- Lead sponsor
- Institut de Médecine et d'Epidémiologie Appliquée - Fondation Internationale Léon M'BaUniversity, hospital or other
- Study start
- Jan 2011
- Primary completion
- Feb 2013 (actual)
- Study completion
- Feb 2013 (actual)
- First posted
- 3 Feb 2015 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study aims to estimate the prevalence of bridging liver fibrosis and cirrhosis (METAVIR score ≥ F2) according to METAVIR score in HIV infected patients not chronically infected by viral hepatitis but exhibiting a metabolic syndrome according to the IDF definition (International Diabetes Foundation).
Detailed description
HIV-associated morbidity and mortality has been considerably modified ever since the availability of potent antiretroviral treatment in 1996. Recent studies have shown the impact of treatment, with the decreased frequency of AIDS-related diseases coinciding with the preponderance of non-AIDS related pathologies.
Consequently, diseases of hepatic origin have become a key problem in the therapeutic course of HIV-infected patients, representing a major source of significant morbidity and mortality. Liver-related diseases comprise of various etiologies, including co-infection with chronic viral hepatitis and excessive alcohol consumption. When excluding these particular diseases, fibrotic patients exhibit an elevated prevalence of metabolic syndrome, regardless of lipodystrophy. Directly linked to metabolic syndrome, non-alcoholic hepatic steatosis has the capacity to induce necro-inflammatory lesions with an increased risk of evolving into cirrhosis and its complications thereto (i.e. hepatocellular carcinoma, liver decompensation, and end-stage liver disease). In the context of HIV, very little data is available concerning the link between metabolic syndrome and hepatic fibrosis, despite the increasing risk of developing such disease during extended life-span, the long-term disruption of glycolipid metabolism induced by antiretroviral treatment, and the presence of various social risk-factors (i.e. increasing trends in weight gain and decreased physical activity).
The principal objective of the present study is to then characterize the prevalence and determinants associated with hepatic fibrosis among HIV-infected patients, without co-infection with other hepatitis viruses, and who present symptoms of metabolic syndrome according to the AHA 2009 definition. In order to more appropriately answer this research question, we will conduct a nested, matched case-control study including 300 HIV-infected patients per group. We will also aim to identify risk-factors of liver fibrosis other than metabolic syndrome, to study agreement in 4 non-invasive scores of liver fibrosis and 3 non-invasive score of steatosis, and to evaluate the performance of the Controlled Attenuation Parameter (CAP) method for use in diagnosing hepatic steatosis.
All patients in this study will be recruited in a clinical center situated in the infectious disease unit at Saint-Antoine Hospital, where 3400 HIV-infected patients have regular consultations. Patients will be identified from an in-house informatics platform, serving as a surveillance tool for metabolic syndrome, among other diseases, with the intention of increasing better-adapted clinical and therapeutic care. Each patient presenting with metabolic syndrome will be matched with a control patient on the following characteristics: age (±5 years), duration of HIV-infection (±2 years), HIV-RNA viral load (in categories of <50-500, 501-1000, or >1000 copies/mL), and gender. Patients with abnormal transaminases will be excluded from this study.
This study will bring about a clearer understanding of the frequency and importance of liver fibrosis risk in patients with metabolic syndrome, which will allow us to determine the more important elements of surveillance necessary in the prevention and development of hepatic lesions. Accordingly, this study will add more pertinent information regarding treatment guidelines specific to this patient population.
Study design
- Observational model
- Case-control
- Time perspective
- Cross-sectional
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Cases | – | Procedure: Noninvasive evaluation of liver fibrosis and steatosisPresence of metabolic syndrome according to the International Diabetes Foundation (IDF) |
| Controls | – | Procedure: Noninvasive evaluation of liver fibrosis and steatosis* age ± 7 years from cases * duration of HIV-1 infection ± 3 years from cases * HIV-1 viral load matched to cases according to 3 thresholds: 50 - 500, 501 - 1000 or > 1000 copies/mL |
Who may qualify
- Ages
- 18 to 90 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- Eligible patients followed in the Infectious Diseases department of Saint-Antoine hospital.
