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Single DermaVir Immunization in HIV-1 Infected Patients on HAART (GIHU004)

Primary Purpose

HIV Infection

Status
Completed
Phase
Phase 1
Locations
Hungary
Study Type
Interventional
Intervention
DermaVir
HAART
Sponsored by
Genetic Immunity
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for HIV Infection focused on measuring HIV, Vaccine, Immune Therapy, DermaVir

Eligibility Criteria

18 Years - 50 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Ability and willingness of subject or legal guardian/representative to give written informed consent
  • HIV-1 infection, as documented by any licensed ELISA test kit and confirmed by Western blot, HIV-1 culture, HIV-1 antigen, plasma HIV-1 RNA, or a second antibody test by a method other than ELISA
  • On a stable antiretroviral regimen without changes or interruptions for at least 12 weeks prior to study entry
  • Plasma HIV-1 RNA level of less than 50 copies/mL, obtained at least twice within the 12 weeks prior to study entry
  • Peak plasma HIV-1 RNA level before initiation of HAART > 1000 copies/mL
  • CD4 cell count > 300 cells/mm3 within the 12 weeks prior to study entry
  • Nadir (lowest) CD4+ cell count > 250 cells/mm3 at any time prior to study entry
  • The following laboratory values, obtained within 30 days prior to study entry:

    • Absolute neutrophil count (ANC) > 1000/mm3
    • Hemoglobin > 9.0 g/dL
    • Platelet count > 50,000/mm3
    • Serum creatinine < upper limit of the laboratory normal range (ULN)
    • AST (SGOT), ALT (SGPT), and alkaline phosphatase < 2.5 x ULN
    • Total bilirubin < 2.5 x ULN
    • Anti-nuclear antibody (ANA) titer of 1:40 or lower and negative for serum anti-double-stranded DNA antibody (anti-ds-DNA) test result at screening.
  • All women of reproductive potential must have a negative urine beta-HCG pregnancy test performed within 14 days prior to study entry.
  • Female study volunteers who are not of reproductive potential or whose male partner has undergone successful vasectomy are eligible without requiring the use of contraception. Acceptable documentation of menopause, sterilization, and azoospermia is written or oral documentation communicated by clinician.
  • All subjects must not participate in a conception process (e.g. active attempt to become pregnant or to impregnate, sperm donation, in vitro fertilization) and, if participating in sexual activity that could lead to pregnancy, the study volunteer/ partner must use two reliable methods of contraception simultaneously while receiving the protocol-specified vaccination and for 3 months after the last vaccination.
  • Karnofsky performance score > 90 within 30 days prior to study entry
  • Men and women age 18-50 years

Exclusion Criteria:

  • Viral load measurement > 50 copies/mL within the last 12 weeks prior to study entry
  • History of or evidence of active skin disease (e.g. atopic dermatitis), chronic autoimmune disease or any other significant active skin disease
  • Treatment with topical corticosteroids in close proximity to the proposed vaccination sites within 2 weeks prior to study entry
  • Excessive exposure to the sun (e.g. sunbathing) within 2 weeks prior to study entry
  • Use of any local skin treatments to the targeted vaccination sites within 7 days prior to study entry
  • History of diabetes and bleeding disorders
  • Previous CDC category C event
  • Pregnancy or breast-feeding
  • Use of immunomodulating therapy, including cyclosporin, IgG-containing products, interleukins, interferons, systemic glucocorticosteroids, or exposure to an experimental HIV vaccine within 6 months prior to study entry
  • Receipt of any vaccine within 30 days prior to study entry
  • Allergy/sensitivity to study vaccine products, including adhesives, will be excluded
  • Active drug or alcohol use or dependence
  • Serious illness until subject either completes therapy or is clinically stable on therapy, in the opinion of the site investigator, for at least 14 days prior to study entry
  • Hepatitis B surface antigen and/or anti-hepatitis C positive

Sites / Locations

  • Saint Laszlo Hospital

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

1

2

3

Arm Description

Single low-dose DermaVir immunization 0.1 mg pDNA/subject, 0.8 mL total volume of DermaVir Administered topically with DermaPrep under two skin patches (0.4 mL/patch)

