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Safety and Effectiveness of Immunotherapy With Autologous HIV-Specific CD8 Cells in HIV Infected Adults

Primary Purpose

HIV Infections

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Adoptive transfer of HIV-specific CD8+ T cells
Aldesleukin
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 Treatment Naive, Treatment Experienced

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria for All Participants: HIV infected CD4 count greater than 200 cells/mm3 at study entry Absolute neutrophil count greater than 1000 cells/mm3 Willing to take Pneumocystis prophylaxis, if indicated Willing to comply with study requirements Willing to forgo other experimental therapy during the 26-week study period Willing to use acceptable forms of contraception Inclusion Criteria for Treatment-Experienced Participants: Currently receiving treatment with an FDA-approved or expanded access antiretroviral agent (or combinations thereof) at a stable dose for at least 24 weeks prior to study entry Inclusion Criteria for Treatment-Naive Participants: Have not received antiretroviral therapy for 6 months prior to study entry Exclusion Criteria: Treatment with other immunomodulatory therapies (interferon, HIV vaccines, intravenous immunoglobulin), pentoxifylline, cancer chemotherapy, radiation therapy, or other investigational agents Past or present infection with mycobacterium avium complex, toxoplasmosis, cryptococcus, or cytomegalovirus (including retinitis) Active opportunistic infection at study entry or serious systemic infection requiring chronic maintenance or suppressive therapy Lymphoma, symptomatic visceral Kaposi's sarcoma, or any malignancy expected to require systemic therapy Serious psychological or emotional disorder that would affect ability to comply with study requirements or that would be exacerbated by protocol participation Alcohol or drug use, abuse, or dependence that, in the opinion of the investigator, would interfere with the study Estimated life expectancy of less than 4 months Abnormal neurocognitive examination Significant abnormality on electrocardiogram or chest radiograph Inability to generate CD8+ HIV-specific cytotoxic T cell clones Previously treated in FHCRC Protocol #827.1 Pregnancy or breastfeeding

Sites / Locations

  • Fred Hutchinson Cancer Research Center
  • University of Washington (UW)

Outcomes

Primary Outcome Measures

To determine the safety of administering CD8+ HIV-specific CTL clones followed by subcutaneous IL-2 (Proleukin, Chiron) daily for up to 21 days
To identify a regimen of IL-2 that will improve the in vivo persistence and function of adoptively transferred CD8+ HIV-specific CTL

Secondary Outcome Measures

To determine whether the administration of IL-2 prolongs the antiviral activity of transferred CD8+ HIV-specific CTL
To determine if IL-2 promotes the accumulation of adoptively transferred CD8+ HIV-specific CTL in lymph nodes

Full Information

First Posted
May 10, 2005
Last Updated
August 7, 2008
Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)
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1. Study Identification

Unique Protocol Identification Number
NCT00110578
Brief Title
Safety and Effectiveness of Immunotherapy With Autologous HIV-Specific CD8 Cells in HIV Infected Adults
Official Title
Safety and Antiviral Efficacy of Cellular Adoptive Immunotherapy With Autologous CD8+ HIV-Specific Cytotoxic T Cells Combined With Interleukin-2 For HIV Seropositive Individuals
Study Type
Interventional

2. Study Status

Record Verification Date
July 2007
Overall Recruitment Status
Completed
Study Start Date
September 1998 (undefined)
Primary Completion Date
undefined (undefined)
Study Completion Date
April 2005 (undefined)

3. Sponsor/Collaborators

Name of the Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)

4. Oversight

5. Study Description

Brief Summary
Effective, suppressive treatment for HIV infected patients can be a major challenge because HIV progressively destroys their immune systems. CD8 cells isolated from a patient's blood and grown in large numbers in the laboratory may increase a patient's immune system response to HIV. The purpose of this study is to determine if CD8 cells will provide effective antiviral activity against HIV when transplanted back in large numbers into HIV infected patients. Study hypothesis: There are specific cells in the immune system that recognize and can kill HIV-infected cells.
Detailed Description
The function of CD8 cells in the human body is to kill infected target cells, such as HIV infected cells. Recent data suggest that intravenous administration of HIV-specific CD8 cells is safe, augments host immunity, and mediates a dramatic reduction in circulating HIV-infected CD4 cells. However, the observed antiviral effects are transient, and HIV infected CD4 cells re-emerge as the number of self CD8 cells declines. Augmenting CD8 cell response to HIV by immunotherapy with CD8 cells may be a useful addition to drug therapy if the infused CD8 cells can survive long-term in vivo. Administration of interleukin-2 (also known as aldesleukin or IL-2), a naturally occurring cytokine, has been proposed as a way to maintain the number of CD8 cells. This study will evaluate the safety and efficacy of immunotherapy with HIV-specific CD8 cells in HIV infected patients. Additionally, this study will determine if aldesleukin injections improve the persistence of self CD8 transplants and the duration of antiviral activity without severe toxicity. This study will last 18 months. CD8 cells will be isolated from the blood of HIV infected patients; the cells will be allowed to multiply in the laboratory, and patients will receive back their CD8 cells. Patients will receive up to 3 infusions of self CD8 cells. On Day 0, patients will receive their first infusion of CD8 cells. On Day 7, patients will receive their second infusion of CD8 cells; this infusion will be followed by 14 days of aldesleukin administered daily by injection under the skin. Patients with less than a Grade 2 toxicity will receive a third infusion of CD8 cells; this infusion will be followed by 21 days of aldesleukin.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HIV Infections
Keywords
Treatment Naive, Treatment Experienced

