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Safety of and Immune Response to an Investigational HIV-1 Vaccine With or Without Interleukin-12 (IL-12) in HIV-1 Infected Adults

Primary Purpose

HIV Infections

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Profectus HIV MAG pDNA vaccine
IL-12
Placebo
Sponsored by
National Institute of Allergy and Infectious Diseases (NIAID)
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for HIV Infections focused on measuring Interleukin-12, Electroporation, HIV Therapeutic Vaccine

Eligibility Criteria

18 Years - 55 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • HIV-1 infected
  • Stable antiretroviral therapy (ART) for a minimum of 6 consecutive months prior to study entry and intention to remain on stable ART until study completion
  • CD4 T-cell count greater than or equal to 500 cells/mm3 (within 30 days prior to study entry)
  • At least two measurements of HIV-1 RNA levels less than or equal to 200 copies/mL (first measurement must be performed at least 6 months prior to study entry and second measurement must be performed between 6 months prior to study entry and at least 30 days prior to study entry)
  • Screening HIV-1 RNA less than 50 copies/mL (within 30 days prior to study entry)
  • Hepatitis B surface antigen negative (within 30 days prior to study entry)
  • Hepatitis C antibody negative or, if hepatitis C antibody positive, hepatitis C virus RNA negative (within 30 days prior to study entry)
  • Certain laboratory values obtained within 30 days prior to study entry; more information can be found in the protocol
  • Females of reproductive potential must have a negative urine pregnancy test within 3 days prior to study entry
  • All study participants participating in sexual activity that could lead to pregnancy must agree to use at least one of the following forms of birth control for at least 21 days prior to study entry until the final study visit:

    • Condoms (male or female) with or without a spermicidal agent
    • Diaphragm or cervical cap with spermicide
    • Intrauterine device (IUD)
    • Hormone-based contraceptive
  • Females who are not of reproductive potential are eligible without requiring the use of a contraceptive
  • Ability and willingness of subject to provide written informed consent
  • Collection of a pre-entry PBMC specimen for immunologic assays and entered into the Laboratory Data Management System (LDMS)

Exclusion Criteria:

  • Confirmed (defined as two consecutive values) CD4 T-cell count less than 200 cells/mm3 at any time or any history or subject recollection of CD4 T-cell count less than 200 cells/mm3 prior to screening
  • Any active malignancy that may require chemotherapy or radiation therapy
  • Bleeding diathesis or condition associated with prolonged bleeding time that would contraindicate IM injection
  • A skin-fold measurement of the cutaneous and subcutaneous tissue for eligible injection sites (on the medial deltoid muscles) that exceeds 40 mm
  • Use of immunomodulatory, cytokine, or growth stimulating factors such as systemic corticosteroids, cyclosporine, methotrexate, azathioprine, anti-CD25 antibody, granulocyte macrophage colony-stimulating factor (GM-CSF), chondrocyte colony-stimulating factor (C-CSF), IFN, or interleukin-2 (IL-2) (within 30 days prior to study entry)
  • Pregnancy or breastfeeding
  • Use of any prior HIV vaccine (prophylactic and/or therapeutic) within 1 year before study entry
  • Use of any investigational treatment within 6 months before study entry
  • Use of any licensed or experimental non-HIV vaccination (e.g., hepatitis B, influenza, pneumococcal polysaccharide) within 4 weeks prior to study entry
  • Use of any infusion blood product or immune globulin within 3 months prior to study entry
  • Known or suspected hypersensitivity to any vaccine component, including hypersensitivity to amide-type local anesthetics, such as lidocaine (Xylocaine), mepivacaine (Polocaine/Carbocaine), etidocaine (Duranest), bupivacaine (Marcaine), or prilocaine
  • Active drug or alcohol use or dependence that, in the opinion of the site investigator, would interfere with adherence to study requirements
  • Serious illness requiring systemic treatment and/or hospitalization within 7 days prior to study entry
  • Current use of any electronic stimulation device, such as cardiac demand pacemakers, automatic implantable cardiac defibrillators, nerve stimulators, or deep brain stimulators
  • History of cardiac arrhythmia or palpitations (e.g., supraventricular tachycardia, atrial fibrillation, frequent ectopy, or sinus bradycardia [i.e., <50 beats per minute on exam]) prior to study entry (NOTE: Sinus arrhythmia is not excluded)
  • History of syncope or fainting episode within 1 year of study entry
  • Seizure disorder or any history of prior seizure
  • Extensive tattoos covering the site of administration (upper left and right medial deltoid muscles)
  • Presence of any surgical or traumatic metal implants at the site of administration (medial deltoid muscles)
  • Any chronic inflammatory disease (e.g., ankylosing spondylitis, psoriasis, inflammatory bowel disease)

