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A Phase I/II Double-Blind Controlled Trial to Determine the Safety and Immunogenicity of HIV-1 MN rgp160 Immuno AG Vaccine Therapy in HIV-Infected Individuals With Greater Than or Equal to 500/mm3 CD4+ T Cells and 200-400/mm3 CD4+ T Cells

Primary Purpose

HIV Infections

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Ritonavir
gp160 Vaccine (Immuno-AG)
Stavudine
Didanosine
Sponsored by
National Institute of Allergy and Infectious Diseases (NIAID)
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for HIV Infections focused on measuring Vaccines, Synthetic, Didanosine, Drug Therapy, Combination, HIV Envelope Protein gp160, Acquired Immunodeficiency Syndrome, AIDS-Related Complex, Stavudine, HIV Protease Inhibitors, AIDS Vaccines, Ritonavir, Reverse Transcriptase Inhibitors, HIV Therapeutic Vaccine

Eligibility Criteria

13 Years - undefined (Child, Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria Concurrent Medication: Allowed: ddI [AS PER AMENDMENT 11/12/96: and d4T]. (Note: Patients in the stratum receiving only vaccine or control may take ddI [AS PER AMENDMENT 11/12/96: and d4T] ONLY IF their CD4 counts have shown a sustained decrease on two consecutive occasions 10-14 days apart.) PCP prophylaxis. Treatment for acute conditions, as indicated. AS PER AMENDMENT 11/12/96: Co-enrollment on other research trials. Patients must have: HIV positivity. Asymptomatic disease. CD4 count >= 50 cells/mm3 (CD4 count must be 50-499 cells/mm3 in patients receiving ddI plus vaccine or control, and must be >= 500 cells/mm3 in patients receiving vaccine or control only) [AS PER AMENDMENT 11/12/96: CD4 count >= 500 cells/mm3 for stratum 1 patients and 200-400 for stratum 2 patients]. HLA A2 positive documentation. An Epstein Barr virus B cell line established within 90 days prior to study entry. Consent of parent or guardian if less than 18 years of age. NOTE: Study is NOT approved for prisoner participation. Exclusion Criteria Co-existing Condition: Patients with the following symptoms or conditions are excluded: Medical contraindication to study participation or inability to comply with study requirements. Grade 2 or worse peripheral neuropathy (applicable only to patients receiving ddI plus vaccine or control). Concurrent Medication: Excluded: Immunomodulating agents, such as inosiplex, ditiocarb sodium, lithium, interferons, interleukin-2, and systemic steroids. Any antiretroviral therapy that may increase the risk of peripheral neuropathy (e.g., stavudine, zalcitabine [AS PER AMENDMENT 11/12/96: e.g., zalcitabine or lamivudine]). Agents such as IV pentamidine that may increase the risk of pancreatitis. Standard of care vaccines (in patients receiving vaccine) [AS PER AMENDMENT 11/12/96: Standard of care immunizations are permitted 60 days before Schedule 1 vaccine therapy and during Schedule 2 vaccine therapy (but not within 2 weeks of study immunization)]. AS PER AMENDMENT 11/12/96: Rifabutin, disulfiram (antabuse), or other medication with similar effects, including metronidazole. 6.AS PER AMENDMENT 11/12/96: The following are prohibited in patients receiving ritonavir: amiodarone, astemizole, bepridil, bupropion, cisapride, clozapine, encainide, flecainide, meperidine, piroxicam, propafenone, propoxyphene, quinidine, rifabutin, terfenadine, alprazolam, clorazepate, diazepam, estazolam, flurazepam, midazolam, triazolam, and zolpidem. Patients with the following prior conditions are excluded: History of grade 2 or worse liver abnormality. Known allergy to vaccine components. Chronic diarrhea persisting for 4 or more weeks within 30 days prior to study entry. History of pancreatitis (applicable only to patients receiving ddI plus vaccine or control). [AS PER AMENDMENT 11/12/96: History of chronic pancreatitis or history of acute pancreatitis within 2 years prior to entry (stratum 2 patients only).] Prior Medication: Excluded: Any prior anti-HIV vaccines. Excluded within 90 days prior to study entry: Immunomodulating agents, such as Inosiplex, ditiocarb sodium, lithium, interferons, interleukin-2, and systemic steroids. Any antiretroviral therapy that may increase the risk of peripheral neuropathy (e.g., stavudine, zalcitabine [AS PER AMENDMENT 11/12/96: e.g., zalcitabine or lamivudine]). Agents such as IV pentamidine that may increase the risk of pancreatitis. Any treatment for an AIDS-defining illness (applicable ONLY to patients in the stratum receiving ddI plus vaccine or control). Excluded within 6 months prior to study entry: Any other antiretrovirals or immunomodulators besides those mentioned above. Allergy desensitization or other vaccines [AS PER AMENDMENT 11/12/96: excluded within 60 days prior to entry].