Single medium-dose DermaVir immunization 0.4 mg pDNA/subject, 3.2 mL total volume of DermaVir Administered topically with DermaPrep under four skin patches (0.8 mL/patch)

Single high-dose DermaVir immunization 0.8 mg pDNA/subject, 6.4 mL total volume of DermaVir Administered topically with DermaPrep under eight skin patches (0.4 mL/patch)

Outcomes

Primary Outcome Measures

Grade 3 Adverse Event Related to DermaVir Treatment
Occurrence of at least one grade 3 or higher adverse event including signs/symptoms, laboratory toxicities and clinical events possibly, probably or definitely related to study treatment as judged by the Principal Investigator or the site investigators during the 28 days after DermaVir administration.

Secondary Outcome Measures

CD4+ T Cell Counts/mm3
Number of Subjects With Detectable Anti-ds Antibody and ANA
Number of Subjects Having More Than 50 Copies/mL HIV RNA
Change in HIV-specific Memory T Cell Responses at Day 28 Compare to Baseline
HIV-specific T cell precursors with high proliferative capacity (PHPC) were quantified as described earlier [Calarota et al. J Immunol 2008]. Gag-, Tat- and Rev-specific T cells were measured representing ca. 25% of HIV epitopes included in DermaVir.

Full Information

First Posted
July 4, 2008
Last Updated
February 19, 2013
Sponsor
Genetic Immunity
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1. Study Identification

Unique Protocol Identification Number
NCT00712530
Brief Title
Single DermaVir Immunization in HIV-1 Infected Patients on HAART
Acronym
GIHU004
Official Title
A Phase I Study to Evaluate the Tolerability and Safety of LC002, a DermaVir Vaccine, in HIV-1-infected Subjects Currently Under Treatment With Highly Active Antiretroviral Therapy (HAART)
Study Type
Interventional

2. Study Status

Record Verification Date
February 2013
Overall Recruitment Status
Completed
Study Start Date
January 2005 (undefined)
Primary Completion Date
June 2006 (Actual)
Study Completion Date
June 2006 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Genetic Immunity

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
DermaVir is a plasmid DNA-containing synthetic nanomedicine. It is administered topically with DermaPrep to target Langerhans cells. Langerhans cells with DermaVir migrate to lymph nodes and express HIV-like particles that induce immune responses to kill HIV-infected cells. Hypothesis: Single DermaVir immunization is safe and immunogenic measured by induction of HIV-specific precursor/memory T cell responses. GIHU004 was a phase I dose escalation study conducted in Hungary. It evaluated the safety and immunogenicity of three dosing regimens of topical DermaVir immunization for the treatment of HIV-infected individuals on fully suppressive highly active antiretroviral therapy (HAART).
Detailed Description
This study enrolled nine HIV-infected adult subjects in three sequential dose cohorts. All had durable suppression of HIV-RNA on HAART over the previous 6 months and CD4 count over 300 cells/mm3. Subjects, received on study Day 0 a single DermaVir immunization: Low dose: 0.1 mg pDNA, 0.8 mL DermaVir administered under two DermaPrep patches. Medium dose: 0.4 mg pDNA, 3.2 mL DermaVir administered under four DermaPrep patches. High dose: 0.8 mg pDNA, 6.4 mL DermaVir administered under eight DermaPrep patches. Subjects were on study for a total of 28 days followed by a post-treatment safety follow-up for 48 weeks. HAART was not interrupted. All subjects completed the 28-day treatment and 48 weeks safety follow up phase.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HIV Infection
Keywords
HIV, Vaccine, Immune Therapy, DermaVir

