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Safety and Immunogenicity of HIVAX in HIV-1 Infected Subjects (GCHT01)

Primary Purpose

HIV Infections

Status
Unknown status
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
HIVAX
saline solution
HIVAX
Sponsored by
GeneCure Biotechnologies
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for HIV Infections focused on measuring HIV-1, therapeutic vaccine, immunotherapy, AIDS

Eligibility Criteria

18 Years - 60 Years (Adult)All SexesDoes not accept healthy volunteers

Part I (vaccination phase) Inclusion Criteria:

  1. HIV-1 infection, as documented by any licensed ELISA test kit and confirmed by Western blot, at any time prior to study entry. HIV-1 culture, HIV-1 antigen, plasma HIV-1 RNA, or a second antibody test by a method other than ELISA is acceptable as an alternative confirmatory test.
  2. On highly active antiretroviral therapy defined as the combination of at least three antiretroviral agents for at least 12 months prior to study entry.

    NOTE: A regimen that included only the combination of 3 NRTIs alone will not meet the study definition of a highly active antiretroviral therapy regimen. The combination of low dose ritonavir and another PI will be considered as one antiretroviral agent. Subjects cannot be on an NNRTI containing regimen at study entry.

  3. Subjects must be on a stable regimen (no change in therapy) for at least 2 months prior to study entry.

    NOTE: A change in formulation or class for reasons other than virologic failure will be allowed but must have documented viral suppression (HIV RNA <50 copies/ml) on at least two consecutive measurements at least two weeks apart.

  4. Prior sustained response to antiretroviral therapy defined as an HIV-1 RNA <50 copies/ml and a CD4 cell count >500 cells/mm3 for twelve months prior to study entry documented on at least three measurements prior to study entry.

    NOTE: cannot have any confirmed HIV-1 RNA ≥50 copies/ml during the 12-months prior to study entry.

  5. CD4 cell count >500 cells/mm3 within 60 days prior to study entry at any laboratory that has a CLIA certification or its equivalent.
  6. HIV-1 RNA <50 copies/ml obtained within 30 days prior to study entry by any laboratory that has a CLIA certification or its equivalent.
  7. Willingness to interrupt all antiretroviral therapy for at least 12 weeks following completion of vaccination phase (Part I).
  8. Laboratory values obtained within 30 days prior to study entry.

    • Absolute neutrophil count (ANC) ≥ 750/mm3.
    • Hemoglobin ≥ 8.5 g/dL.
    • Platelet count ≥ 75,000/mm3.
    • AST (SGOT), ALT (SGPT), and alkaline phosphatase ≤ 2.5 x ULN.
    • Total bilirubin ≤ 2.5 x ULN.
    • PT < 1.2 ULN and PTT < 1.5 ULN NOTE: Asymptomatic subjects with total bilirubin ≥2.5 x ULN, receiving indinavir and/or atazanavir are eligible.
  9. Negative pregnancy test within 14 days prior to study entry.
  10. Willingness to use adequate contraception by study participants

    Subjects must agree not to participate in a conception process (e.g., active attempts to become pregnant or to impregnate, sperm donation, or in vitro fertilization), and if participating in sexual activity that could lead to pregnancy, subjects must use a form of contraception as listed below while on study vaccine and for 60 days after stopping study vaccine.

    Women without reproductive potential (i.e., have reached menopause or undergone hysterectomy, bilateral oophorectomy, or tubal ligation) or women whose male partner has undergone successful vasectomy with documented azoospermia or has documented azoospermia for any other reason, are eligible without requiring the use of contraception.

    NOTE: Subject-reported history is acceptable documentation of sterilization (hysterectomy, bilateral oophorectomy, tubal ligation, or vasectomy).

    As appropriate, at least one of the following methods must be used appropriately with or without a hormonal-based method during the study:

    • Condoms (male or female) with or without a spermicidal agent.
    • Diaphragm or cervical cap with spermicidal agent
    • IUD
  11. Karnovsky performance score ≥ 90.
  12. Men and women ≥ 18 years of age and < 60 years of age.
  13. Ability and willingness of subject to give written informed consent.

