Vaginal Antibody Safety Trial: Safety Study of Monoclonal Antibodies to Reduce the Vaginal Transmission of Herpes Simplex Virus (HSV) and Human Immunodeficiency Virus (HIV) (VAST)
HIV, Herpes Simplex Infections
About this trial
This is an interventional treatment trial for HIV
Eligibility Criteria
Inclusion Criteria:
- Age 18 through 45 years (inclusive) at screening
- Able and willing to provide written informed consent to be screened for and enrolled in the study
- Able and willing to provide adequate locator information at screening
- HIV-uninfected based on testing performed by study staff at
- In general good health as determined by the site clinician
- Agree to abstain from any vaginal insertions, including products, douches, devices such as sex toys, or penile or oral intercourse from 5 days prior to Visit 2 (Enrollment Visit) until the final Study Visit (one week after last dose of study film). Only tampons during menses and clinically indicated speculum exams are allowed.
- Agree to use condoms provided by the study staff from one week after last use of study film until three weeks after last use of study film
- Willingness to undergo all study-related assessments and follow all study-related procedures
- Be currently using an effective method of contraception at enrollment (used continuously and with good compliance for the past 60 days as determined by participant self-report) with plans to continue use throughout the study period. Acceptable methods include any hormonal method (except vaginal ring); intrauterine device (IUD) inserted at least 90 days prior to enrollment; female sterilization; abstinent from sexual activity with male partner for the past 60 days; sexual activity with vasectomized partner; engages in sex exclusively with women.
- For participants 21 and older, a Pap result in the 36 calendar months prior to the Enrollment Visit consistent with Grade 0 according to the Female Genital Grading Table for Use in Microbicide Studies Addendum 1 to the DAIDS Table for Grading Adult and Pediatric Adverse Events satisfactory evaluation with no treatment required of non-Grade 0 Pap result per American Society for Colposcopy and Cervical Pathology (ASCCP) guidelines or per local standard of care, within the last 36 calendar months prior to enrollment. Note: For participants aged 18-21, a Grade-0 or adequately evaluated abnormal Pap smear is not required as the American Society for Colposcopy and Cervical Pathology recommends initiating screening at age 21.
- At screening and enrollment, agrees not to participate in other research studies involving drugs, medical devices, or vaginal products while enrolled in this trial -
Exclusion Criteria:
- Menopausal at screening (as defined as amenorrhea or irregular periods for one year or more without an alternative etiology)
- Hysterectomy
- Known adverse reaction to any of the study products (ever)
- Known adverse reaction to latex (ever)
- Non-therapeutic injection drug use in the 12 months prior to screening
- Surgical procedure involving the pelvis in the 90 days prior to screening (includes dilation and curettage or evacuation, and cryosurgery; does not include cervical biopsy for evaluation of an abnormal pap smear or IUD placement)
- Participation in a drug, spermicide and/or microbicide study in the 30 days prior to screening or anticipated participation in an investigational drug study in the next 8 weeks
- Pregnancy within 90 days prior to screening
- Lactating
- Use of a diaphragm, NuvaRing®, or spermicide for contraception
- As determined by the PI, a degree of menstrual cycle irregularity that would make it difficult to schedule follow up visits without interruption by menses
- Active sexually transmitted infection or documented treatment of sexually transmitted infections in the last 6 months, including, but not limited to: chlamydia, gonorrhea, syphilis, trichomonas, cervicitis or pelvic inflammatory disease, or currently active HSV lesions or other sores. (Participants seropositive for or with a history of HSV without current active lesions will not be excluded.)
- Women who by history engage in condom-less intercourse with HIV-infected partners, or who exchange sex for money, shelter, or gifts, or who in the opinion of the investigators, may be at risk for HIV acquisition during the duration of the study
- More than one sex partner within the past 3 months
- Current sexual partner known by participant to be HIV seropositive
- Current or planned use of pre-exposure prophylaxis against HIV infection
- Currently active genital HSV lesions, or other genital tract epithelial disruption or inflammation
- Current or episodic use of anti-herpes suppressive therapy
- Urinary tract infection, symptomatic candidiasis, or symptomatic bacterial vaginosis within 14 days of enrollment, or currently residual symptoms thereof Note: women with these infections at screening can be enrolled after treatment and resolution of the infection.
- Antibiotic or antifungal therapy (vaginal or systemic) within 7 days of enrollment
- Use of systemic immunomodulatory medications within 4 weeks of enrollment
Menses or other vaginal bleeding at the time of enrollment* or expecting menses in the 10 days after enrollment (Segment A participants) or 16 days after enrollment (for Segment B participants)
*Note: for women with monthly cycles, every attempt will be made to enroll these participants in the first half of their menstrual cycle. Women who have vaginal bleeding at the scheduled Enrollment Visit may return at a different date to be re-examined and possibly enrolled provided they are still within the screening window and meet all criteria.
- Lack of stable living conditions to allow reliable room temperature storage of study product (Segment B participants only)
At enrollment has any of the following laboratory abnormalities per the Division of AIDS (DAIDS) Table for Grading the Severity of Adult and Pediatric Adverse Events, Version 2.0, Nov 2014:
- Grade 1 or higher AST (aspartate aminotransferase) or ALT (alanine aminotransferase)
- Grade 1 or higher creatinine
- Grade 2 or higher hemoglobin
- Grade 1 or higher platelets Note: otherwise eligible participants with an exclusionary test may be re-tested once during the screening process.
- As determined by the Principal Investigator (PI), any subject who has any significant uncontrolled active or chronic cardiovascular, renal, liver, hematologic, neurologic, gastrointestinal, psychiatric, endocrine, respiratory, immunologic disorder or infectious disease, anticoagulation with warfarin or heparin; or any other condition that, in the opinion of the Investigator, would preclude provision of consent, make participation in the study unsafe, complicate interpretation of study outcome data, or otherwise interfere with achieving the study objectives.
Sites / Locations
- The Miriam Hospital
Arms of the Study
Arm 1
Arm 2
Arm 3
Experimental
Placebo Comparator
Experimental
Segment A: Single MB66 Administration
Segment B: Repeated Administrations Placebo Film
Segment B: Repeated Administrations MB66
10 mg of HSV8-N and 10 mg of VRC01-N monoclonal antibodies per MB66 film
The placebo film is composed of the identical excipients as MB66 without the monoclonal antibodies.
10 mg of HSV8-N and 10 mg of VRC01-N monoclonal antibodies per MB66 film