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Study of Boosting Strategies After Vaccination With ALVAC-HIV and AIDSVAX® B/E

Primary Purpose

HIV Infections

Status
Unknown status
Phase
Phase 2
Locations
Thailand
Study Type
Interventional
Intervention
ALVAC-HIV
AIDSVAX B/E
ALVAC-HIV Placebo
AIDSVAX B/E Placebo
Sponsored by
U.S. Army Medical Research and Development Command
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional basic science trial for HIV Infections

Eligibility Criteria

20 Years - 40 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  1. Healthy, HIV-uninfected male and female volunteers between age 20 and 40, weighing over 45 kilograms, and available for a period of 24 months and having a Thai identity card.
  2. Must be at low risk for HIV infection per investigator assessment.
  3. Must be able to understand and complete the informed consent process.
  4. Must be capable of reading Thai.
  5. Must successfully complete a Test of Understanding prior to enrollment.
  6. Must be in good general health without clinically significant medical history.
  7. HIV-uninfected per diagnostic algorithm within 45 days of enrollment.
  8. Laboratory screening analysis:

    • Hemoglobin: Women ≥12.0 g/dL, Men ≥12.5 g/dL
    • White cell count: 4,000 to 11,000 cells/mm^3
    • Platelets: 150,000 to 450,000/mm^3
    • ALT and AST ≤1.25 institutional upper limit of reference range
    • Creatinine: ≤1.25 institutional upper limit of reference range
    • Urinalysis (dipstick) for blood and protein no greater than 1+ and negative glucose.
  9. Female-Specific Criteria:

    • Negative pregnancy test for women at screening and prior to each vaccination(same day)and prior to any of the invasive procedures.
    • Be using adequate birth control methods for 45 days prior to the first vaccine/placebo vaccination and for at least 3 months after the final vaccine/placebo vaccination. Adequate birth control is defined as follows: Contraceptive medications delivered orally, intramuscularly, vaginally, or implanted, underneath the skin, surgical methods (hysterectomy or bilateral tubal ligation), condoms, diaphragms, intrauterine device (IUD), or abstinence.

Exclusion Criteria:

  1. Asplenia: any condition resulting in the absence of a functional spleen.
  2. Bleeding disorder diagnosed by a medical doctor (e.g., factor deficiency, coagulopathy, or platelet disorder requiring special precautions).
  3. Therapeutic anticoagulation resulting in an abnormal prothrombin (PT) / international normalized ration (INR) of partial prothrombin time (PTT).
  4. Women breast-feeding or pregnant (positive pregnancy test) or planning to become pregnant during the window between study enrollment and 3 months after the last vaccination visit.
  5. History of anaphylaxis or other serious adverse reaction to vaccines or allergies or reactions likely to be exacerbated by any component of the vaccine or placebo, including eggs, egg products, streptomycin, or neomycin.
  6. Subject has received any of the following substances:

    • Chronic use of therapies that may modify immune response, such as IV immuneglobulin and systemic corticosteroids (in doses of > 20 mg/day prednisone equivalent for periods exceeding 10 days). The following exceptions are permitted and will not exclude study participation: use of corticosteroid nasal spray for rhinitis, topical corticosteroids for an acute uncomplicated dermatitis; or a short course (duration of 10 days or less, or a single injection) of corticosteroid for a non-chronic condition (based on investigator clinical judgment) at least 2 weeks prior to enrollment in this study.
    • Blood products within 120 days prior to HIV screening.
    • Immunoglobulins within 30 days prior to HIV screening.
    • Any licensed vaccine within 14 days prior to initial study vaccine administration in the present study.
    • Receipt of any investigational HIV vaccine.
    • Investigational research agents or vaccine within 30 days prior to enrollment in the present study.
    • Anti-tuberculosis prophylaxis or therapy during the past 90 days prior to enrollment.
  7. Active sexually transmitted infection confirmed by clinical exam and diagnostic test.
  8. Any medical, psychiatric, social condition, occupational reason, or other responsibility that, in the judgment of the investigator, is a contradiction to protocol compliance or impairs a subject's ability to give informed consent.
  9. Psychiatric condition that precludes compliance with the protocol; past or present psychoses; past or present bipolar disorder; disorder requiring lithium; or within 5 years prior to enrollment, a history of suicide ideation or attempt.
  10. Study site employees who are involved in the protocol and/or may have direct access to study related area.