Part I (vaccination phase) Exclusion Criteria:

  1. Active infection with schistosomiasis or Treponema pallidum (syphilis).
  2. Seropositive for VSV-G antibody, hepatitis B surface antigen (HBsAg) or concurrent chronic active hepatitis C.
  3. Autoimmune diseases or clinically serious cardiac, pulmonary, gastrointestinal, hepatic, renal or neurologic disease, which in the opinion of the investigator will compromise ability to participate in the study.
  4. Receipt of immune globulin or blood products within 90 days prior to study entry.
  5. Receipt of any vaccinations within 30 days prior to study entry.
  6. Previous receipt of any HIV vaccine. NOTE: Subjects who participated previously in an HIV vaccine trial who have documentation of receipt of only placebo may be eligible after discussion with the protocol chair.
  7. Pregnancy and breast-feeding.
  8. Prior systemic cancer chemotherapy,
  9. Investigational agents and immunomodulators (cyclosporine, hematological growth factors, systemic corticosteroids, interleukins or interferons) within 90 days prior to study entry.

    NOTE: Subjects may be on antiretroviral agents not yet approved by the FDA as part of a clinical trial or expanded access program.

  10. Anaphylaxis or allergy to vaccine components (See section 5.1.1).
  11. Active drug or alcohol use or dependence that, in the opinion of the investigator, would interfere with adherence to study requirements.
  12. Serious illness requiring systemic treatment and/or hospitalization until subject either completes therapy or is clinically stable on therapy, in the opinion of the investigator, for at least 30 days prior to study entry.
  13. History of any AIDS-defining illness. NOTE: Subjects whose sole AIDS-defining illness is Kaposi's sarcoma limited to the skin that is not anticipated to require systemic therapy may be eligible after discussion with the protocol chair.
  14. Nadir CD4 cell count <250 cell/mm3.
  15. Changes in antiretroviral therapy for virologic failure prior to study entry.
  16. Prisoners.

Part II (treatment interruption phase) Inclusion Criteria (Arm I and III only):

  1. Receipt of three vaccinations . At the completion of the first 24 weeks of the study, potential eligible subjects for Part II will be unblinded, as to the receipt of active vaccine.

    NOTE: Subjects in Arm II and IV (vaccine placebo recipients) participation in the study will end with Part I.

  2. Willingness to interrupt potent antiretroviral therapy for 12 weeks.
  3. CD4 cell count > 500 cells/mm3 within 14 days prior to antiretroviral treatment interruption.

Part II Exclusion Criteria:

  1. Confirmed viral flare, defined as two consecutive plasma HIV-1 RNA >5,000 copies/ml, during the immunization phase (Part I).
  2. Development of any condition during the immunization phase that in the opinion of the investigator would place the subject at an increased risk for HIV viral rebound.

Sites / Locations

  • University of Miami School of Medicine, AIDS Clinical Research unit

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Placebo Comparator

Experimental

Arm Label

Arm I

Arm II

Arm III

Arm Description

Lower dose HIVAX vaccine

lower dose, placebo control

Higher dose HIVAX vaccine

Outcomes

Primary Outcome Measures

• To evaluate the safety of a replication-defective HIV-1 vaccine (HIVAX™) in HIV-1 infected subjects on highly active antiretroviral therapy.
Frequency and severity of adverse events, laboratory abnormalities, and local and systemic reactogenicity signs and symptoms following vaccinations.
• To evaluate the potential immunogenicity of a replication-defective HIV-1 vaccine (HIVAX™) as determined by IFN-γ and IL-2 ELISPOT to pooled gag and env HIV peptides.
Magnitude of IFN-γ & IL-2 producing CD4+ and CD8+ T cells to pooled gag and env HIV peptides at 4 weeks post vaccinations.

Secondary Outcome Measures

To explore the potential effectiveness of a replication-defective HIV-1 vaccine as a therapeutic vaccine
Changes in CD4+ and CD8+ T-cell counts between the vaccine and placebo groups. Changes in functional and phenotypic specific HIV gag and env induced T cell responses including in CD8 and CD4 T subsets. HIV-1 RNA viral set point following antiretroviral treatment interruption, defined as the average of HIV-1 RNA values during the last two study visits of the antiretroviral treatment interruption. Time to virologic rebound (HIV-1 RNA ≥ 5,000 copies/ml). Breadth of HV-1 specific CD8+ T cell responses as determined by IFN-γ ELISPOT using overlapping HIV peptides for gag and env.
To monitor the impact of antiretroviral treatment interruption on viral resistance among subjects with virologic rebound (HIV-1 RNA ≥5,000 copies/ml) following resumption of antiretroviral treatment.
Treatment interruption: the number and percentage: 1)meet HIV-1 RNA (>2.0 fold above nadir and >5,000 copies/mL on two consecutive measurements verified at least one week apart) and CD4+ criteria (<400 cell/mm3 or 50% decreases from baseline in CD4 cell count on two consecutive measurements verified at least one week apart) to re-institute treatment before 12 wks; 2)genotypic resistance in re-emergent virus. Treatment resumption: the number and percentage: 1)meet criteria for virologic failure; 2)genotypic resistance in patients with virologic failure.