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
24 (false)

8. Arms, Groups, and Interventions

Intervention Type
Procedure
Intervention Name(s)
Adoptive transfer of HIV-specific CD8+ T cells
Intervention Type
Drug
Intervention Name(s)
Aldesleukin
Primary Outcome Measure Information:
Title
To determine the safety of administering CD8+ HIV-specific CTL clones followed by subcutaneous IL-2 (Proleukin, Chiron) daily for up to 21 days
Title
To identify a regimen of IL-2 that will improve the in vivo persistence and function of adoptively transferred CD8+ HIV-specific CTL
Secondary Outcome Measure Information:
Title
To determine whether the administration of IL-2 prolongs the antiviral activity of transferred CD8+ HIV-specific CTL
Title
To determine if IL-2 promotes the accumulation of adoptively transferred CD8+ HIV-specific CTL in lymph nodes

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria for All Participants: HIV infected CD4 count greater than 200 cells/mm3 at study entry Absolute neutrophil count greater than 1000 cells/mm3 Willing to take Pneumocystis prophylaxis, if indicated Willing to comply with study requirements Willing to forgo other experimental therapy during the 26-week study period Willing to use acceptable forms of contraception Inclusion Criteria for Treatment-Experienced Participants: Currently receiving treatment with an FDA-approved or expanded access antiretroviral agent (or combinations thereof) at a stable dose for at least 24 weeks prior to study entry Inclusion Criteria for Treatment-Naive Participants: Have not received antiretroviral therapy for 6 months prior to study entry Exclusion Criteria: Treatment with other immunomodulatory therapies (interferon, HIV vaccines, intravenous immunoglobulin), pentoxifylline, cancer chemotherapy, radiation therapy, or other investigational agents Past or present infection with mycobacterium avium complex, toxoplasmosis, cryptococcus, or cytomegalovirus (including retinitis) Active opportunistic infection at study entry or serious systemic infection requiring chronic maintenance or suppressive therapy Lymphoma, symptomatic visceral Kaposi's sarcoma, or any malignancy expected to require systemic therapy Serious psychological or emotional disorder that would affect ability to comply with study requirements or that would be exacerbated by protocol participation Alcohol or drug use, abuse, or dependence that, in the opinion of the investigator, would interfere with the study Estimated life expectancy of less than 4 months Abnormal neurocognitive examination Significant abnormality on electrocardiogram or chest radiograph Inability to generate CD8+ HIV-specific cytotoxic T cell clones Previously treated in FHCRC Protocol #827.1 Pregnancy or breastfeeding
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Stanley Riddell, MD
Organizational Affiliation
Fred Hutchinson Cancer Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Fred Hutchinson Cancer Research Center
City
Seattle
State/Province
Washington
ZIP/Postal Code
98109
Country
United States
Facility Name
University of Washington (UW)
City
Seattle
State/Province
Washington
ZIP/Postal Code
98122
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
21422474
Citation
Chapuis AG, Casper C, Kuntz S, Zhu J, Tjernlund A, Diem K, Turtle CJ, Cigal ML, Velez R, Riddell S, Corey L, Greenberg PD. HIV-specific CD8+ T cells from HIV+ individuals receiving HAART can be expanded ex vivo to augment systemic and mucosal immunity in vivo. Blood. 2011 May 19;117(20):5391-402. doi: 10.1182/blood-2010-11-320226. Epub 2011 Mar 21.
Results Reference
derived

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Safety and Effectiveness of Immunotherapy With Autologous HIV-Specific CD8 Cells in HIV Infected Adults

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