Sites / Locations

  • UCLA CARE Center CRS
  • Stanford AIDS Clinical Trials Unit CRS
  • Ucsf Hiv/Aids Crs
  • University of Colorado Hospital CRS
  • Massachusetts General Hospital Clinical Research Site (MGH CRS) CRS
  • Brigham and Women's Hospital Therapeutics Clinical Research Site (BWH TCRS) CRS
  • Washington University Therapeutics (WT) CRS
  • Trillium Health ACTG CRS
  • Univ. of Rochester ACTG CRS
  • Cincinnati CRS
  • Penn Therapeutics Crs
  • University of Pittsburgh CRS
  • Houston AIDS Research Team CRS

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm 7

Arm 8

Arm 9

Arm 10

Arm Type

Experimental

Placebo Comparator

Experimental

Placebo Comparator

Experimental

Placebo Comparator

Experimental

Placebo Comparator

Experimental

Placebo Comparator

Arm Label

Cohort 1: Vaccine alone IM/EP

Cohort 1: Placebo

Cohort 2: Vaccine plus IL-12 IM/EP

Cohort 2: Placebo

Cohort 3: Vaccine plus IL-12 IM/EP

Cohort 3: Placebo

Cohort 4: Vaccine plus IL-12 IM/EP

Cohort 4: Placebo

Cohort 5: Vaccine plus IL-12 IM

Cohort 5: Placebo

Arm Description

HIV MAG pDNA alone IM/EP

Placebo given as an injection in each upper arm

HIV MAG pDNA plus 50 mcg of IL-12 pDNA IM/EP

Placebo given as an injection in each upper arm

HIV MAG pDNA plus 250 mcg of IL-12 pDNA IM/EP

Placebo given as an injection in each upper arm

HIV MAG pDNA plus 1,000 mcg of IL-12 pDNA IM/EP

Placebo given as an injection in each upper arm

HIV MAG pDNA plus 1,000 mcg (or highest dose reached) IL-12 pDNA IM

Placebo given as an injection in each upper arm

Outcomes

Primary Outcome Measures

Occurrence of at least one greater than Grade 3 adverse event (AE) including signs/symptoms, lab toxicities, and/or clinical events that is possibly, probably, or definitely related to study treatment, as judged by the core team
Change in the number of interferon (IFN)-gamma generating (in response to gag) CD4 T cells/million peripheral blood mononuclear cells (PBMCs) as measured by intracellular cytokine staining (ICS)

Secondary Outcome Measures

Answering "no" to the question, "In your opinion, would this study's vaccination procedure be acceptable as part of a treatment for HIV, if it proved to be effective?"
Answering "no" to the question, "In your opinion, would this study's vaccination procedure be acceptable if it could contribute to increased scientific knowledge about how best to administer vaccines to prevent or treat infections?"
Premature treatment discontinuation for reasons related to study treatment or related to any real or perceived effect of study vaccination or its administration
Rated pain (for participants administered vaccine/placebo by the EP device)
Changes from baseline and absolute values of multiple functions of CD4 and CD8 T cells in response to gag and other vaccine-coded antigens individually and in sum

Full Information

First Posted
December 23, 2010
Last Updated
October 28, 2021
Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)
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1. Study Identification

Unique Protocol Identification Number
NCT01266616
Brief Title
Safety of and Immune Response to an Investigational HIV-1 Vaccine With or Without Interleukin-12 (IL-12) in HIV-1 Infected Adults
Official Title
A Phase I Randomized, Partially Double-Blind, Placebo-Controlled, Dose-Escalation Study to Evaluate the Safety and Immunogenicity of a Cytokine Enhanced HIV-1 Multi-Antigen (HIV MAG) pDNA Vaccine Delivered Intramuscularly Followed by in Vivo Electroporation (IM/EP) or Intramuscularly in HIV-1 Infected Adults Receiving ART
Study Type
Interventional

