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A HIV Vaccine Trial in Individuals Who Started Antiretrovirals During Primary or Chronic Infection (EHVA T02)

Primary Purpose

HIV-1-infection

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Vaccine and vedolizumab (Entyvio)
Placebo vaccine and vedolizumab infusion (Entyvio)
Placebo vaccine and placebo infusion
Sponsored by
ANRS, Emerging Infectious Diseases
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for HIV-1-infection

Eligibility Criteria

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

Inclusion Criteria:

  1. HIV-1-infected
  2. Aged 18 - 65 years old on the day of screening
  3. Weight >50kg
  4. Willing and able to provide written informed consent
  5. Nadir CD4 count > 300 cells/mm3
  6. CD4 count at screening > 500 cells/mm3
  7. Viral load <50 copies/ml at screening.
  8. Started cART after 2009 and on cART for at least one year prior to screening
  9. Willing to interrupt cART for up to 24 weeks and change cART regimen if required
  10. If sexually active, willing to use a reliable method of reducing the risk of transmission to their sexual partners during treatment interruption (which could include PrEP for their sexual partners)
  11. If heterosexually active and able to have children, willing to use a highly effective method of contraception with partner (combined oral contraceptive pill; injectable or implanted contraceptive; IUD/IUS; physiological or anatomical sterility (in self or partner) from 2 weeks before enrolment until 18 weeks after the last injection/infusion
  12. If women of childbearing potential*, willing to undergo urine pregnancy tests prior to administration of an injection and an infusion
  13. Willing to avoid all other vaccines within 4 weeks of scheduled study injections
  14. Willing and able to comply with visit schedule and provide blood samples
  15. Being covered by medical insurance or in National Healthcare System

    • A woman will be considered of childbearing potential following menarche and until becoming post-menopausal unless permanently sterile. Permanent sterilisation methods include hysterectomy, bilateral salpingectomy and bilateral oophorectomy.

Exclusion Criteria:

  1. Pregnant or lactating
  2. HIV-2 infection (either isolated or associated with HIV-1)
  3. VL >200 copies/ml on 2 occasions in the 12 months prior to screening
  4. Previous interruptions in cART
  5. Previous virological failures defined by loss of virological suppression with the presence of resistant mutations
  6. Haemoglobin (Hb <12g/dL for males, <11g/dL for females)
  7. Concomitant or previous conditions that preclude injection of vaccines/infusion of monoclonal antibody and PML in the past
  8. History of experimental vaccinations against HIV
  9. Previous treatment with chemotherapy (except for chemotherapy injected into skin lesions for Kaposi's sarcoma)
  10. Treatment with systemic corticoids or immuno-suppressive agents ongoing or in the 12 weeks prior to randomisation in the trial
  11. Received natalizumab or rituximab ever in the past
  12. Received a TNF blocker in the past 60 days
  13. Administration of an inactivated vaccine within 30 days or a live vaccine within 60 days prior to randomisation
  14. Presence of a skin condition or marking that precludes inspection of the injection/infusion site
  15. History of cancer (except basal cellular skin carcinoma or Kaposi's sarcoma)
  16. History of significant neurological disease or cardiovascular disease (angina, myocardial infarction, transient ischemic attack, stroke); participants with controlled blood pressure are eligible
  17. History of clinical autoimmune disease
  18. Ongoing diseases including uncontrolled active severe infection, cardiac, pulmonary (excluding mild asthma), thyroid, renal or neurological (peripheral or central) diseases
  19. Active or latent tuberculosis (unless prophylaxis in past as per local practice) - (participant must be screened for tuberculosis before starting infusions, according to routine practice)
  20. Presence of pathogenic bacteria or parasites in faeces at screening
  21. Participating in another biomedical research study within 30 days of randomisation
  22. Known hypersensitivity to any component of the vaccine formulation used in this trial including eggs or have severe or multiple allergies to drugs or pharmaceutical agents, or any hypersensitivity to the active substance or to any of the excipients of vedolizumab.
  23. Liver disease including hepatitis B (surface antigen positive) or hepatitis C (antigen or PCR positive)
  24. A clinically significant abnormality on ECG
  25. Hypernatraemia or hyperchloraemia
  26. History of severe local or general reaction to vaccination defined as

