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Pilot Peg-Interferon-a2b in Decreasing Viral DNA in HIV

Primary Purpose

HIV-1 Infection

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Pegylated Interferon alpha 2b
Sponsored by
The Wistar Institute
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for HIV-1 Infection focused on measuring HIV-1, Interferon alpha, Integrated DNA, Latent reservoir

Eligibility Criteria

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

Inclusion Criteria:

  • 18-65 years of age
  • Body weight between 125 and 299 lbs
  • Confirmed diagnosis of HIV-1 infection by western blot or by a documented HIV-1 viral load
  • Currently receiving ART and on ART for > 1 year
  • VL < 50 copies/ml for ≥ 1 year, with at least 2 measurements in the previous year, 1 viral "blip" with VL< 400 copies/ml allowed
  • HIV viral load of <50 copies/ml at screening.
  • CD4 >450 cells/µL at screening.
  • A negative ECG if >45yrs men/>55yrs women years of age or if below these years of age but with two added risk factors for coronary artery disease [smoking, hypertension (BP >140/90 or on antihypertensive medications), low HDL (<40 mg/dL), family history of premature CHD (<55 yrs males/<65 females)] or a Framingham score > 15% (men) or 10% (women))

Exclusion Criteria:

  • Confirmed clinical history of developing resistance to ART regimens that resulted in treatment changes
  • Receiving didanosine as part of the participant's ART regimen at the time of screening
  • Ongoing treatment with Isoniazide, pyrazinamide, Rifabutin, Rifampicin, Diadenosine Ganciclovir, Valgancyclovir, Oxymetholone, Thalidomide or Theophylline.
  • Use of any investigational drug within 30 days prior to screening
  • History or current use of immunomodulatory therapy for over 2 weeks during the 6 months prior to enrollment, including, but not limited to: IFN-alpha or gamma (recombinant or pegylated), systemic corticosteroids (nasal or pulmonary steroids will be allowed; systemic cancer chemotherapy/irradiation; cyclosporin; tacrolimus (FK-506); OKT-3; any Interleukin, including IL-2; cyclophosphamide; methotrexate; IVIG (gamma globulin); G/M-CSF; hydroxyurea; thalidomide; pentoxifylline; thymopentin; thymosin; dithiocarbonate; polyribonucleotide.
  • History of adverse or allergic reactions to any type-1 interferon (e.g. IFN-alpha2a, IFN-α2b, IFN-beta)
  • History of severe depression, or ongoing moderate depression determined by PHQ-9 at screening
  • Type I diabetes mellitus, or type II diabetes mellitus that is not controlled with oral agents and/or insulin.
  • Prior diagnosis of multiple sclerosis or other neurodegenerative disorders
  • Significant co-existing lab abnormalities including:

    1. Anemia (Hgb <9.1 mg/dl men, <8.9 mg/dl women)
    2. WBC <2000 cells/µl
    3. Absolute neutrophil count (ANC) <1200 cells/ µl
    4. Platelet count <60,000 cells/ µl
    5. Liver disease (AST/ALT > 2.5x, Total Bilirubin > 1.5x upper limits of norm (ULN), or Total Bilirubin >3x ULN if receiving indinavir OR Atazanavir)
    6. Renal disease (creatinine > 2x upper normal limits or creatinine clearance <60mg/dl (by Crockoff-Gault)
  • Chronic HCV infection (HCV viremia), or HBV Ag positive and/ or HBV viremia (Notice: subjects with prior HCV infection with a documented sustained virologic response with treatment finishing >1 year prior to screening are eligible for enrollment).
  • Liver cirrhosis or hepatic decompensation with Child Pugh score > 6
  • History of major organ transplantation with an existing functional graft.
  • Evidence of OI or other active infectious diseases or active malignancies
  • Active Autoimmune diseases, including autoimmune hepatitis
  • History of retinopathy or clinically significant ophthalmologic disease on eye exam performed within 6 months prior to initiation of IFN
  • Pregnancy, actively attempting to become pregnant, or breastfeeding
  • Body weight under 125 lbs or over 300 lbs
  • Other conditions, such as active drug/alcohol abuse or dependence which would interfere with study compliance