Sites / Locations

  • Stanford CRS

Outcomes

Primary Outcome Measures

Secondary Outcome Measures

Full Information

First Posted
November 2, 1999
Last Updated
October 27, 2021
Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)
Collaborators
Bristol-Myers Squibb, Immuno-US
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1. Study Identification

Unique Protocol Identification Number
NCT00000822
Brief Title
A Phase I/II Double-Blind Controlled Trial to Determine the Safety and Immunogenicity of HIV-1 MN rgp160 Immuno AG Vaccine Therapy in HIV-Infected Individuals With Greater Than or Equal to 500/mm3 CD4+ T Cells and 200-400/mm3 CD4+ T Cells
Official Title
A Phase I/II Double-Blind Controlled Trial to Determine the Safety and Immunogenicity of HIV-1 MN rgp160 Immuno AG Vaccine Therapy in HIV-Infected Individuals With Greater Than or Equal to 500/mm3 CD4+ T Cells and 200-400/mm3 CD4+ T Cells
Study Type
Interventional

2. Study Status

Record Verification Date
October 2021
Overall Recruitment Status
Completed
Study Start Date
undefined (undefined)
Primary Completion Date
undefined (undefined)
Study Completion Date
May 1999 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)
Collaborators
Bristol-Myers Squibb, Immuno-US

4. Oversight

5. Study Description

Brief Summary
To evaluate the safety and immunogenicity of HIV-1 MN rgp160 (Immuno-AG) in HIV-infected patients. To evaluate the immunogenicity of HIV-1 MN rgp160 immunogen by lymphocyte proliferation, specific antibody responses, and DTH reaction. To describe the durability of the immunogen in patients who respond to the first 7 injections when they are boosted every 8 weeks for an additional 6-12 months [AS PER AMENDMENT 11/12/96: stratum 1 patients only]. To describe the ability of the immunogen to induce a response after an additional 6-12 months of injections among patients who did not respond to the first 7 injections [AS PER AMENDMENT 11/12/96: stratum 1 patients only]. HIV-specific cellular immune responses appear to play an important role in HIV disease progression since both T helper and cytotoxic function against HIV decrease with disease progression.
Detailed Description
HIV-specific cellular immune responses appear to play an important role in HIV disease progression since both T helper and cytotoxic function against HIV decrease with disease progression. Patients with CD4 counts greater than or equal to 500 cells/mm3 are randomized to receive HIV-1 MN rgp160 (Immuno-AG) or control. Patients with CD4 counts 50-499 cells/mm3 receive didanosine (ddI) and are then randomized to receive ddI plus vaccine or control. Vaccine or control is given every 4 weeks for 7 injections, then every 8 weeks for 6-12 months or until 1 year after the last patient is randomized. AS PER AMENDMENT 11/12/96: Stratum 1 is composed of 16 subjects with CD4+ T cells greater than or equal to 500 mm3. These subjects are randomized to vaccine therapy or vaccine control. HIV-1 MN rgp160 vaccine or control is given every 4 weeks for 7 injections (Schedule 1), then every 8 weeks until 52 weeks after the last subject has been randomized to stratum 1 (Schedule 2). Stratum 1 patients receive ddI or d4T only if their CD4 cell count has a sustained decrease on 2 consecutive occasions 10-14 days apart and/or HIV/RNA plasma viral load increases to greater than 10,000 copies/ml on 2 consecutive occasions 10-14 days apart. Stratum 2 is composed of 30 subjects with CD4+ T cells 200-400/mm3; accrual to this stratum was activated based on preliminary results from stratum 1 (closed as of 4/5/97). Patients on stratum 2 (open as of 3/4/97) initially receive ritonavir at escalating doses for 2 weeks. Subjects then have ddI and d4T added to the regimen for 7 weeks. Subjects are then randomized to vaccine therapy or vaccine control every 4 weeks for 7 injections, with ritonavir/ddI/d4T continued during vaccine therapy. AS PER AMENDMENT 3/23/98: As of 6/1/98 vaccine consists of sodium chloride for injection (USP).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HIV Infections
Keywords
Vaccines, Synthetic, Didanosine, Drug Therapy, Combination, HIV Envelope Protein gp160, Acquired Immunodeficiency Syndrome, AIDS-Related Complex, Stavudine, HIV Protease Inhibitors, AIDS Vaccines, Ritonavir, Reverse Transcriptase Inhibitors, HIV Therapeutic Vaccine

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Masking
Double
Enrollment
46 (false)

8. Arms, Groups, and Interventions

Intervention Type
Drug
Intervention Name(s)
Ritonavir
Intervention Type
Biological
Intervention Name(s)
gp160 Vaccine (Immuno-AG)
Intervention Type
Drug
Intervention Name(s)
Stavudine
Intervention Type
Drug
Intervention Name(s)
Didanosine