    1. local: extensive, indurated redness and swelling involving most of the arm, not resolving within 72 hours
    2. general: fever >= 39.5oC within 48 hours; anaphylaxis; bronchospasm; laryngeal oedema; collapse; convulsions or encephalopathy within 72 hours
  27. Grade 2 or worse routine laboratory parameters. Hyperbilirubinaemia to be considered an exclusion criterion only when confirmed to be conjugated bilirubinaemia

Sites / Locations

  • Service Immunologie clinique et maladies infectieuses, Hôpital Henri Mondor
  • Hotel Dieu
  • Centre d'Immunothérapie et Vaccinologie, CHUV
  • St Stephens Centre, Chelsea & Westminster Hospital

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Placebo Comparator

Arm Label

Vaccine and Vedolizumab infusion

Placebo vaccine and Vedolizumab infusion

Placebo vaccine and placebo infusion

Arm Description

Vaccine: The vaccine is MVA HIV-B which is a solution of HIV MVA vectors in S08 buffer (10mM Tris/hydrochloride (Tris/HCl), Saccharose 5% (w/v), 10mM Sodium Glutamate (Na Glu), 50mM Sodium Chloride (NaCl), water PPI, pH 8.0). Vedolizumab infusion (Entyvio): Vedolizumab (300mg) is administered as an intravenous infusion (255 ml).

Placebo vaccine: The placebo for MVA HIV-B to be used in this trial is a solution composed of S08 buffer (as for the MVA vaccine). Vedolizumab infusion (Entyvio): Vedolizumab (300mg) is administered as an intravenous infusion (255 ml)

Placebo vaccine: The placebo for MVA HIV-B to be used in this trial is a solution composed of S08 buffer (as for the MVA vaccine). Placebo infusion: Sodium Chloride (NaCl) 0.9% administered as an intravenous infusion (255ml)

Outcomes

Primary Outcome Measures

Area under the HIV RNA curve
Area under the HIV RNA curve from treatment interruption (scheduled for 18 weeks after entering the trial)

Secondary Outcome Measures

Virological outcome measures
Time from treatment interruption (scheduled for 18 weeks after entering the trial) to the earliest of reaching HIV RNA ≥ 100 000 copies/ml (confirmed on a separate sample) or resuming antiretroviral therapy for any reason over a period of 24 weeks.
Virological outcome measures
Level of HIV total RNA
Virological outcome measures
Cell Associated (CA) HIV RNA Quantification
Virological outcome measures
First local maximum (peak) level of HIV total RNA during treatment interruption
Virological outcome measures
Rate of increase of HIV total RNA between the last measure below the lower detection and the first local maximum
Virological outcome measures
Setpoint (two stable measures following a transient increase of HIV RNA)

Full Information

First Posted
September 30, 2019
Last Updated
August 3, 2023
Sponsor
ANRS, Emerging Infectious Diseases
Collaborators
EuroVacc Foundation, European AIDS Treatment Group (EATG), Medical Research Council, University College London Hospitals, University of Liverpool, Erasmus Medical Center, Henri Mondor University Hospital, European Georges Pompidou Hospital, Saint-Louis Hospital, Paris, France, Centre Hospitalier Universitaire Vaudois, Chelsea and Westminster Hospital, UK, Universitätsklinikum Hamburg-Eppendorf, Hospital Clinic of Barcelona, Istituto Nazionale Malattie Infettive Lazaro Spallanzani, Imperial College London, Institut d'Investigacions Biomèdiques August Pi i Sunyer, European Commission, Swiss Government
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1. Study Identification

Unique Protocol Identification Number
NCT04120415
Brief Title
A HIV Vaccine Trial in Individuals Who Started Antiretrovirals During Primary or Chronic Infection (EHVA T02)
Official Title
EHVA T02 (European HIV Vaccine Alliance Therapeutic Trial 02)/ANRS VRI07: A Phase II Randomised, Placebo-controlled Trial of Vedolizumab With or Without Therapeutic HIV MVA Vaccine in Individuals Who Started Antiretrovirals During Primary or Chronic Infection
Study Type
Interventional

