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A Phase I, Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial to Evaluate the Safety and Immunogenicity of HIV-1 MN rsgp120 and Bivalent AIDSVAX B/E (HIV-1 MN rgp120/A244 rgp120) in Combination With QS-21 With or Without Alum in Healthy HIV-1 Uninfected Adults

Primary Purpose

HIV Infections

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
MN rgp120/HIV-1 and A244 rgp120/HIV-1
QS-21
rgp120/HIV-1MN
Sponsored by
National Institute of Allergy and Infectious Diseases (NIAID)
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional prevention trial for HIV Infections focused on measuring Vaccines, Synthetic, HIV Antibodies, HIV Antigens, HIV-1, Adjuvants, Immunologic, AIDS Vaccines, T-Lymphocytes, Cytotoxic, HIV Seronegativity, HIV Envelope Protein gp120, Alum Compounds, HIV Preventive Vaccine

Eligibility Criteria

18 Years - 50 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria Volunteers must have: Negative ELISA for HIV within 8 weeks prior to immunization. CD4 count greater than or equal to 400 cells/mm3. Normal history and physical examination. [Refer to Laboratory values for additional requirements.] Exclusion Criteria Co-existing Condition: Volunteers with the following conditions or symptoms are excluded: Medical or psychiatric conditions or occupational responsibilities which preclude subject compliance with the protocol. Recent suicidal ideation or psychosis. Active syphilis. NOTE: If the serology is documented to be a false positive or due to a remote (greater than 6 months) treated infection, the volunteer is eligible. Active tuberculosis. NOTE: Volunteers with a positive PPD and a normal chest x-ray showing no evidence of TB and not requiring INH therapy are eligible. Positive for hepatitis B surface antigen. Volunteers with the following prior conditions are excluded: History of immunodeficiency, chronic illness, or autoimmune disease. History of cancer unless there has been surgical excision followed by a sufficient observation period to give a reasonable assurance of cure. History of suicide attempts, recent suicidal ideation, or past or present psychosis. History of anaphylaxis or other serious adverse reactions to vaccines. History of serious allergic reaction to any substance requiring hospitalization or emergency medical care (e.g., Stevens-Johnson syndrome, bronchospasm, or hypotension). History of reaction to thimerosal. Prior Medication: Excluded: Live attenuated vaccine within 60 days of study. NOTE: Medically indicated subunit or killed vaccines (e.g., influenza, pneumococcal) are not exclusionary, but should be given at least 2 weeks away from HIV immunizations. Experimental agents within 30 days prior to study. HIV-1 vaccines or placebo as part of a previous HIV vaccine trial. Prior Treatment: Excluded: Blood products or immunoglobulin in the past 6 months. Experimental agents within 30 days prior to study. Risk Behavior: Excluded: Volunteers with an identifiable higher- or intermediate-risk sexual behavior for HIV infection (i.e., AVEG Risk Groups C or D ). History of intravenous drug use within 12 months prior to enrollment.

Sites / Locations

  • JHU AVEG
  • Univ. of Rochester AVEG
  • Vanderbilt Univ. Hosp. AVEG
  • UW - Seattle AVEG

Outcomes

Primary Outcome Measures

Secondary Outcome Measures

Full Information

First Posted
November 2, 1999
Last Updated
October 28, 2021
Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)
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1. Study Identification

Unique Protocol Identification Number
NCT00001096
Brief Title
A Phase I, Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial to Evaluate the Safety and Immunogenicity of HIV-1 MN rsgp120 and Bivalent AIDSVAX B/E (HIV-1 MN rgp120/A244 rgp120) in Combination With QS-21 With or Without Alum in Healthy HIV-1 Uninfected Adults
Official Title
A Phase I, Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial to Evaluate the Safety and Immunogenicity of HIV-1 MN rsgp120 and Bivalent AIDSVAX B/E (HIV-1 MN rgp120/A244 rgp120) in Combination With QS-21 With or Without Alum in Healthy HIV-1 Uninfected Adults
Study Type
Interventional

2. Study Status

Record Verification Date
October 2021
Overall Recruitment Status
Completed
Study Start Date
undefined (undefined)
Primary Completion Date
undefined (undefined)
Study Completion Date
March 2000 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)