Sites / Locations

  • Royal Thai Army Clinical Research Center, AFRIMS
  • Vaccine Trial Centre, Faculty of Tropical Medicine, Mahidol University
  • Research Institute for Health Sciences (RIHES), Chiang Mai University

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm 7

Arm 8

Arm Type

Experimental

Placebo Comparator

Experimental

Placebo Comparator

Experimental

Placebo Comparator

Experimental

Placebo Comparator

Arm Label

Group Ia

Group Ib

Group IIa

Group IIb

Group IIIa

Group IIIb

Group IVa

Group IVb

Arm Description

ALVAC-HIV at Weeks 0 and 4; ALVAC-HIV + AIDSVAX B/E at Weeks 12 and 24

ALVAC-HIV Placebo at Weeks 0 and 4; ALVAC-HIV Placebo + AIDSVAX B/E Placebo at Weeks 12 and 24

ALVAC-HIV at Weeks 0 and 4; ALVAC-HIV + AIDSVAX B/E at Weeks 12, 24 and 48

ALVAC-HIV Placebo at Weeks 0 and 4; ALVAC-HIV Placebo + AIDSVAX B/E Placebo at Weeks 12, 24 and 48

ALVAC-HIV at Weeks 0 and 4; ALVAC-HIV + AIDSVAX B/E at Weeks 12 and 24; AIDSVAX B/E at Week 48

ALVAC-HIV Placebo at Weeks 0 and 4; ALVAC-HIV Placebo + AIDSVAX B/E Placebo at Weeks 12 and 24; AIDSVAX B/E Placebo at Week 48

ALVAC-HIV at Weeks 0, 4 and 48; ALVAC-HIV + AIDSVAX B/E at Weeks 12 and 24

ALVAC-HIV Placebo at Weeks 0, 4 and 48; ALVAC-HIV Placebo + AIDSVAX B/E Placebo at Weeks 12 and 24

Outcomes

Primary Outcome Measures

Change in Immune Response
Characterization of vaccine-induced immune responses in the systemic and mucosal compartments by intracellular cytokine staining (ICS) and IFN-gamma ELISPOT at Baseline, Weeks 4, 12, 14, 24, 26, 36, 48, 50, 72 and 96.
Change in Humoral Immune Response
Characterization of vaccine-induced humoral immune response in the systemic and mucosal compartments by binding and neutralizing antibodies at Baseline, Weeks 4, 12, 14, 24, 26, 36, 48, 50, 72 and 96.

Secondary Outcome Measures

Safety Monitoring
Post-vaccination reactions including erythema, induration, pain/tenderness, swelling and limitation of arm movement, fever, tiredness, chills, myalgia, arthralgia, headache, nausea, dizziness, and rash will be assessed and recorded on diary cards during the 3 days post-vaccination.

Full Information

First Posted
August 12, 2013
Last Updated
March 25, 2021
Sponsor
U.S. Army Medical Research and Development Command
Collaborators
National Institute of Allergy and Infectious Diseases (NIAID)
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1. Study Identification

Unique Protocol Identification Number
NCT01931358
Brief Title
Study of Boosting Strategies After Vaccination With ALVAC-HIV and AIDSVAX® B/E
Official Title
Randomized, Double Blind Evaluation of Different One-Year Boosts After Sanofi Pasteur Live Recombinant ALVAC-HIV (vCP1521) and Global Solutions for Infectious Diseases (GSID) gp120 B/E (AIDSVAX® B/E) Prime-Boost Regimen in HIV-uninfected Thai Adults
Study Type
Interventional