2. Study Status

Record Verification Date
July 2023
Overall Recruitment Status
Completed
Study Start Date
June 21, 2022 (Actual)
Primary Completion Date
July 12, 2023 (Actual)
Study Completion Date
July 12, 2023 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
ANRS, Emerging Infectious Diseases
Collaborators
EuroVacc Foundation, European AIDS Treatment Group (EATG), Medical Research Council, University College London Hospitals, University of Liverpool, Erasmus Medical Center, Henri Mondor University Hospital, European Georges Pompidou Hospital, Saint-Louis Hospital, Paris, France, Centre Hospitalier Universitaire Vaudois, Chelsea and Westminster Hospital, UK, Universitätsklinikum Hamburg-Eppendorf, Hospital Clinic of Barcelona, Istituto Nazionale Malattie Infettive Lazaro Spallanzani, Imperial College London, Institut d'Investigacions Biomèdiques August Pi i Sunyer, European Commission, Swiss Government

4. Oversight

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

5. Study Description

Brief Summary
EHVA T02 is an international, phase II, double-blind study to evaluate two experimental arms each compared to placebo control in HIV-1 positive participants to see if either has a clinically relevant impact on viral replication.
Detailed Description
Screening will take place during the 6 weeks prior to randomisation. Eligible participants will be enrolled at week 0 and randomised to MVA HIV-B vaccine followed by vedolizumab, vedolizumab + placebo vaccine, or placebo vaccine + placebo infusions. Participants will be randomised at each centre through web-based randomisation after entering the eligibility criteria. There will be two strata: one for those who started treatment during primary infection, and one for those who started treatment during chronic infection. 69 eligible individuals from collaborating European Countries will be enrolled, aiming for approximately half who started cART in primary infection and half who started in chronic infection. Participants continue from the screening visit (up to 6 weeks before enrolment) to the last visit, a maximum of 60 weeks (around 14 months), although follow-up will continue through to the time when virus is fully suppressed. Treatment will be interrupted at week 18 and resumed when the viral load is confirmed to have rebounded to ≥100,000 copies/ml, or the CD4 falls to ≤350 cells/mm3, confirmed, or there is evidence of disease progression, or they have completed 24 weeks of treatment interruption.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HIV-1-infection