2. Study Status

Record Verification Date
October 2021
Overall Recruitment Status
Completed
Study Start Date
March 2011 (undefined)
Primary Completion Date
October 2012 (Actual)
Study Completion Date
April 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Therapeutic HIV vaccines are designed to control HIV infection by boosting the body's natural immune response. There are currently no FDA-approved therapeutic HIV vaccines. This study will test whether giving an HIV-1 vaccine together with or without interleukin 12 (IL-12) is safe and effective. This study will also test a new way of giving the vaccine called electroporation (EP).
Detailed Description
Although highly active antiretroviral therapy (HAART) has greatly reduced HIV infection-related morbidity and mortality, individual response to therapy can be variable. Therapeutic vaccination works by augmenting virus-specific immunity and can be given with or without immunomodulatory agents or adjuvants. In conjunction with HAART, therapeutic vaccination may be a more effective treatment for the suppression of HIV-1 replication. This study will examine the safety and efficacy of giving an investigational vaccine with or without IL-12 in HIV-1 infected adults receiving HAART. This study will also test whether delivering the vaccine using EP is safe and increases the efficacy of the vaccine. Participation in this study will last approximately 36 weeks. Participants will be randomly assigned to one of five cohorts. Cohort 1 will receive the HIV multi-antigen plasmid DNA (HIV MAG pDNA) vaccine or placebo intramuscularly (IM) in the upper arm followed by EP. Cohorts 2 through 4 will receive the HIV MAG pDNA vaccine and sequentially increasing doses of GENEVAX IL-12 pDNA or placebo by IM/EP. Cohort 5 will receive the HIV MAG pDNA vaccine with the highest dose of IL-12 pDNA or placebo by needle and syringe in the upper arm. Participants receive two injections at Weeks 0, 4, and 12. Participants will complete a questionnaire that assesses the acceptability of the vaccine and remain at the clinic 30 minutes for observation after each vaccination. Participants will be contacted by telephone 2 to 3 days post-vaccination to assess vaccination-related signs and/or symptoms. All participants will be asked to record their temperatures and any symptoms they experience daily for 4 days following each vaccination on a Vaccination Report Card (VRC). All nonstudy vaccines or medications should also be recorded on the VRC. Study visits will occur at Weeks 0, 1, 2, 4, 5, 6, 8, 12, 13, 14, 16, 24, and 36. At most visits, participants will undergo a physical examination. Women of reproductive potential will also undergo pregnancy testing before receiving injections on Weeks 0, 4, and 12. Blood will be drawn at various time points to evaluate participants' health and measure immunologic markers, CD4 and CD8 T-cell counts, and cytokine levels. Blood and plasma will also be stored for future exploratory studies.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HIV Infections
Keywords
Interleukin-12, Electroporation, HIV Therapeutic Vaccine

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
62 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Cohort 1: Vaccine alone IM/EP
Arm Type
Experimental
Arm Description
HIV MAG pDNA alone IM/EP
Arm Title
Cohort 1: Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo given as an injection in each upper arm
Arm Title
Cohort 2: Vaccine plus IL-12 IM/EP
Arm Type
Experimental
Arm Description
HIV MAG pDNA plus 50 mcg of IL-12 pDNA IM/EP
Arm Title
Cohort 2: Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo given as an injection in each upper arm
Arm Title
Cohort 3: Vaccine plus IL-12 IM/EP
Arm Type
Experimental
Arm Description
HIV MAG pDNA plus 250 mcg of IL-12 pDNA IM/EP
Arm Title
Cohort 3: Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo given as an injection in each upper arm
Arm Title
Cohort 4: Vaccine plus IL-12 IM/EP
Arm Type
Experimental
Arm Description
HIV MAG pDNA plus 1,000 mcg of IL-12 pDNA IM/EP
Arm Title
Cohort 4: Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo given as an injection in each upper arm
Arm Title
Cohort 5: Vaccine plus IL-12 IM
Arm Type
Experimental
Arm Description
HIV MAG pDNA plus 1,000 mcg (or highest dose reached) IL-12 pDNA IM
Arm Title
Cohort 5: Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo given as an injection in each upper arm
Intervention Type
Biological
Intervention Name(s)
Profectus HIV MAG pDNA vaccine
Intervention Description
3,000 mcg admixture of two vaccine plasmids: ProfectusVax DNA Plasmid (HIV-1 gag/pol) and ProfectusVax DNA Plasmid (HIV-1 nef/tat/vif, env) at Weeks 0, 4, and 12
Intervention Type
Biological
Intervention Name(s)
IL-12
Intervention Description
Administered at Weeks 0, 4, and 12
Intervention Type
Other
Intervention Name(s)
Placebo
Intervention Description
Saline injections at Weeks 0, 4, and 12
Primary Outcome Measure Information:
Title
Occurrence of at least one greater than Grade 3 adverse event (AE) including signs/symptoms, lab toxicities, and/or clinical events that is possibly, probably, or definitely related to study treatment, as judged by the core team
Time Frame
From the first day of study treatment until 28 days after the last study vaccine administration
Title
Change in the number of interferon (IFN)-gamma generating (in response to gag) CD4 T cells/million peripheral blood mononuclear cells (PBMCs) as measured by intracellular cytokine staining (ICS)
Time Frame
From Baseline to Week 14
Secondary Outcome Measure Information:
Title
Answering "no" to the question, "In your opinion, would this study's vaccination procedure be acceptable as part of a treatment for HIV, if it proved to be effective?"
Time Frame
From Week 0 to Week 36
Title
Answering "no" to the question, "In your opinion, would this study's vaccination procedure be acceptable if it could contribute to increased scientific knowledge about how best to administer vaccines to prevent or treat infections?"
Time Frame
From Week 0 to Week 36
Title
Premature treatment discontinuation for reasons related to study treatment or related to any real or perceived effect of study vaccination or its administration
Time Frame
From Week 0 to Week 36
Title
Rated pain (for participants administered vaccine/placebo by the EP device)
Time Frame
When the device was placed on the skin and the vaccine/placebo was injected; at the time of the electrical stimulation and muscle contraction; and at 10 and 30 minutes after the procedure was completed at Weeks 0, 4, and 12
Title
Changes from baseline and absolute values of multiple functions of CD4 and CD8 T cells in response to gag and other vaccine-coded antigens individually and in sum
Time Frame
At Week 8, Week 14, and possibly other time points depending on the first set of data in an ICS assay