2. Study Status

Record Verification Date
March 2021
Overall Recruitment Status
Unknown status
Study Start Date
September 24, 2013 (Actual)
Primary Completion Date
December 2021 (Anticipated)
Study Completion Date
December 2021 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
U.S. Army Medical Research and Development Command
Collaborators
National Institute of Allergy and Infectious Diseases (NIAID)

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The primary purpose of the study is to better define the relative contributions of AIDSVAX® B/E alone, ALVAC-HIV alone, or ALVAC-HIV plus AIDSVAX® B/E combination to the observed immune profile in the weeks and months after receiving the original prime and boost vaccine regimen from study protocol RV 144, and their booster effects in both the systemic and mucosal compartments. In addition, this study will provide more intensive and comprehensive characterization of the innate, cell-mediated and humoral immune responses than possible within the RV 144 study.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HIV Infections

7. Study Design

Primary Purpose
Basic Science
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
360 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Group Ia
Arm Type
Experimental
Arm Description
ALVAC-HIV at Weeks 0 and 4; ALVAC-HIV + AIDSVAX B/E at Weeks 12 and 24
Arm Title
Group Ib
Arm Type
Placebo Comparator
Arm Description
ALVAC-HIV Placebo at Weeks 0 and 4; ALVAC-HIV Placebo + AIDSVAX B/E Placebo at Weeks 12 and 24
Arm Title
Group IIa
Arm Type
Experimental
Arm Description
ALVAC-HIV at Weeks 0 and 4; ALVAC-HIV + AIDSVAX B/E at Weeks 12, 24 and 48
Arm Title
Group IIb
Arm Type
Placebo Comparator
Arm Description
ALVAC-HIV Placebo at Weeks 0 and 4; ALVAC-HIV Placebo + AIDSVAX B/E Placebo at Weeks 12, 24 and 48
Arm Title
Group IIIa
Arm Type
Experimental
Arm Description
ALVAC-HIV at Weeks 0 and 4; ALVAC-HIV + AIDSVAX B/E at Weeks 12 and 24; AIDSVAX B/E at Week 48
Arm Title
Group IIIb
Arm Type
Placebo Comparator
Arm Description
ALVAC-HIV Placebo at Weeks 0 and 4; ALVAC-HIV Placebo + AIDSVAX B/E Placebo at Weeks 12 and 24; AIDSVAX B/E Placebo at Week 48
Arm Title
Group IVa
Arm Type
Experimental
Arm Description
ALVAC-HIV at Weeks 0, 4 and 48; ALVAC-HIV + AIDSVAX B/E at Weeks 12 and 24
Arm Title
Group IVb
Arm Type
Placebo Comparator
Arm Description
ALVAC-HIV Placebo at Weeks 0, 4 and 48; ALVAC-HIV Placebo + AIDSVAX B/E Placebo at Weeks 12 and 24
Intervention Type
Biological
Intervention Name(s)
ALVAC-HIV
Intervention Description
1 mL intramuscular injection containing 10^6 CCID50/dose
Intervention Type
Biological
Intervention Name(s)
AIDSVAX B/E
Intervention Description
1 mL per injection (300 ug dose/antigen for a total of 600ug/dose administered)
Intervention Type
Biological
Intervention Name(s)
ALVAC-HIV Placebo
Intervention Description
1 mL per injection
Intervention Type
Biological
Intervention Name(s)
AIDSVAX B/E Placebo
Intervention Description
1 mL per injection
Primary Outcome Measure Information:
Title
Change in Immune Response
Description
Characterization of vaccine-induced immune responses in the systemic and mucosal compartments by intracellular cytokine staining (ICS) and IFN-gamma ELISPOT at Baseline, Weeks 4, 12, 14, 24, 26, 36, 48, 50, 72 and 96.
Time Frame
Through Week 96
Title
Change in Humoral Immune Response
Description
Characterization of vaccine-induced humoral immune response in the systemic and mucosal compartments by binding and neutralizing antibodies at Baseline, Weeks 4, 12, 14, 24, 26, 36, 48, 50, 72 and 96.
Time Frame
Through Week 96
Secondary Outcome Measure Information:
Title
Safety Monitoring
Description
Post-vaccination reactions including erythema, induration, pain/tenderness, swelling and limitation of arm movement, fever, tiredness, chills, myalgia, arthralgia, headache, nausea, dizziness, and rash will be assessed and recorded on diary cards during the 3 days post-vaccination.
Time Frame
Through Week 48