Sites / Locations

  • AIDS Clinical Trials Unit (ACTU), and Department of Medicine, University of Pennsylvania Perelman School of Medicine
  • Presbyterian Hospital, Department of Medicine, University of Pennsylvania Perelman School of Medicine
  • Jonathan Lax Clinic, Philadelphia FIGHT

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Interferon alpha

Arm Description

pegylated Interferon alpha 2b (Pegintron) 1 µg/kg per week, 20 weeks

Outcomes

Primary Outcome Measures

Change From Baseline in Copies of HIV DNA Per CD4+ T Cell at Week 24
Difference in copies of HIV DNA per CD4+ T cell between baseline and week 24, assessed by Alu-HIVgag polymerase chain reaction

Secondary Outcome Measures

Full Information

First Posted
August 27, 2013
Last Updated
July 5, 2023
Sponsor
The Wistar Institute
Collaborators
University of Pennsylvania, Merck Sharp & Dohme LLC
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1. Study Identification

Unique Protocol Identification Number
NCT01935089
Brief Title
Pilot Peg-Interferon-a2b in Decreasing Viral DNA in HIV
Official Title
Pilot Study: Single Arm, Multi-site, Open-label Study to Assess the Effectiveness of Peg-IFN-a2b in Decreasing the Levels of Cell-associated Integrated Viral DNA in HIV Chronic Infection
Study Type
Interventional

2. Study Status

Record Verification Date
July 2023
Overall Recruitment Status
Completed
Study Start Date
August 7, 2013 (undefined)
Primary Completion Date
March 25, 2015 (Actual)
Study Completion Date
May 2, 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
The Wistar Institute
Collaborators
University of Pennsylvania, Merck Sharp & Dohme LLC

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
We propose to test our primary hypothesis that treatment with Peg-IFN-α-2b will result in a decrease in integrated HIV DNA in peripheral blood and tissue in chronically HIV-infected immune-reconstituted individuals (see section 3.1) in a prospective, interventional, 1-arm, open label clinical trial. To this end, we propose to enroll 25 HIV-1-infected subjects (please refer to power calculations in section 10.1 below) currently stably suppressed (> 1y with VL < 50 copies/ml) on ART and with CD4 count > 450 cells/µl. We hypothesize that 20 weeks of treatment with Peg-IFN-alpha-2b, in the presence of HIV reactivation (i.e.: ART interruption), will result in activation of intrinsic and/or immune-mediated anti-HIV mechanisms resulting in a decrease in the levels of viral reservoir in chronically HIV-infected, immune-reconstituted individuals.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HIV-1 Infection
Keywords
HIV-1, Interferon alpha, Integrated DNA, Latent reservoir

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
20 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Interferon alpha
Arm Type
Experimental
Arm Description
pegylated Interferon alpha 2b (Pegintron) 1 µg/kg per week, 20 weeks
Intervention Type
Drug
Intervention Name(s)
Pegylated Interferon alpha 2b
Other Intervention Name(s)
Pegintron
Intervention Description
1µg/kg/week
Primary Outcome Measure Information:
Title
Change From Baseline in Copies of HIV DNA Per CD4+ T Cell at Week 24
Description
Difference in copies of HIV DNA per CD4+ T cell between baseline and week 24, assessed by Alu-HIVgag polymerase chain reaction
Time Frame
Week 3 and 24