Full Information

First Posted
September 1, 2011
Last Updated
June 8, 2020
Sponsor
GeneCure Biotechnologies
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1. Study Identification

Unique Protocol Identification Number
NCT01428596
Brief Title
Safety and Immunogenicity of HIVAX in HIV-1 Infected Subjects
Acronym
GCHT01
Official Title
A Phase I Dose-escalation Clinical Trial to Evaluate the Safety and Immunogenicity of a Replication-defective HIV-1 Vaccine (HIVAX™) in HIV-1 Infected Subjects Receiving Highly Active Antiretroviral Therapy
Study Type
Interventional

2. Study Status

Record Verification Date
June 2020
Overall Recruitment Status
Unknown status
Study Start Date
September 2010 (undefined)
Primary Completion Date
December 2020 (Anticipated)
Study Completion Date
December 2020 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
GeneCure Biotechnologies

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This study is to test a therapeutic HIV-1 vaccine (HIVAX™) in HIV-1 infected subjects. The safety and immune responses will be studied in vaccine recipients. The anti-viral effect of HIVAX vaccine will be monitored during a 12-week treatment interruption phase.
Detailed Description
This is a randomized, placebo-controlled dose-escalation clinical trial to evaluate the safety and the immunogenicity of two doses of a replication defective HIV-1 vaccine (HIVAX™) in subjects receiving stable highly active antiretroviral therapy (HAART) who have an HIV-1 RNA <50 copies/ml and CD4 cell count >500 cells/mm3. Following the randomized placebo-controlled vaccination phase subjects who received active vaccine and who meet eligibility will undergo a 12-week analytical antiretroviral treatment interruption followed by reinstitution of antiretroviral therapy (or continued interruption) with follow up through week 48.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HIV Infections
Keywords
HIV-1, therapeutic vaccine, immunotherapy, AIDS