Key inclusion criteria (11 listed)
- For all patients:
- >18 years of age
- HIV-1 infection for a minimum of 5 years confirmed by Western Blot or ELISA
- Signed and full comprehension of informed consent
- Affiliation to Sécurité Sociale
Key exclusion criteria (8 listed)
- Chronic hepatitis B (HBs-Ag positive or isolated positive antiHBc-Ab with positive HBV-DNA)
- Chronic hepatitis C (positive antiHCV-Ab)
- Active IV or oral drug use and/or ongoing substitution therapy
- Other known chronic hepatitis : auto-immune hepatitis, primary or secondary biliary cirrhosis, hemochromatosis, Wilson disease, alpha 1 anti-trypsin deficit, primary or secondary sclerosing cholangitis, biliary obstruction, liver vascular disease associated with HIV infection, biliary or liver cancer
- CD4 < 50/mm3
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Noninvasive evaluation of liver fibrosis and steatosisTransient elastography (using the Fibroscan, CAP Fibroscan) and biomarker panels (FibroTest, Fibromètre, Hepascore, Steatotest, Nashtest) | Procedure or surgery | Cases, Controls |
Primary outcome
Liver fibrosis
Time frame: One time
Liver fibrosis as measured by Fibroscanner
2 secondary outcomes
Liver steatosis
Time frame: One time
Hand osteoarthritis
Time frame: One time
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 3 Feb 2015.
- Background: PubMed 18645512Lewden C, May T, Rosenthal E, Burty C, Bonnet F, Costagliola D, Jougla E, Semaille C, Morlat P, Salmon D, Cacoub P, Chene G; ANRS EN19 Mortalite Study Group and Mortavic1. Changes in causes of death among adults infected by HIV between 2000 and 2005: The "Mortalite 2000 and 2005" surveys (ANRS EN19 and Mortavic). J Acquir Immune Defic Syndr. 2008 Aug 15;48(5):590-8. doi: 10.1097/QAI.0b013e31817efb54.
- Background: PubMed 19910787Worm SW, Friis-Moller N, Bruyand M, D'Arminio Monforte A, Rickenbach M, Reiss P, El-Sadr W, Phillips A, Lundgren J, Sabin C; D:A:D study group. High prevalence of the metabolic syndrome in HIV-infected patients: impact of different definitions of the metabolic syndrome. AIDS. 2010 Jan 28;24(3):427-35. doi: 10.1097/QAD.0b013e328334344e.
- Background: PubMed 20401768Fonquernie F, Lacombe K, Vincensini JP, Boccara F, Clozel S, Ayouch Boda A, Bollens D, Campa P, Pacanowski J, Meynard JL, Meyohas MC, Girard PM. How to improve the quality of a disease management program for HIV-infected patients using a computerized data system. The Saint-Antoine Orchestra program. AIDS Care. 2010 May;22(5):588-96. doi: 10.1080/09540120903280893.
- Derived from this study: PubMed 27034453Tomi AL, Sellam J, Lacombe K, Fellahi S, Sebire M, Rey-Jouvin C, Miquel A, Bastard JP, Maheu E, Haugen IK, Felson DT, Capeau J, Girard PM, Berenbaum F, Meynard JL. Increased prevalence and severity of radiographic hand osteoarthritis in patients with HIV-1 infection associated with metabolic syndrome: data from the cross-sectional METAFIB-OA study. Ann Rheum Dis. 2016 Dec;75(12):2101-2107. doi: 10.1136/annrheumdis-2016-209262. Epub 2016 Mar 31.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
Questions about this trial
What is this clinical trial studying?
An observational study of Abdominal Obesity Metabolic Syndrome and HIV, run by Institut de Médecine et d'Epidémiologie Appliquée - Fondation Internationale Léon M'Ba.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 11 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 3 Feb 2015. Status can change between updates, so confirm with the study contact before making plans.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Liver fibrosis (time frame: One time). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT02353767, which also lists 4 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 3 Feb 2015.