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
55 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: HIV-1 infected Stable antiretroviral therapy (ART) for a minimum of 6 consecutive months prior to study entry and intention to remain on stable ART until study completion CD4 T-cell count greater than or equal to 500 cells/mm3 (within 30 days prior to study entry) At least two measurements of HIV-1 RNA levels less than or equal to 200 copies/mL (first measurement must be performed at least 6 months prior to study entry and second measurement must be performed between 6 months prior to study entry and at least 30 days prior to study entry) Screening HIV-1 RNA less than 50 copies/mL (within 30 days prior to study entry) Hepatitis B surface antigen negative (within 30 days prior to study entry) Hepatitis C antibody negative or, if hepatitis C antibody positive, hepatitis C virus RNA negative (within 30 days prior to study entry) Certain laboratory values obtained within 30 days prior to study entry; more information can be found in the protocol Females of reproductive potential must have a negative urine pregnancy test within 3 days prior to study entry All study participants participating in sexual activity that could lead to pregnancy must agree to use at least one of the following forms of birth control for at least 21 days prior to study entry until the final study visit: Condoms (male or female) with or without a spermicidal agent Diaphragm or cervical cap with spermicide Intrauterine device (IUD) Hormone-based contraceptive Females who are not of reproductive potential are eligible without requiring the use of a contraceptive Ability and willingness of subject to provide written informed consent Collection of a pre-entry PBMC specimen for immunologic assays and entered into the Laboratory Data Management System (LDMS) Exclusion Criteria: Confirmed (defined as two consecutive values) CD4 T-cell count less than 200 cells/mm3 at any time or any history or subject recollection of CD4 T-cell count less than 200 cells/mm3 prior to screening Any active malignancy that may require chemotherapy or radiation therapy Bleeding diathesis or condition associated with prolonged bleeding time that would contraindicate IM injection A skin-fold measurement of the cutaneous and subcutaneous tissue for eligible injection sites (on the medial deltoid muscles) that exceeds 40 mm Use of immunomodulatory, cytokine, or growth stimulating factors such as systemic corticosteroids, cyclosporine, methotrexate, azathioprine, anti-CD25 antibody, granulocyte macrophage colony-stimulating factor (GM-CSF), chondrocyte colony-stimulating factor (C-CSF), IFN, or interleukin-2 (IL-2) (within 30 days prior to study entry) Pregnancy or breastfeeding Use of any prior HIV vaccine (prophylactic and/or therapeutic) within 1 year before study entry Use of any investigational treatment within 6 months before study entry Use of any licensed or experimental non-HIV vaccination (e.g., hepatitis B, influenza, pneumococcal polysaccharide) within 4 weeks prior to study entry Use of any infusion blood product or immune globulin within 3 months prior to study entry Known or suspected hypersensitivity to any vaccine component, including hypersensitivity to amide-type local anesthetics, such as lidocaine (Xylocaine), mepivacaine (Polocaine/Carbocaine), etidocaine (Duranest), bupivacaine (Marcaine), or prilocaine Active drug or alcohol use or dependence that, in the opinion of the site investigator, would interfere with adherence to study requirements Serious illness requiring systemic treatment and/or hospitalization within 7 days prior to study entry Current use of any electronic stimulation device, such as cardiac demand pacemakers, automatic implantable cardiac defibrillators, nerve stimulators, or deep brain stimulators History of cardiac arrhythmia or palpitations (e.g., supraventricular tachycardia, atrial fibrillation, frequent ectopy, or sinus bradycardia [i.e., <50 beats per minute on exam]) prior to study entry (NOTE: Sinus arrhythmia is not excluded) History of syncope or fainting episode within 1 year of study entry Seizure disorder or any history of prior seizure Extensive tattoos covering the site of administration (upper left and right medial deltoid muscles) Presence of any surgical or traumatic metal implants at the site of administration (medial deltoid muscles) Any chronic inflammatory disease (e.g., ankylosing spondylitis, psoriasis, inflammatory bowel disease)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jeffrey Jacobson, MD