10. Eligibility

Sex
All
Minimum Age & Unit of Time
20 Years
Maximum Age & Unit of Time
40 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Healthy, HIV-uninfected male and female volunteers between age 20 and 40, weighing over 45 kilograms, and available for a period of 24 months and having a Thai identity card. Must be at low risk for HIV infection per investigator assessment. Must be able to understand and complete the informed consent process. Must be capable of reading Thai. Must successfully complete a Test of Understanding prior to enrollment. Must be in good general health without clinically significant medical history. HIV-uninfected per diagnostic algorithm within 45 days of enrollment. Laboratory screening analysis: Hemoglobin: Women ≥12.0 g/dL, Men ≥12.5 g/dL White cell count: 4,000 to 11,000 cells/mm^3 Platelets: 150,000 to 450,000/mm^3 ALT and AST ≤1.25 institutional upper limit of reference range Creatinine: ≤1.25 institutional upper limit of reference range Urinalysis (dipstick) for blood and protein no greater than 1+ and negative glucose. Female-Specific Criteria: Negative pregnancy test for women at screening and prior to each vaccination(same day)and prior to any of the invasive procedures. Be using adequate birth control methods for 45 days prior to the first vaccine/placebo vaccination and for at least 3 months after the final vaccine/placebo vaccination. Adequate birth control is defined as follows: Contraceptive medications delivered orally, intramuscularly, vaginally, or implanted, underneath the skin, surgical methods (hysterectomy or bilateral tubal ligation), condoms, diaphragms, intrauterine device (IUD), or abstinence. Exclusion Criteria: Asplenia: any condition resulting in the absence of a functional spleen. Bleeding disorder diagnosed by a medical doctor (e.g., factor deficiency, coagulopathy, or platelet disorder requiring special precautions). Therapeutic anticoagulation resulting in an abnormal prothrombin (PT) / international normalized ration (INR) of partial prothrombin time (PTT). Women breast-feeding or pregnant (positive pregnancy test) or planning to become pregnant during the window between study enrollment and 3 months after the last vaccination visit. History of anaphylaxis or other serious adverse reaction to vaccines or allergies or reactions likely to be exacerbated by any component of the vaccine or placebo, including eggs, egg products, streptomycin, or neomycin. Subject has received any of the following substances: Chronic use of therapies that may modify immune response, such as IV immuneglobulin and systemic corticosteroids (in doses of > 20 mg/day prednisone equivalent for periods exceeding 10 days). The following exceptions are permitted and will not exclude study participation: use of corticosteroid nasal spray for rhinitis, topical corticosteroids for an acute uncomplicated dermatitis; or a short course (duration of 10 days or less, or a single injection) of corticosteroid for a non-chronic condition (based on investigator clinical judgment) at least 2 weeks prior to enrollment in this study. Blood products within 120 days prior to HIV screening. Immunoglobulins within 30 days prior to HIV screening. Any licensed vaccine within 14 days prior to initial study vaccine administration in the present study. Receipt of any investigational HIV vaccine. Investigational research agents or vaccine within 30 days prior to enrollment in the present study. Anti-tuberculosis prophylaxis or therapy during the past 90 days prior to enrollment. Active sexually transmitted infection confirmed by clinical exam and diagnostic test. Any medical, psychiatric, social condition, occupational reason, or other responsibility that, in the judgment of the investigator, is a contradiction to protocol compliance or impairs a subject's ability to give informed consent. Psychiatric condition that precludes compliance with the protocol; past or present psychoses; past or present bipolar disorder; disorder requiring lithium; or within 5 years prior to enrollment, a history of suicide ideation or attempt. Study site employees who are involved in the protocol and/or may have direct access to study related area.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Punnee Pitisuttithum, MD, DTM&H
Organizational Affiliation
Mahidol University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Royal Thai Army Clinical Research Center, AFRIMS
City
Bangkok
ZIP/Postal Code
10400
Country
Thailand
Facility Name
Vaccine Trial Centre, Faculty of Tropical Medicine, Mahidol University
City
Bangkok
ZIP/Postal Code
10400
Country
Thailand
Facility Name
Research Institute for Health Sciences (RIHES), Chiang Mai University
City
Chiang Mai
ZIP/Postal Code
50202
Country
Thailand