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: 18-65 years of age Body weight between 125 and 299 lbs Confirmed diagnosis of HIV-1 infection by western blot or by a documented HIV-1 viral load Currently receiving ART and on ART for > 1 year VL < 50 copies/ml for ≥ 1 year, with at least 2 measurements in the previous year, 1 viral "blip" with VL< 400 copies/ml allowed HIV viral load of <50 copies/ml at screening. CD4 >450 cells/µL at screening. A negative ECG if >45yrs men/>55yrs women years of age or if below these years of age but with two added risk factors for coronary artery disease [smoking, hypertension (BP >140/90 or on antihypertensive medications), low HDL (<40 mg/dL), family history of premature CHD (<55 yrs males/<65 females)] or a Framingham score > 15% (men) or 10% (women)) Exclusion Criteria: Confirmed clinical history of developing resistance to ART regimens that resulted in treatment changes Receiving didanosine as part of the participant's ART regimen at the time of screening Ongoing treatment with Isoniazide, pyrazinamide, Rifabutin, Rifampicin, Diadenosine Ganciclovir, Valgancyclovir, Oxymetholone, Thalidomide or Theophylline. Use of any investigational drug within 30 days prior to screening History or current use of immunomodulatory therapy for over 2 weeks during the 6 months prior to enrollment, including, but not limited to: IFN-alpha or gamma (recombinant or pegylated), systemic corticosteroids (nasal or pulmonary steroids will be allowed; systemic cancer chemotherapy/irradiation; cyclosporin; tacrolimus (FK-506); OKT-3; any Interleukin, including IL-2; cyclophosphamide; methotrexate; IVIG (gamma globulin); G/M-CSF; hydroxyurea; thalidomide; pentoxifylline; thymopentin; thymosin; dithiocarbonate; polyribonucleotide. History of adverse or allergic reactions to any type-1 interferon (e.g. IFN-alpha2a, IFN-α2b, IFN-beta) History of severe depression, or ongoing moderate depression determined by PHQ-9 at screening Type I diabetes mellitus, or type II diabetes mellitus that is not controlled with oral agents and/or insulin. Prior diagnosis of multiple sclerosis or other neurodegenerative disorders Significant co-existing lab abnormalities including: Anemia (Hgb <9.1 mg/dl men, <8.9 mg/dl women) WBC <2000 cells/µl Absolute neutrophil count (ANC) <1200 cells/ µl Platelet count <60,000 cells/ µl Liver disease (AST/ALT > 2.5x, Total Bilirubin > 1.5x upper limits of norm (ULN), or Total Bilirubin >3x ULN if receiving indinavir OR Atazanavir) Renal disease (creatinine > 2x upper normal limits or creatinine clearance <60mg/dl (by Crockoff-Gault) Chronic HCV infection (HCV viremia), or HBV Ag positive and/ or HBV viremia (Notice: subjects with prior HCV infection with a documented sustained virologic response with treatment finishing >1 year prior to screening are eligible for enrollment). Liver cirrhosis or hepatic decompensation with Child Pugh score > 6 History of major organ transplantation with an existing functional graft. Evidence of OI or other active infectious diseases or active malignancies Active Autoimmune diseases, including autoimmune hepatitis History of retinopathy or clinically significant ophthalmologic disease on eye exam performed within 6 months prior to initiation of IFN Pregnancy, actively attempting to become pregnant, or breastfeeding Body weight under 125 lbs or over 300 lbs Other conditions, such as active drug/alcohol abuse or dependence which would interfere with study compliance
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Luis J Montaner, DPhil
Organizational Affiliation
University of Pennsylvania
Official's Role
Principal Investigator
Facility Information:
Facility Name
AIDS Clinical Trials Unit (ACTU), and Department of Medicine, University of Pennsylvania Perelman School of Medicine
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
Facility Name
Presbyterian Hospital, Department of Medicine, University of Pennsylvania Perelman School of Medicine
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
Facility Name
Jonathan Lax Clinic, Philadelphia FIGHT
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19107
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
34049356
Citation
Papasavvas E, Azzoni L, Ross BN, Fair M, Howell BJ, Hazuda DJ, Mounzer K, Kostman JR, Tebas P, Montaner LJ. Comparable HIV suppression by pegylated-IFN-alpha2a or pegylated-IFN-alpha2b during a 4-week analytical treatment interruption. AIDS. 2021 Oct 1;35(12):2051-2054. doi: 10.1097/QAD.0000000000002961.
Results Reference
derived
PubMed Identifier
33323024
Citation
Papasavvas E, Azzoni L, Pagliuzza A, Abdel-Mohsen M, Ross BN, Fair M, Howell BJ, Hazuda DJ, Chomont N, Li Q, Mounzer K, Kostman JR, Tebas P, Montaner LJ. Safety, Immune, and Antiviral Effects of Pegylated Interferon Alpha 2b Administration in Antiretroviral Therapy-Suppressed Individuals: Results of Pilot Clinical Trial. AIDS Res Hum Retroviruses. 2021 Jun;37(6):433-443. doi: 10.1089/AID.2020.0243. Epub 2021 Jan 29.
Results Reference
derived

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Pilot Peg-Interferon-a2b in Decreasing Viral DNA in HIV

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