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
2 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Vaccine and Vedolizumab infusion
Arm Type
Experimental
Arm Description
Vaccine: The vaccine is MVA HIV-B which is a solution of HIV MVA vectors in S08 buffer (10mM Tris/hydrochloride (Tris/HCl), Saccharose 5% (w/v), 10mM Sodium Glutamate (Na Glu), 50mM Sodium Chloride (NaCl), water PPI, pH 8.0). Vedolizumab infusion (Entyvio): Vedolizumab (300mg) is administered as an intravenous infusion (255 ml).
Arm Title
Placebo vaccine and Vedolizumab infusion
Arm Type
Experimental
Arm Description
Placebo vaccine: The placebo for MVA HIV-B to be used in this trial is a solution composed of S08 buffer (as for the MVA vaccine). Vedolizumab infusion (Entyvio): Vedolizumab (300mg) is administered as an intravenous infusion (255 ml)
Arm Title
Placebo vaccine and placebo infusion
Arm Type
Placebo Comparator
Arm Description
Placebo vaccine: The placebo for MVA HIV-B to be used in this trial is a solution composed of S08 buffer (as for the MVA vaccine). Placebo infusion: Sodium Chloride (NaCl) 0.9% administered as an intravenous infusion (255ml)
Intervention Type
Biological
Intervention Name(s)
Vaccine and vedolizumab (Entyvio)
Intervention Description
Vaccine and vedolizumab infusion (Entyvio): 0.5ml of MVA HIV-B (1 x 108 pfu/ml) will be administered intramuscularly in the deltoid muscle of the non-dominant upper arm at weeks 0 and 8. Participants will be observed after the injection. Vedolizumab (300mg) is administered as an intravenous infusion (255 ml) over 30 mins in the dominant arm at weeks 10,12,16,20,24,28 and 32. After infusion, the line should be flushed with 30ml of normal saline. Participants will be observed throughout and after the infusion.
Intervention Type
Biological
Intervention Name(s)
Placebo vaccine and vedolizumab infusion (Entyvio)
Intervention Description
Placebo Vaccine: The placebo for MVA HIV-B to be used is a solution composed of S08 buffer (as for the MVA vaccine) that will be intramuscularly in the deltoid muscle of the non-dominant upper arm at weeks 0 and 8. Participants will be observed after the injection. Vedolizumab infusion (Entyvio): Vedolizumab (300mg) is administered as an intravenous infusion (255 ml) over 30 mins in the dominant arm at weeks 10,12,16,20,24,28 and 32. After infusion, the line should be flushed with 30ml of normal saline. Participants will be observed throughout and after the infusion.
Intervention Type
Biological
Intervention Name(s)
Placebo vaccine and placebo infusion
Intervention Description
Placebo Vaccine: The placebo for MVA HIV-B to be used is a solution composed of S08 buffer (as for the MVA vaccine) that will be intramuscularly in the deltoid muscle of the non-dominant upper arm at weeks 0 and 8. Participants will be observed after the injection. Placebo infusion (Entyvio): 255ml Sodium Chloride (NaCl) 0.9% bag administered as an intravenous infusion over 30 mins in the dominant arm at weeks 10,12,16,20,24,28 and 32. Participants will be observed throughout and after the infusion.
Primary Outcome Measure Information:
Title
Area under the HIV RNA curve
Description
Area under the HIV RNA curve from treatment interruption (scheduled for 18 weeks after entering the trial)
Time Frame
Time from treatment interruption (scheduled for 18 weeks after entering the trial) to 24 weeks post-treatment interruption
Secondary Outcome Measure Information:
Title
Virological outcome measures
Description
Time from treatment interruption (scheduled for 18 weeks after entering the trial) to the earliest of reaching HIV RNA ≥ 100 000 copies/ml (confirmed on a separate sample) or resuming antiretroviral therapy for any reason over a period of 24 weeks.
Time Frame
For participants commencing treatment interruption only, critical time points weeks 19 through to to week 42.
Title
Virological outcome measures
Description
Level of HIV total RNA
Time Frame
From randomisation to study completion about 54 weeks
Title
Virological outcome measures
Description
Cell Associated (CA) HIV RNA Quantification
Time Frame
From randomisation to study completion about 54 weeks
Title
Virological outcome measures
Description
First local maximum (peak) level of HIV total RNA during treatment interruption
Time Frame
Time from treatment interruption, only in participants commencing treatment interruption, up to 24 weeks after ATI
Title
Virological outcome measures
Description
Rate of increase of HIV total RNA between the last measure below the lower detection and the first local maximum
Time Frame
Time from treatment interruption, only in participants commencing treatment interruption, up to 24 weeks after ATI
Title
Virological outcome measures
Description
Setpoint (two stable measures following a transient increase of HIV RNA)
Time Frame
Time from treatment interruption, only in participants commencing treatment interruption, up to 24 weeks after ATI
Other Pre-specified Outcome Measures:
Title
Safety outcome measures: Grade 3 or worse solicited clinical and laboratory adverse events
Description
Occurrence of grade 3 or worse solicited clinical and laboratory adverse events
Time Frame
From randomisation to study completion about 54 weeks
Title
Safety outcome measures: Any adverse event leading to interruption in the vaccine/placebo or vedolizumab/placebo
Description
Occurrence of any adverse event leading to interruption in the vaccine/placebo or vedolizumab/placebo
Time Frame
From randomisation to study completion about 54 weeks
Title
Safety outcome measures: Any event that results in resuming treatment during the ATI
Description
Occurrence of any event that results in resuming treatment during the ATI
Time Frame
Time form treatment interruption to resuming treatment, up to 24 weeks after ATI
Title
Safety outcome measures: Serious Adverse Events
Description
Occurrence of Serious Adverse Events
Time Frame
From randomisation until 30 days after the last protocol visit
Title
Safety outcome measures: Other clinical and laboratory adverse events
Description
Occurrence of other clinical and laboratory adverse events
Time Frame
From randomisation to study completion about 54 weeks
Title
Safety outcome measures: Change in absolute CD4
Description
Observation of change in absolute CD4 count
Time Frame
From randomisation to study completion about 54 weeks
Title
Safety outcome measures: Time to VL suppression after restarting cART
Description
Time to VL suppression after restarting cART
Time Frame
From randomisation to VL suppression (= VL is undetectable (<50copies/ml)) after restarting cART until the participant returns to an undetectable viral load, about 54 weeks]
Title
Exploratory Immunological outcome measures: Characterization of vaccine induced CD4 and CD8 T-cell produced cytokine profile
Description
Observation of vaccine induced CD4 and CD8 T-cell produced cytokines by flow cytometry
Time Frame
From randomisation to study completion about 54 weeks