10. Eligibility

Sex
All
Minimum Age & Unit of Time
13 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria Concurrent Medication: Allowed: ddI [AS PER AMENDMENT 11/12/96: and d4T]. (Note: Patients in the stratum receiving only vaccine or control may take ddI [AS PER AMENDMENT 11/12/96: and d4T] ONLY IF their CD4 counts have shown a sustained decrease on two consecutive occasions 10-14 days apart.) PCP prophylaxis. Treatment for acute conditions, as indicated. AS PER AMENDMENT 11/12/96: Co-enrollment on other research trials. Patients must have: HIV positivity. Asymptomatic disease. CD4 count >= 50 cells/mm3 (CD4 count must be 50-499 cells/mm3 in patients receiving ddI plus vaccine or control, and must be >= 500 cells/mm3 in patients receiving vaccine or control only) [AS PER AMENDMENT 11/12/96: CD4 count >= 500 cells/mm3 for stratum 1 patients and 200-400 for stratum 2 patients]. HLA A2 positive documentation. An Epstein Barr virus B cell line established within 90 days prior to study entry. Consent of parent or guardian if less than 18 years of age. NOTE: Study is NOT approved for prisoner participation. Exclusion Criteria Co-existing Condition: Patients with the following symptoms or conditions are excluded: Medical contraindication to study participation or inability to comply with study requirements. Grade 2 or worse peripheral neuropathy (applicable only to patients receiving ddI plus vaccine or control). Concurrent Medication: Excluded: Immunomodulating agents, such as inosiplex, ditiocarb sodium, lithium, interferons, interleukin-2, and systemic steroids. Any antiretroviral therapy that may increase the risk of peripheral neuropathy (e.g., stavudine, zalcitabine [AS PER AMENDMENT 11/12/96: e.g., zalcitabine or lamivudine]). Agents such as IV pentamidine that may increase the risk of pancreatitis. Standard of care vaccines (in patients receiving vaccine) [AS PER AMENDMENT 11/12/96: Standard of care immunizations are permitted 60 days before Schedule 1 vaccine therapy and during Schedule 2 vaccine therapy (but not within 2 weeks of study immunization)]. AS PER AMENDMENT 11/12/96: Rifabutin, disulfiram (antabuse), or other medication with similar effects, including metronidazole. 6.AS PER AMENDMENT 11/12/96: The following are prohibited in patients receiving ritonavir: amiodarone, astemizole, bepridil, bupropion, cisapride, clozapine, encainide, flecainide, meperidine, piroxicam, propafenone, propoxyphene, quinidine, rifabutin, terfenadine, alprazolam, clorazepate, diazepam, estazolam, flurazepam, midazolam, triazolam, and zolpidem. Patients with the following prior conditions are excluded: History of grade 2 or worse liver abnormality. Known allergy to vaccine components. Chronic diarrhea persisting for 4 or more weeks within 30 days prior to study entry. History of pancreatitis (applicable only to patients receiving ddI plus vaccine or control). [AS PER AMENDMENT 11/12/96: History of chronic pancreatitis or history of acute pancreatitis within 2 years prior to entry (stratum 2 patients only).] Prior Medication: Excluded: Any prior anti-HIV vaccines. Excluded within 90 days prior to study entry: Immunomodulating agents, such as Inosiplex, ditiocarb sodium, lithium, interferons, interleukin-2, and systemic steroids. Any antiretroviral therapy that may increase the risk of peripheral neuropathy (e.g., stavudine, zalcitabine [AS PER AMENDMENT 11/12/96: e.g., zalcitabine or lamivudine]). Agents such as IV pentamidine that may increase the risk of pancreatitis. Any treatment for an AIDS-defining illness (applicable ONLY to patients in the stratum receiving ddI plus vaccine or control). Excluded within 6 months prior to study entry: Any other antiretrovirals or immunomodulators besides those mentioned above. Allergy desensitization or other vaccines [AS PER AMENDMENT 11/12/96: excluded within 60 days prior to entry].
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Kundu Smriti
Official's Role
Study Chair
First Name & Middle Initial & Last Name & Degree
Merigan T
Official's Role
Study Chair
Facility Information:
Facility Name
Stanford CRS
City
Stanford
State/Province
California
ZIP/Postal Code
943055107
Country
United States

12. IPD Sharing Statement

Citations:
Citation
Katzenstein D, Valentine F, Kundu S, Haslett P, Smith G, Merigan T. Delayed-type-hypersensitivity reactions to intradermal gp160 in HIV infected individuals immunized with gp160. Int Conf AIDS. 1992 Jul 19-24;8(2):A35 (abstract no PoA 2192)
Results Reference
background
PubMed Identifier
11679149
Citation
Kundu-Raychaudhuri S, Sevin A, Kilgo P, Nokta M, Pollard RB, Merigan TC. Effect of therapeutic immunization with HIV type 1 recombinant glycoprotein 160 ImmunoAG vaccine in HIV-infected individuals with CD4+ T cell counts of >or=500 and 200-400/mm3 (AIDS Clinical Trials Group Study 246/946). AIDS Res Hum Retroviruses. 2001 Oct 10;17(15):1371-8. doi: 10.1089/088922201753197033.
Results Reference
background

Learn more about this trial

A Phase I/II Double-Blind Controlled Trial to Determine the Safety and Immunogenicity of HIV-1 MN rgp160 Immuno AG Vaccine Therapy in HIV-Infected Individuals With Greater Than or Equal to 500/mm3 CD4+ T Cells and 200-400/mm3 CD4+ T Cells

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