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
1
Arm Type
Experimental
Arm Description
Single low-dose DermaVir immunization 0.1 mg pDNA/subject, 0.8 mL total volume of DermaVir Administered topically with DermaPrep under two skin patches (0.4 mL/patch)
Arm Title
2
Arm Type
Experimental
Arm Description
Single medium-dose DermaVir immunization 0.4 mg pDNA/subject, 3.2 mL total volume of DermaVir Administered topically with DermaPrep under four skin patches (0.8 mL/patch)
Arm Title
3
Arm Type
Experimental
Arm Description
Single high-dose DermaVir immunization 0.8 mg pDNA/subject, 6.4 mL total volume of DermaVir Administered topically with DermaPrep under eight skin patches (0.4 mL/patch)
Intervention Type
Biological
Intervention Name(s)
DermaVir
Other Intervention Name(s)
LC002
Intervention Description
DermaVir is a synthetic pathogen-like nanomedicine. The active pharmaceutical ingredient is a plasmid DNA expressing fifteen HIV proteins that assemble into HIV-like particles. These particles are safe, cannot replicate, integrate or reverse transcribed. DermaVir is targeted to Langerhans cells with DermaPrep medical device. These DermaVir-containing Langerhans cells migrate to the lymph nodes, where induce HIV-specific cytotoxic T cells that can recognize and kill HIV-infected cells.
Intervention Type
Drug
Intervention Name(s)
HAART
Other Intervention Name(s)
Highly active antiretroviral therapy
Intervention Description
Three or more antiretroviral drugs that can fully suppress HIV RNA
Primary Outcome Measure Information:
Title
Grade 3 Adverse Event Related to DermaVir Treatment
Description
Occurrence of at least one grade 3 or higher adverse event including signs/symptoms, laboratory toxicities and clinical events possibly, probably or definitely related to study treatment as judged by the Principal Investigator or the site investigators during the 28 days after DermaVir administration.
Time Frame
28 days
Secondary Outcome Measure Information:
Title
CD4+ T Cell Counts/mm3
Time Frame
28 days
Title
Number of Subjects With Detectable Anti-ds Antibody and ANA
Time Frame
28 days
Title
Number of Subjects Having More Than 50 Copies/mL HIV RNA
Time Frame
28 days
Title
Change in HIV-specific Memory T Cell Responses at Day 28 Compare to Baseline
Description
HIV-specific T cell precursors with high proliferative capacity (PHPC) were quantified as described earlier [Calarota et al. J Immunol 2008]. Gag-, Tat- and Rev-specific T cells were measured representing ca. 25% of HIV epitopes included in DermaVir.
Time Frame
28 days
Other Pre-specified Outcome Measures:
Title
Change in HIV-specific Memory T Cell Responses at Week 48
Description
HIV-specific T cell precursors with high proliferative capacity (PHPC) were quantified as described earlier [Calarota et al. J Immunol 2008]. Gag-, Tat- and Rev-specific T cells were measured representing ca. 25% of HIV epitopes included in DermaVir. Note, group Single low-dose was measured at 24 weeks, for this group the 48 weeks data is not available
Time Frame
48 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Ability and willingness of subject or legal guardian/representative to give written informed consent HIV-1 infection, as documented by any licensed ELISA test kit and confirmed by Western blot, HIV-1 culture, HIV-1 antigen, plasma HIV-1 RNA, or a second antibody test by a method other than ELISA On a stable antiretroviral regimen without changes or interruptions for at least 12 weeks prior to study entry Plasma HIV-1 RNA level of less than 50 copies/mL, obtained at least twice within the 12 weeks prior to study entry Peak plasma HIV-1 RNA level before initiation of HAART > 1000 copies/mL CD4 cell count > 300 cells/mm3 within the 12 weeks prior to study entry Nadir (lowest) CD4+ cell count > 250 cells/mm3 at any time prior to study entry The following laboratory values, obtained within 30 days prior to study entry: Absolute neutrophil count (ANC) > 1000/mm3 Hemoglobin > 9.0 g/dL Platelet count > 50,000/mm3 Serum creatinine < upper limit of the laboratory normal range (ULN) AST (SGOT), ALT (SGPT), and alkaline phosphatase < 2.5 x ULN Total bilirubin < 2.5 x ULN Anti-nuclear antibody (ANA) titer of 1:40 or lower and negative for serum anti-double-stranded DNA antibody (anti-ds-DNA) test result at screening. All women of reproductive potential must have a negative urine beta-HCG pregnancy test performed within 14 days prior to study entry. Female study volunteers who are not of reproductive potential or whose male partner has undergone successful vasectomy are eligible without requiring the use of contraception. Acceptable documentation of menopause, sterilization, and azoospermia is written or oral documentation communicated by clinician. All subjects must not participate in a conception process (e.g. active attempt to become pregnant or to impregnate, sperm donation, in vitro fertilization) and, if participating in sexual activity that could lead to pregnancy, the study volunteer/ partner must use two reliable methods of contraception simultaneously while receiving the protocol-specified vaccination and for 3 months after the last vaccination. Karnofsky performance score > 90 within 30 days prior to study entry Men and women age 18-50 years Exclusion Criteria: Viral load measurement > 50 copies/mL within the last 12 weeks prior to study entry History of or evidence of active skin disease (e.g. atopic dermatitis), chronic autoimmune disease or any other significant active skin disease Treatment with topical corticosteroids in close proximity to the proposed vaccination sites within 2 weeks prior to study entry Excessive exposure to the sun (e.g. sunbathing) within 2 weeks prior to study entry Use of any local skin treatments to the targeted vaccination sites within 7 days prior to study entry History of diabetes and bleeding disorders Previous CDC category C event Pregnancy or breast-feeding Use of immunomodulating therapy, including cyclosporin, IgG-containing products, interleukins, interferons, systemic glucocorticosteroids, or exposure to an experimental HIV vaccine within 6 months prior to study entry Receipt of any vaccine within 30 days prior to study entry Allergy/sensitivity to study vaccine products, including adhesives, will be excluded Active drug or alcohol use or dependence Serious illness until subject either completes therapy or is clinically stable on therapy, in the opinion of the site investigator, for at least 14 days prior to study entry Hepatitis B surface antigen and/or anti-hepatitis C positive
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Denes Banhegyi, MD
Organizational Affiliation
Saint Laszlo Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Saint Laszlo Hospital
City
Budapest
ZIP/Postal Code
1097
Country
Hungary