12. IPD Sharing Statement

Citations:
PubMed Identifier
19843557
Citation
Rerks-Ngarm S, Pitisuttithum P, Nitayaphan S, Kaewkungwal J, Chiu J, Paris R, Premsri N, Namwat C, de Souza M, Adams E, Benenson M, Gurunathan S, Tartaglia J, McNeil JG, Francis DP, Stablein D, Birx DL, Chunsuttiwat S, Khamboonruang C, Thongcharoen P, Robb ML, Michael NL, Kunasol P, Kim JH; MOPH-TAVEG Investigators. Vaccination with ALVAC and AIDSVAX to prevent HIV-1 infection in Thailand. N Engl J Med. 2009 Dec 3;361(23):2209-20. doi: 10.1056/NEJMoa0908492. Epub 2009 Oct 20.
Results Reference
background
PubMed Identifier
22837492
Citation
Rerks-Ngarm S, Paris RM, Chunsutthiwat S, Premsri N, Namwat C, Bowonwatanuwong C, Li SS, Kaewkungkal J, Trichavaroj R, Churikanont N, de Souza MS, Andrews C, Francis D, Adams E, Flores J, Gurunathan S, Tartaglia J, O'Connell RJ, Eamsila C, Nitayaphan S, Ngauy V, Thongcharoen P, Kunasol P, Michael NL, Robb ML, Gilbert PB, Kim JH. Extended evaluation of the virologic, immunologic, and clinical course of volunteers who acquired HIV-1 infection in a phase III vaccine trial of ALVAC-HIV and AIDSVAX B/E. J Infect Dis. 2013 Apr 15;207(8):1195-205. doi: 10.1093/infdis/jis478. Epub 2012 Jul 26.
Results Reference
background
PubMed Identifier
32035516
Citation
Pitisuttithum P, Nitayaphan S, Chariyalertsak S, Kaewkungwal J, Dawson P, Dhitavat J, Phonrat B, Akapirat S, Karasavvas N, Wieczorek L, Polonis V, Eller MA, Pegu P, Kim D, Schuetz A, Jongrakthaitae S, Zhou Y, Sinangil F, Phogat S, Diazgranados CA, Tartaglia J, Heger E, Smith K, Michael NL, Excler JL, Robb ML, Kim JH, O'Connell RJ, Vasan S; RV306 study group. Late boosting of the RV144 regimen with AIDSVAX B/E and ALVAC-HIV in HIV-uninfected Thai volunteers: a double-blind, randomised controlled trial. Lancet HIV. 2020 Apr;7(4):e238-e248. doi: 10.1016/S2352-3018(19)30406-0. Epub 2020 Feb 6.
Results Reference
derived

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Study of Boosting Strategies After Vaccination With ALVAC-HIV and AIDSVAX® B/E

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