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
30 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Arm I
Arm Type
Experimental
Arm Description
Lower dose HIVAX vaccine
Arm Title
Arm II
Arm Type
Placebo Comparator
Arm Description
lower dose, placebo control
Arm Title
Arm III
Arm Type
Experimental
Arm Description
Higher dose HIVAX vaccine
Intervention Type
Biological
Intervention Name(s)
HIVAX
Intervention Description
Vaccine 1.0 ml SQ lower dose (10^8 TU) at weeks 0, 8 and 16.
Intervention Type
Biological
Intervention Name(s)
saline solution
Intervention Description
Saline solution 1.0 ml SQ at weeks 0, 8 and 16.
Intervention Type
Biological
Intervention Name(s)
HIVAX
Intervention Description
Vaccine 1.0 ml SQ higher dose (10^9 TU) at weeks 0, 8 and 16.
Primary Outcome Measure Information:
Title
• To evaluate the safety of a replication-defective HIV-1 vaccine (HIVAX™) in HIV-1 infected subjects on highly active antiretroviral therapy.
Description
Frequency and severity of adverse events, laboratory abnormalities, and local and systemic reactogenicity signs and symptoms following vaccinations.
Time Frame
48 weeks
Title
• To evaluate the potential immunogenicity of a replication-defective HIV-1 vaccine (HIVAX™) as determined by IFN-γ and IL-2 ELISPOT to pooled gag and env HIV peptides.
Description
Magnitude of IFN-γ & IL-2 producing CD4+ and CD8+ T cells to pooled gag and env HIV peptides at 4 weeks post vaccinations.
Time Frame
48 weeks
Secondary Outcome Measure Information:
Title
To explore the potential effectiveness of a replication-defective HIV-1 vaccine as a therapeutic vaccine
Description
Changes in CD4+ and CD8+ T-cell counts between the vaccine and placebo groups. Changes in functional and phenotypic specific HIV gag and env induced T cell responses including in CD8 and CD4 T subsets. HIV-1 RNA viral set point following antiretroviral treatment interruption, defined as the average of HIV-1 RNA values during the last two study visits of the antiretroviral treatment interruption. Time to virologic rebound (HIV-1 RNA ≥ 5,000 copies/ml). Breadth of HV-1 specific CD8+ T cell responses as determined by IFN-γ ELISPOT using overlapping HIV peptides for gag and env.
Time Frame
48 weeks
Title
To monitor the impact of antiretroviral treatment interruption on viral resistance among subjects with virologic rebound (HIV-1 RNA ≥5,000 copies/ml) following resumption of antiretroviral treatment.
Description
Treatment interruption: the number and percentage: 1)meet HIV-1 RNA (>2.0 fold above nadir and >5,000 copies/mL on two consecutive measurements verified at least one week apart) and CD4+ criteria (<400 cell/mm3 or 50% decreases from baseline in CD4 cell count on two consecutive measurements verified at least one week apart) to re-institute treatment before 12 wks; 2)genotypic resistance in re-emergent virus. Treatment resumption: the number and percentage: 1)meet criteria for virologic failure; 2)genotypic resistance in patients with virologic failure.
Time Frame
16 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
60 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Part I (vaccination phase) Inclusion Criteria: HIV-1 infection, as documented by any licensed ELISA test kit and confirmed by Western blot, at any time prior to study entry. HIV-1 culture, HIV-1 antigen, plasma HIV-1 RNA, or a second antibody test by a method other than ELISA is acceptable as an alternative confirmatory test. On highly active antiretroviral therapy defined as the combination of at least three antiretroviral agents for at least 12 months prior to study entry. NOTE: A regimen that included only the combination of 3 NRTIs alone will not meet the study definition of a highly active antiretroviral therapy regimen. The combination of low dose ritonavir and another PI will be considered as one antiretroviral agent. Subjects cannot be on an NNRTI containing regimen at study entry. Subjects must be on a stable regimen (no change in therapy) for at least 2 months prior to study entry. NOTE: A change in formulation or class for reasons other than virologic failure will be allowed but must have documented viral suppression (HIV RNA <50 copies/ml) on at least two consecutive measurements at least two weeks apart. Prior sustained response to antiretroviral therapy defined as an HIV-1 RNA <50 copies/ml and a CD4 cell count >500 cells/mm3 for twelve months prior to study entry documented on at least three measurements prior to study entry. NOTE: cannot have any confirmed HIV-1 RNA ≥50 copies/ml during the 12-months prior to study entry. CD4 cell count >500 cells/mm3 within 60 days prior to study entry at any laboratory that has a CLIA certification or its equivalent. HIV-1 RNA <50 copies/ml obtained within 30 days prior to study entry by any laboratory that has a CLIA certification or its equivalent. Willingness to interrupt all antiretroviral therapy for at least 12 weeks following completion of vaccination phase (Part I). Laboratory values obtained within 30 days prior to study entry. Absolute neutrophil count (ANC) ≥ 750/mm3. Hemoglobin ≥ 8.5 g/dL. Platelet count ≥ 75,000/mm3. AST (SGOT), ALT (SGPT), and alkaline phosphatase ≤ 2.5 x ULN. Total bilirubin ≤ 2.5 x ULN. PT < 1.2 ULN and PTT < 1.5 ULN NOTE: Asymptomatic subjects with total bilirubin ≥2.5 x ULN, receiving indinavir and/or atazanavir are eligible. Negative pregnancy test within 14 days prior