4. Oversight

5. Study Description

Brief Summary
To assess the safety and immune response to two experimental vaccines when formulated with QS-21 or QS-21 plus alum. To determine whether the new preparation of QS-21 in polysorbate 80 is less reactogenic than the QS-21 formulation used in AVEG Protocols 016, 016A, and 016B. To examine whether QS-21 is immunologically equivalent to that used in 16B. To determine if QS-21, when given with low doses of antigen, induces measurable HIV-1-specific CTL activity. To evaluate if the QS-21 dose-sparing effect extends to an antigen dose of 0.5 micrograms. To determine if the bivalent vaccine gives responses equivalent to the monovalent product or if a broadening of the HIV-1-specific binding and neutralizing antibody responses occurs. An effective vaccine to prevent HIV-1 infection may need to generate diverse and multifaceted immunologic responses. Required parts of the immune response may include: humoral antibodies, which broadly neutralize non-syncytium-inducing strains of HIV-1; T cell help provided by both CD4 and CD8 positive subsets; and a class I-restricted cytotoxic lymphocyte response. Other effector responses, such as the generation of antibody-dependent cellular cytotoxicity, cytokines, chemokines, or other antiviral factors may also be critical in mounting protective immunity. Given the lack of a surrogate immunologic marker, the most practical approach for possible efficacy trials would be to evaluate a candidate vaccine that elicits as many of these responses as possible.
Detailed Description
An effective vaccine to prevent HIV-1 infection may need to generate diverse and multifaceted immunologic responses. Required parts of the immune response may include: humoral antibodies, which broadly neutralize non-syncytium-inducing strains of HIV-1; T cell help provided by both CD4 and CD8 positive subsets; and a class I-restricted cytotoxic lymphocyte response. Other effector responses, such as the generation of antibody-dependent cellular cytotoxicity, cytokines, chemokines, or other antiviral factors may also be critical in mounting protective immunity. Given the lack of a surrogate immunologic marker, the most practical approach for possible efficacy trials would be to evaluate a candidate vaccine that elicits as many of these responses as possible. Volunteers in each of 5 groups receive vaccine or placebo by intramuscular injection at Months 0, 1, and 6. All patients receive one of two doses of QS-21 along with vaccine or placebo and some groups receive alum as follows: Group 1: low-dose MN rsgp120/HIV-1 plus QS-21 (13 volunteers). Group 2: high-dose MN rsgp120/HIV-1 plus QS-21 (13 volunteers). Group 3: AIDSVAX B/E (injection contains each of the two vaccine components, HIV-1 MN rgp120 and A244 rgp120/HIV-1) plus QS-21 plus alum (13 volunteers). Group 4: high-dose MN rgp120/HIV-1 plus QS-21 plus alum (13 volunteers). Group 5: placebo plus QS-21 (8 volunteers). Volunteers will be closely monitored after each immunization and followed for a minimum of 12 months after the initial immunization.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HIV Infections
Keywords
Vaccines, Synthetic, HIV Antibodies, HIV Antigens, HIV-1, Adjuvants, Immunologic, AIDS Vaccines, T-Lymphocytes, Cytotoxic, HIV Seronegativity, HIV Envelope Protein gp120, Alum Compounds, HIV Preventive Vaccine

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 1
Masking
Double
Enrollment
60 (false)

8. Arms, Groups, and Interventions

Intervention Type
Biological
Intervention Name(s)
MN rgp120/HIV-1 and A244 rgp120/HIV-1
Intervention Type
Biological
Intervention Name(s)
QS-21
Intervention Type
Biological
Intervention Name(s)
rgp120/HIV-1MN

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria Volunteers must have: Negative ELISA for HIV within 8 weeks prior to immunization. CD4 count greater than or equal to 400 cells/mm3. Normal history and physical examination. [Refer to Laboratory values for additional requirements.] Exclusion Criteria Co-existing Condition: Volunteers with the following conditions or symptoms are excluded: Medical or psychiatric conditions or occupational responsibilities which preclude subject compliance with the protocol. Recent suicidal ideation or psychosis. Active syphilis. NOTE: If the serology is documented to be a false positive or due to a remote (greater than 6 months) treated infection, the volunteer is eligible. Active tuberculosis. NOTE: Volunteers with a positive PPD and a normal chest x-ray showing no evidence of TB and not requiring INH therapy are eligible. Positive for hepatitis B surface antigen. Volunteers with the following prior conditions are excluded: History of immunodeficiency, chronic illness, or autoimmune disease. History of cancer unless there has been surgical excision followed by a sufficient observation period to give a reasonable assurance of cure. History of suicide attempts, recent suicidal ideation, or past or present psychosis. History of anaphylaxis or other serious adverse reactions to vaccines. History of serious allergic reaction to any substance requiring hospitalization or emergency medical care (e.g., Stevens-Johnson syndrome, bronchospasm, or hypotension). History of reaction to thimerosal. Prior Medication: Excluded: Live attenuated vaccine within 60 days of study. NOTE: Medically indicated subunit or killed vaccines (e.g., influenza, pneumococcal) are not exclusionary, but should be given at least 2 weeks away from HIV immunizations. Experimental agents within 30 days prior to study. HIV-1 vaccines or placebo as part of a previous HIV vaccine trial. Prior Treatment: Excluded: Blood products or immunoglobulin in the past 6 months. Experimental agents within 30 days prior to study. Risk Behavior: Excluded: Volunteers with an identifiable higher- or intermediate-risk sexual behavior for HIV infection (i.e., AVEG Risk Groups C or D ). History of intravenous drug use within 12 months prior to enrollment.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Tom Evans
Official's Role
Study Chair
Facility Information:
Facility Name
JHU AVEG
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21205
Country
United States
Facility Name
Univ. of Rochester AVEG
City
Rochester
State/Province
New York
ZIP/Postal Code
14642
Country
United States
Facility Name
Vanderbilt Univ. Hosp. AVEG
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37232
Country
United States
Facility Name
UW - Seattle AVEG
City
Seattle
State/Province
Washington
ZIP/Postal Code
98104
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
11228380
Citation
Evans TG, McElrath MJ, Matthews T, Montefiori D, Weinhold K, Wolff M, Keefer MC, Kallas EG, Corey L, Gorse GJ, Belshe R, Graham BS, Spearman PW, Schwartz D, Mulligan MJ, Goepfert P, Fast P, Berman P, Powell M, Francis D; NIAID AIDS Vaccine Evaluation Group. QS-21 promotes an adjuvant effect allowing for reduced antigen dose during HIV-1 envelope subunit immunization in humans. Vaccine. 2001 Feb 28;19(15-16):2080-91. doi: 10.1016/s0264-410x(00)00415-1.
Results Reference
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A Phase I, Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial to Evaluate the Safety and Immunogenicity of HIV-1 MN rsgp120 and Bivalent AIDSVAX B/E (HIV-1 MN rgp120/A244 rgp120) in Combination With QS-21 With or Without Alum in Healthy HIV-1 Uninfected Adults

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