Organizational Affiliation
Division of Infectious Diseases and HIV Medicine, Drexel University College of Medicine
Official's Role
Study Chair
Facility Information:
Facility Name
UCLA CARE Center CRS
City
Los Angeles
State/Province
California
ZIP/Postal Code
90035
Country
United States
Facility Name
Stanford AIDS Clinical Trials Unit CRS
City
Palo Alto
State/Province
California
ZIP/Postal Code
94304-5350
Country
United States
Facility Name
Ucsf Hiv/Aids Crs
City
San Francisco
State/Province
California
ZIP/Postal Code
94110
Country
United States
Facility Name
University of Colorado Hospital CRS
City
Aurora
State/Province
Colorado
ZIP/Postal Code
80045
Country
United States
Facility Name
Massachusetts General Hospital Clinical Research Site (MGH CRS) CRS
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02114
Country
United States
Facility Name
Brigham and Women's Hospital Therapeutics Clinical Research Site (BWH TCRS) CRS
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02115
Country
United States
Facility Name
Washington University Therapeutics (WT) CRS
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States
Facility Name
Trillium Health ACTG CRS
City
Rochester
State/Province
New York
ZIP/Postal Code
14607
Country
United States
Facility Name
Univ. of Rochester ACTG CRS
City
Rochester
State/Province
New York
ZIP/Postal Code
14642
Country
United States
Facility Name
Cincinnati CRS
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45219
Country
United States
Facility Name
Penn Therapeutics Crs
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
Facility Name
University of Pittsburgh CRS
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15213-2582
Country
United States
Facility Name
Houston AIDS Research Team CRS
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
10229227
Citation
Finzi D, Blankson J, Siliciano JD, Margolick JB, Chadwick K, Pierson T, Smith K, Lisziewicz J, Lori F, Flexner C, Quinn TC, Chaisson RE, Rosenberg E, Walker B, Gange S, Gallant J, Siliciano RF. Latent infection of CD4+ T cells provides a mechanism for lifelong persistence of HIV-1, even in patients on effective combination therapy. Nat Med. 1999 May;5(5):512-7. doi: 10.1038/8394.
Results Reference
background
PubMed Identifier
8207839
Citation
Koup RA, Safrit JT, Cao Y, Andrews CA, McLeod G, Borkowsky W, Farthing C, Ho DD. Temporal association of cellular immune responses with the initial control of viremia in primary human immunodeficiency virus type 1 syndrome. J Virol. 1994 Jul;68(7):4650-5. doi: 10.1128/JVI.68.7.4650-4655.1994.
Results Reference
background
PubMed Identifier
17961089
Citation
Luxembourg A, Evans CF, Hannaman D. Electroporation-based DNA immunisation: translation to the clinic. Expert Opin Biol Ther. 2007 Nov;7(11):1647-64. doi: 10.1517/14712598.7.11.1647.
Results Reference
background
PubMed Identifier
26761518
Citation
Jacobson JM, Zheng L, Wilson CC, Tebas P, Matining RM, Egan MA, Eldridge J, Landay AL, Clifford DB, Luetkemeyer AF, Tiu J, Martinez AL, Janik J, Spitz TA, Hural J, McElrath J, Frahm N; ACTG A5281 Protocol Team. The Safety and Immunogenicity of an Interleukin-12-Enhanced Multiantigen DNA Vaccine Delivered by Electroporation for the Treatment of HIV-1 Infection. J Acquir Immune Defic Syndr. 2016 Feb 1;71(2):163-71. doi: 10.1097/QAI.0000000000000830.
Results Reference
derived

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Safety of and Immune Response to an Investigational HIV-1 Vaccine With or Without Interleukin-12 (IL-12) in HIV-1 Infected Adults

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