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: HIV-1-infected Aged 18 - 65 years old on the day of screening Weight >50kg Willing and able to provide written informed consent Nadir CD4 count > 300 cells/mm3 CD4 count at screening > 500 cells/mm3 Viral load <50 copies/ml at screening. Started cART after 2009 and on cART for at least one year prior to screening Willing to interrupt cART for up to 24 weeks and change cART regimen if required If sexually active, willing to use a reliable method of reducing the risk of transmission to their sexual partners during treatment interruption (which could include PrEP for their sexual partners) If heterosexually active and able to have children, willing to use a highly effective method of contraception with partner (combined oral contraceptive pill; injectable or implanted contraceptive; IUD/IUS; physiological or anatomical sterility (in self or partner) from 2 weeks before enrolment until 18 weeks after the last injection/infusion If women of childbearing potential*, willing to undergo urine pregnancy tests prior to administration of an injection and an infusion Willing to avoid all other vaccines within 4 weeks of scheduled study injections Willing and able to comply with visit schedule and provide blood samples Being covered by medical insurance or in National Healthcare System A woman will be considered of childbearing potential following menarche and until becoming post-menopausal unless permanently sterile. Permanent sterilisation methods include hysterectomy, bilateral salpingectomy and bilateral oophorectomy. Exclusion Criteria: Pregnant or lactating HIV-2 infection (either isolated or associated with HIV-1) VL >200 copies/ml on 2 occasions in the 12 months prior to screening Previous interruptions in cART Previous virological failures defined by loss of virological suppression with the presence of resistant mutations Haemoglobin (Hb <12g/dL for males, <11g/dL for females) Concomitant or previous conditions that preclude injection of vaccines/infusion of monoclonal antibody and PML in the past History of experimental vaccinations against HIV Previous treatment with chemotherapy (except for chemotherapy injected into skin lesions for Kaposi's sarcoma) Treatment with systemic corticoids or immuno-suppressive agents ongoing or in the 12 weeks prior to randomisation in the trial Received natalizumab or rituximab ever in the past Received a TNF blocker in the past 60 days Administration of an inactivated vaccine within 30 days or a live vaccine within 60 days prior to randomisation Presence of a skin condition or marking that precludes inspection of the injection/infusion site History of cancer (except basal cellular skin carcinoma or Kaposi's sarcoma) History of significant neurological disease or cardiovascular disease (angina, myocardial infarction, transient ischemic attack, stroke); participants with controlled blood pressure are eligible History of clinical autoimmune disease Ongoing diseases including uncontrolled active severe infection, cardiac, pulmonary (excluding mild asthma), thyroid, renal or neurological (peripheral or central) diseases Active or latent tuberculosis (unless prophylaxis in past as per local practice) - (participant must be screened for tuberculosis before starting infusions, according to routine practice) Presence of pathogenic bacteria or parasites in faeces at screening Participating in another biomedical research study within 30 days of randomisation Known hypersensitivity to any component of the vaccine formulation used in this trial including eggs or have severe or multiple allergies to drugs or pharmaceutical agents, or any hypersensitivity to the active substance or to any of the excipients of vedolizumab. Liver disease including hepatitis B (surface antigen positive) or hepatitis C (antigen or PCR positive) A clinically significant abnormality on ECG Hypernatraemia or hyperchloraemia History of severe local or general reaction to vaccination defined as local: extensive, indurated redness and swelling involving most of the arm, not resolving within 72 hours general: fever >= 39.5oC within 48 hours; anaphylaxis; bronchospasm; laryngeal oedema; collapse; convulsions or encephalopathy within 72 hours Grade 2 or worse routine laboratory parameters. Hyperbilirubinaemia to be considered an exclusion criterion only when confirmed to be conjugated bilirubinaemia
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Yves Levy, MD
Organizational Affiliation
Institut National de la Santé Et de la Recherche Médicale, France
Official's Role
Study Director
Facility Information:
Facility Name
Service Immunologie clinique et maladies infectieuses, Hôpital Henri Mondor
City
Paris
State/Province
Creteil
ZIP/Postal Code
94010
Country
France
Facility Name
Hotel Dieu
City
Paris
ZIP/Postal Code
75004
Country
France
Facility Name
Centre d'Immunothérapie et Vaccinologie, CHUV
City
Lausanne
State/Province
Vaud
ZIP/Postal Code
1011
Country
Switzerland
Facility Name
St Stephens Centre, Chelsea & Westminster Hospital
City
London
ZIP/Postal Code
SW10 9NH
Country
United Kingdom

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

A HIV Vaccine Trial in Individuals Who Started Antiretrovirals During Primary or Chronic Infection (EHVA T02)

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