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Establishing a Controlled Human Hookworm Infection Model at Leiden University Medical Center (CHHIL)

Primary Purpose

Necator Americanus Infection

Status
Completed
Phase
Not Applicable
Locations
Netherlands
Study Type
Interventional
Intervention
Necator americanus L3 larvae
Sponsored by
Leiden University Medical Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional other trial for Necator Americanus Infection focused on measuring hookworm, controlled human infection model

Eligibility Criteria

18 Years - 45 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

In order to be eligible to participate in this study, a subject must meet all of the following criteria:

  1. Subject is aged ≥ 18 and ≤ 45 years.
  2. Subject has adequate understanding of the procedures of the study and agrees to abide strictly thereby.
  3. Subject is able to communicate well with the investigator, is available to attend all study visits.
  4. Subjects are able to respond to phone or email within 24 hours during the first 12 weeks of the study.
  5. Subject agrees to refrain from blood donation to Sanquin or for other purposes throughout the study period.
  6. For female subjects: subject agrees to use adequate contraception and not to breastfeed for the duration of study.
  7. Subject has signed informed consent

A potential subject who meets any of the following criteria will be excluded from participation in this study:

  1. Any history, or evidence at screening, of clinically significant symptoms, physical signs or abnormal laboratory values suggestive of systemic conditions, such as cardiovascular, pulmonary, renal, hepatic, neurological, dermatological, endocrine, malignant, haematological, infectious, immune-deficient, psychiatric and other disorders, which could compromise the health of the volunteer during the study or interfere with the interpretation of the study results. These include, but are not limited to, any of the following:

    • history of severe asthma or other health conditions that may require future steroid use;
    • body weight <50 kg or Body Mass Index (BMI) <18.0 or >30.0 kg/m2 at screening;
    • positive HIV, HBV or HCV screening tests;
    • the use of immune modifying drugs within three months prior to study onset (inhaled and topical corticosteroids and oral anti-histamines exempted) or expected use of such during the study period;
    • having one of the following laboratory abnormalities: ferritine <10 ug/L, transferrine <2.04 g/L or Hb <7.5 mmol/L for females or <8.5 mmol/L for males.
    • history of malignancy of any organ system (other than localized basal cell carcinoma of the skin), treated or untreated, within the past 5 years;
    • any history of treatment for severe psychiatric disease by a psychiatrist in the past year;
    • history of drug or alcohol abuse interfering with normal social function in the period of one year prior to study onset.
  2. Known hypersensitivity to or contra-indications for use of albendazole. Including co-medication known to interact with albendazole metabolism (e.g. carbamazepine, phenobarbital, phenytoin, cimetidine, theophylline, dexamethasone).
  3. Known type 1 hypersensitivity to amphotericin B or gentamicin.
  4. For female subjects: positive urine pregnancy test at screening.
  5. Positive faecal PCR or Kato-Katz for hookworm at screening, any known history of hookworm infection or treatment for hookworm infection or possible exposure to hookworm in the past.
  6. Being an employee or student of the department of Parasitology of the LUMC.
  7. Current or past scars, tattoos, or other disruptions of skin integrity at the intended site of larval application.
  8. Subjects with planned travel to hookworm-endemic areas with a stay in non-hygienic environment during this trial.

Sites / Locations

  • Leiden University Medical Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Intervention

Arm Description

Four healthy hookworm-naive volunteers will be infected with 50 Necator americanus L3 larvae.

Outcomes

Primary Outcome Measures

Detection of hookworm eggs by faeces microscopy (Kato-Katz) at any week between week 9 to 12 post-infection.
Detection of hookworm eggs by faeces microscopy (Kato-Katz) at any week between week 9 to 12 post-infection.

Secondary Outcome Measures

Number of adverse events following single exposure to hookworm larvae
Number of adverse events following single exposure to hookworm larvae
Humoral (antibody) and cellular immunological changes after controlled human hookworm infection
Humoral (antibody) and cellular immunological changes after controlled human hookworm infection
Time to positive faeces test for hookworm as defined by Kato-Katz and qPCR
Time to positive faeces test for hookworm as defined by Kato-Katz and qPCR

Full Information

First Posted
March 29, 2017
Last Updated
December 20, 2021
Sponsor
Leiden University Medical Center
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1. Study Identification

Unique Protocol Identification Number
NCT03126552
Brief Title
Establishing a Controlled Human Hookworm Infection Model at Leiden University Medical Center
Acronym
CHHIL
Official Title
Establishing a Controlled Human Hookworm Infection Model at Leiden University Medical Center
Study Type
Interventional

2. Study Status

Record Verification Date
December 2021
Overall Recruitment Status
Completed
Study Start Date
April 1, 2017 (Actual)
Primary Completion Date
August 15, 2017 (Actual)
Study Completion Date
November 22, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Leiden University Medical Center

