Ribavirin to Enhance Hepatitis B Virus Nucleotide Analog Antiviral Activity

Ottawa Hospital Research Institute (Other)
Overall Status
CT.gov ID
Anticipated Duration (Months)
Patients Per Site
Patients Per Site Per Month

Study Details

Study Description

Brief Summary

Hepatitis B virus (HBV) leads to life-threatening disease like liver failure and liver cancer. For most, a cure is unattainable as current HBV antiviral therapy (using nucleoside analogues) are not able to clear the virus from their liver. While HBV treatments are typically administered alone (monotherapy), this study will explore the use of Ribavirin in combination with standard therapy to enhance current treatment regimens. Ribavirin is commonly used to treat Hepatitis C Virus (HCV) but there is evidence that Ribavirin also induces immune effects that are beneficial in HBV treatment. The aim of this study is to determine whether combination of Ribavirin and a nucleoside analog is more effective compared to nucleoside analog treatment alone. Enrolled patients will be followed for treatment response according to standard clinical and virological tests, as well as immune response to HBV. Our ultimate goal is to find a more effective treatment and improve health outcomes for persons living with HBV.

Condition or DiseaseIntervention/TreatmentPhase
Phase 3

Study Design

Study Type:
Anticipated Enrollment :
24 participants
Intervention Model:
Parallel Assignment
Intervention Model Description:
None (Open Label)
Primary Purpose:
Official Title:
Use of Immune Modulatory Properties of Ribavirin to Enhance Hepatitis B Virus Nucleotide Analog Antiviral Activity: Proposal for Pilot Clinical Trial
Actual Study Start Date :
Jan 10, 2019
Anticipated Primary Completion Date :
Jan 31, 2022
Anticipated Study Completion Date :
Sep 30, 2022

Arms and Interventions

Experimental: Group 1

Tenofovir (TDF) 300 mg po once a day (OD)

Drug: Tenofovir
Tenofovir as per standard of care

Active Comparator: Group 2

Tenofovir 300 mg po OD + Ribavirin 400 mg twice a day (BID) if <70kg / 600 mg every (q) in the morning (AM) and 400 mg q in the evening (PM) if ≥70kg

Drug: Ribavirin
Ribavirin will be added to the standard of care treatment (tenofovir) regime for 24 weeks.

Drug: Tenofovir
Tenofovir as per standard of care

Outcome Measures

Primary Outcome Measures

  1. The Decline of Participants Serum HBV DNA values for both study arms at each study. [24 weeks]

    The absolute decline in HBV DNA and quantitative HBsAg titre will be compared with baseline level at each study visit overall and between study arms (with or without RBV).

Secondary Outcome Measures

  1. Fibroscan score [24 weeks]

    Individual fibroscan scores pre and post treatment for each group, using fibrosis scores calculated in kilopascal F0 representing no fibrosis and F4 value indicating cirrhosis.

  2. Liver enzyme values [24 weeks]

    Participants individual reduction in liver enzymes at each visit.

  3. Number of participants with treatment related adverse events as assessed by CTCAE v4.0. [28 weeks]

    Safety profile of TDF plus Ribavirin regime

Eligibility Criteria


Ages Eligible for Study:
18 Years and Older
Sexes Eligible for Study:
Accepts Healthy Volunteers:
Inclusion Criteria:
  1. HBV Hepatitis B surface antigen (HBsAg) positive for a minimum of 24 weeks

  2. HBV DNA level >20,000 IU/mL

  3. ≥ 18 years of age

Exclusion Criteria:
  1. Willingness and ability to sign an informed consent

  2. HBV nucleos(t)ides and/or interferon exposure within 24 weeks of study medication dosing

  3. HIV and other immune compromising condition (e.g. cancer with the exception of non-invasive cutaneous malignancy, autoimmune condition) or therapy (i.e. systemic steroids, chemotherapy)

  4. HCV co-infected

  5. Cirrhosis (defined by biopsy criteria or as >18.4 kilopascal (kPa) by transient elastography)

  6. Creatinine Clearance <60 ml/min

  7. Baseline hemoglobin <130 g/L in males and <120 g/L in females

  8. Unwilling or unable to use contraception (unless confirmed surgical sterilization)

  9. Pregnancy confirmed by blood test

Contacts and Locations


SiteCityStateCountryPostal Code
1Cumming School of Medicine, University of CalgaryCalgaryAlbertaCanadaT2N4Z6
2Ottawa Hospital Research InstituteOttawaOntarioCanadaK1H8L6

Sponsors and Collaborators

  • Ottawa Hospital Research Institute


  • Principal Investigator: Curtis L Cooper, MD, Ottawa Hospital Research Institute

Study Documents (Full-Text)

None provided.

More Information


None provided.
Responsible Party:
Ottawa Hospital Research Institute
ClinicalTrials.gov Identifier:
Other Study ID Numbers:
  • 20180733
First Posted:
Nov 30, 2018
Last Update Posted:
Sep 14, 2021
Last Verified:
Sep 1, 2021
Studies a U.S. FDA-regulated Drug Product:
Studies a U.S. FDA-regulated Device Product:
Additional relevant MeSH terms:

Study Results

No Results Posted as of Sep 14, 2021