12. IPD Sharing Statement

Citations:
PubMed Identifier
21839051
Citation
Lorincz O, Toke ER, Somogyi E, Horkay F, Chandran PL, Douglas JF, Szebeni J, Lisziewicz J. Structure and biological activity of pathogen-like synthetic nanomedicines. Nanomedicine. 2012 May;8(4):497-506. doi: 10.1016/j.nano.2011.07.013. Epub 2011 Aug 10.
Results Reference
background
PubMed Identifier
21109034
Citation
Somogyi E, Xu J, Gudics A, Toth J, Kovacs AL, Lori F, Lisziewicz J. A plasmid DNA immunogen expressing fifteen protein antigens and complex virus-like particles (VLP+) mimicking naturally occurring HIV. Vaccine. 2011 Jan 17;29(4):744-53. doi: 10.1016/j.vaccine.2010.11.019. Epub 2010 Nov 23.
Results Reference
background
PubMed Identifier
20347027
Citation
Toke ER, Lorincz O, Somogyi E, Lisziewicz J. Rational development of a stable liquid formulation for nanomedicine products. Int J Pharm. 2010 Jun 15;392(1-2):261-7. doi: 10.1016/j.ijpharm.2010.03.048. Epub 2010 Mar 25.
Results Reference
background
PubMed Identifier
18424710
Citation
Calarota SA, Foli A, Maserati R, Baldanti F, Paolucci S, Young MA, Tsoukas CM, Lisziewicz J, Lori F. HIV-1-specific T cell precursors with high proliferative capacity correlate with low viremia and high CD4 counts in untreated individuals. J Immunol. 2008 May 1;180(9):5907-15. doi: 10.4049/jimmunol.180.9.5907.
Results Reference
background
PubMed Identifier
22590502
Citation
Lisziewicz J, Bakare N, Calarota SA, Banhegyi D, Szlavik J, Ujhelyi E, Toke ER, Molnar L, Lisziewicz Z, Autran B, Lori F. Single DermaVir immunization: dose-dependent expansion of precursor/memory T cells against all HIV antigens in HIV-1 infected individuals. PLoS One. 2012;7(5):e35416. doi: 10.1371/journal.pone.0035416. Epub 2012 May 9.
Results Reference
result
PubMed Identifier
22659241
Citation
Lisziewicz J, Toke ER. Nanomedicine applications towards the cure of HIV. Nanomedicine. 2013 Jan;9(1):28-38. doi: 10.1016/j.nano.2012.05.012. Epub 2012 May 30.
Results Reference
result
Links:
URL
http://www.geneticimmunity.com
Description
Genetic Immunity's homepage

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Single DermaVir Immunization in HIV-1 Infected Patients on HAART

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