to study entry. Willingness to use adequate contraception by study participants Subjects must agree not to participate in a conception process (e.g., active attempts to become pregnant or to impregnate, sperm donation, or in vitro fertilization), and if participating in sexual activity that could lead to pregnancy, subjects must use a form of contraception as listed below while on study vaccine and for 60 days after stopping study vaccine. Women without reproductive potential (i.e., have reached menopause or undergone hysterectomy, bilateral oophorectomy, or tubal ligation) or women whose male partner has undergone successful vasectomy with documented azoospermia or has documented azoospermia for any other reason, are eligible without requiring the use of contraception. NOTE: Subject-reported history is acceptable documentation of sterilization (hysterectomy, bilateral oophorectomy, tubal ligation, or vasectomy). As appropriate, at least one of the following methods must be used appropriately with or without a hormonal-based method during the study: Condoms (male or female) with or without a spermicidal agent. Diaphragm or cervical cap with spermicidal agent IUD Karnovsky performance score ≥ 90. Men and women ≥ 18 years of age and < 60 years of age. Ability and willingness of subject to give written informed consent. Part I (vaccination phase) Exclusion Criteria: Active infection with schistosomiasis or Treponema pallidum (syphilis). Seropositive for VSV-G antibody, hepatitis B surface antigen (HBsAg) or concurrent chronic active hepatitis C. Autoimmune diseases or clinically serious cardiac, pulmonary, gastrointestinal, hepatic, renal or neurologic disease, which in the opinion of the investigator will compromise ability to participate in the study. Receipt of immune globulin or blood products within 90 days prior to study entry. Receipt of any vaccinations within 30 days prior to study entry. Previous receipt of any HIV vaccine. NOTE: Subjects who participated previously in an HIV vaccine trial who have documentation of receipt of only placebo may be eligible after discussion with the protocol chair. Pregnancy and breast-feeding. Prior systemic cancer chemotherapy, Investigational agents and immunomodulators (cyclosporine, hematological growth factors, systemic corticosteroids, interleukins or interferons) within 90 days prior to study entry. NOTE: Subjects may be on antiretroviral agents not yet approved by the FDA as part of a clinical trial or expanded access program. Anaphylaxis or allergy to vaccine components (See section 5.1.1). Active drug or alcohol use or dependence that, in the opinion of the investigator, would interfere with adherence to study requirements. Serious illness requiring systemic treatment and/or hospitalization until subject either completes therapy or is clinically stable on therapy, in the opinion of the investigator, for at least 30 days prior to study entry. History of any AIDS-defining illness. NOTE: Subjects whose sole AIDS-defining illness is Kaposi's sarcoma limited to the skin that is not anticipated to require systemic therapy may be eligible after discussion with the protocol chair. Nadir CD4 cell count <250 cell/mm3. Changes in antiretroviral therapy for virologic failure prior to study entry. Prisoners. Part II (treatment interruption phase) Inclusion Criteria (Arm I and III only): Receipt of three vaccinations . At the completion of the first 24 weeks of the study, potential eligible subjects for Part II will be unblinded, as to the receipt of active vaccine. NOTE: Subjects in Arm II and IV (vaccine placebo recipients) participation in the study will end with Part I. Willingness to interrupt potent antiretroviral therapy for 12 weeks. CD4 cell count > 500 cells/mm3 within 14 days prior to antiretroviral treatment interruption. Part II Exclusion Criteria: Confirmed viral flare, defined as two consecutive plasma HIV-1 RNA >5,000 copies/ml, during the immunization phase (Part I). Development of any condition during the immunization phase that in the opinion of the investigator would place the subject at an increased risk for HIV viral rebound.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Margaret Fischl, MD
Organizational Affiliation
University of Miami
Official's Role
Study Director
Facility Information:
Facility Name
University of Miami School of Medicine, AIDS Clinical Research unit
City
Miami
State/Province
Florida
ZIP/Postal Code
33136
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
32387010
Citation
Pallikkuth S, Bolivar H, Fletcher MA, Babic DZ, De Armas LR, Gupta S, Termini JM, Arheart KL, Stevenson M, Tung FY, Fischl MA, Pahwa S, Stone GW. A therapeutic HIV-1 vaccine reduces markers of systemic immune activation and latent infection in patients under highly active antiretroviral therapy. Vaccine. 2020 Jun 2;38(27):4336-4345. doi: 10.1016/j.vaccine.2020.04.015. Epub 2020 May 6.
Results Reference
derived
PubMed Identifier
27002500
Citation
Tung FY, Tung JK, Pallikkuth S, Pahwa S, Fischl MA. A therapeutic HIV-1 vaccine enhances anti-HIV-1 immune responses in patients under highly active antiretroviral therapy. Vaccine. 2016 Apr 27;34(19):2225-32. doi: 10.1016/j.vaccine.2016.03.021. Epub 2016 Mar 19.
Results Reference
derived

Learn more about this trial

Safety and Immunogenicity of HIVAX in HIV-1 Infected Subjects

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