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
Four healthy hookworm-naive volunteers will be exposed to 50 L3 Necator americanus larvae once and will retain infection for up to 2 years.
Detailed Description
Four volunteers will be exposed to 50 Necator americanus L3 larvae. Volunteers will be followed on a weekly basis until week 12 after infection. If volunteers develop a patent infection, defined by detectable egg production in stool by microscopy at any timepoint within week 9 to 12, they will be scheduled to donate faeces on request. Two years after infection or if volunteers do not excrete eggs detectable by microscopy on week 9 to 12, volunteers will be treated with a 3-day regimen of albendazole to abrogate the infection. Retreatment with albendazole will be given to volunteers who remain positive for hookworm after treatment. Six months after the treatment, volunteers will undergo their last visit.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Necator Americanus Infection
Keywords
hookworm, controlled human infection model

7. Study Design

Primary Purpose
Other
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
4 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Intervention
Arm Type
Experimental
Arm Description
Four healthy hookworm-naive volunteers will be infected with 50 Necator americanus L3 larvae.
Intervention Type
Biological
Intervention Name(s)
Necator americanus L3 larvae
Intervention Description
50 Necator americanus L3 larvae
Primary Outcome Measure Information:
Title
Detection of hookworm eggs by faeces microscopy (Kato-Katz) at any week between week 9 to 12 post-infection.
Description
Detection of hookworm eggs by faeces microscopy (Kato-Katz) at any week between week 9 to 12 post-infection.
Time Frame
12 weeks
Secondary Outcome Measure Information:
Title
Number of adverse events following single exposure to hookworm larvae
Description
Number of adverse events following single exposure to hookworm larvae
Time Frame
2 years
Title
Humoral (antibody) and cellular immunological changes after controlled human hookworm infection
Description
Humoral (antibody) and cellular immunological changes after controlled human hookworm infection
Time Frame
2 years
Title
Time to positive faeces test for hookworm as defined by Kato-Katz and qPCR
Description
Time to positive faeces test for hookworm as defined by Kato-Katz and qPCR
Time Frame
12 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
45 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: In order to be eligible to participate in this study, a subject must meet all of the following criteria: Subject is aged ≥ 18 and ≤ 45 years. Subject has adequate understanding of the procedures of the study and agrees to abide strictly thereby. Subject is able to communicate well with the investigator, is available to attend all study visits. Subjects are able to respond to phone or email within 24 hours during the first 12 weeks of the study. Subject agrees to refrain from blood donation to Sanquin or for other purposes throughout the study period. For female subjects: subject agrees to use adequate contraception and not to breastfeed for the duration of study. Subject has signed informed consent A potential subject who meets any of the following criteria will be excluded from participation in this study: Any history, or evidence at screening, of clinically significant symptoms, physical signs or abnormal laboratory values suggestive of systemic conditions, such as cardiovascular, pulmonary, renal, hepatic, neurological, dermatological, endocrine, malignant, haematological, infectious, immune-deficient, psychiatric and other disorders, which could compromise the health of the volunteer during the study or interfere with the interpretation of the study results. These include, but are not limited to, any of the following: history of severe asthma or other health conditions that may require future steroid use; body weight <50 kg or Body Mass Index (BMI) <18.0 or >30.0 kg/m2 at screening; positive HIV, HBV or HCV screening tests; the use of immune modifying drugs within three months prior to study onset (inhaled and topical corticosteroids and oral anti-histamines exempted) or expected use of such during the study period; having one of the following laboratory abnormalities: ferritine <10 ug/L, transferrine <2.04 g/L or Hb <7.5 mmol/L for females or <8.5 mmol/L for males. history of malignancy of any organ system (other than localized basal cell carcinoma of the skin), treated or untreated, within the past 5 years; any history of treatment for severe psychiatric disease by a psychiatrist in the past year; history of drug or alcohol abuse interfering with normal social function in the period of one year prior to study onset. Known hypersensitivity to or contra-indications for use of albendazole. Including co-medication known to interact with albendazole metabolism (e.g. carbamazepine, phenobarbital, phenytoin, cimetidine, theophylline, dexamethasone). Known type 1 hypersensitivity to amphotericin B or gentamicin. For female subjects: positive urine pregnancy test at screening. Positive faecal PCR or Kato-Katz for hookworm at screening, any known history of hookworm infection or treatment for hookworm infection or possible exposure to hookworm in the past. Being an employee or student of the department of Parasitology of the LUMC. Current or past scars, tattoos, or other disruptions of skin integrity at the intended site of larval application. Subjects with planned travel to hookworm-endemic areas with a stay in non-hygienic environment during this trial.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Meta Roestenberg, MD, PhD
Organizational Affiliation
LUMC
Official's Role
Principal Investigator
Facility Information:
Facility Name
Leiden University Medical Center
City
Leiden
ZIP/Postal Code
2333 ZA
Country
Netherlands

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
31077279
Citation
Hoogerwerf MA, Coffeng LE, Brienen EAT, Janse JJ, Langenberg MCC, Kruize YCM, Gootjes C, Manurung MD, Dekker M, Becker L, Erkens MAA, van der Beek MT, Ganesh MS, Feijt C, Winkel BMF, Westra IM, Meij P, Loukas A, Visser LG, de Vlas SJ, Yazdanbakhsh M, van Lieshout L, Roestenberg M. New Insights Into the Kinetics and Variability of Egg Excretion in Controlled Human Hookworm Infections. J Infect Dis. 2019 Aug 9;220(6):1044-1048. doi: 10.1093/infdis/jiz218.
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Establishing a Controlled Human Hookworm Infection Model at Leiden University Medical Center

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