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A Phase I Safety and Immunogenicity Preventive Vaccine Trial Based on the HIV-1 Tat and V2-deleted Env Proteins (ISS P-002)

Primary Purpose

HIV Infection

Status
Terminated
Phase
Phase 1
Locations
Italy
Study Type
Interventional
Intervention
HIV-1 Tat/delta-V2 Env combined vaccine
HIV-1 delta-V2 Env vaccine
HIV-1 Tat vaccine 7.5 microg
HIV-1 Tat vaccine 30 microg
Sponsored by
Barbara Ensoli, MD
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for HIV Infection focused on measuring HIV, preventive vaccine, Tat, Env

Eligibility Criteria

18 Years - 55 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  1. Age: 18 to 55 years;
  2. Negative blood pregnancy test for women of childbearing potential at screening evaluation (a urine dipstick test will be repeated just before each vaccination), and use of an acceptable mean of contraception by both men and women, since one month prior to immunization (only for women) and until at least 6 months after the last immunization;
  3. Blood pressure, heart rate and ECG within normal ranges or with mild alterations acknowledged as non clinically significant by the site clinician;
  4. Haematological and biochemical parameters within the clinical site normal ranges or with mild alterations acknowledged by the site clinician as non clinically significant;
  5. Normal urine dipstick with esterase and nitrite;
  6. Normal thyroid function;
  7. Negative for HIV infection and for anti-Tat antibodies;
  8. Good physical and mental health status;
  9. Availability for the planned study duration;
  10. Signed informed consent.

Exclusion Criteria:

  1. Concomitant neoplastic diseases;
  2. History of malignant neoplastic diseases;
  3. History of encephalopathy, neuropathy or unstable CNS pathology, immunodeficiency, autoimmune disease, angina or cardiac arrhythmias, or any other clinically significant medical problems;
  4. History of anaphylaxis or serious adverse reactions to vaccines as well as serum IgE levels exceeding 1,000 U.I./mL;
  5. History of serious allergic reaction to any substance, requiring hospitalization or emergency medical care;
  6. Chest radiography showing evidence of active or acute cardiac or pulmonary disease;
  7. Any unstable cardiovascular disease;
  8. Active syphilis by TPHA and RPR tests [NOTE: If the serology is documented to be a false positive or due to an adequately treated infection, the volunteer is eligible];
  9. Active tuberculosis by cutaneous TB diagnostic test [NOTE: Volunteers with a positive PPD and a normal chest X-ray showing no evidence of TB and not requiring specific therapy are eligible];
  10. Medical or psychiatric condition or occupational responsibilities which preclude subject compliance with the protocol. Persons with psychotic disorders, major affective disorders or suicidal ideation are specifically excluded;
  11. Current use of psychotropic drugs;
  12. Drug and/or alcohol abuse;
  13. Current or prior therapy with immunomodulators or immunosuppressive drugs and anticoagulant drugs within 30 days prior to study medication administration;
  14. Live attenuated vaccines within 60 days prior to study entry [NOTE: Medically indicated sub-unit or killed vaccines (e.g, influenza, pneumococcal, hepatitis A and B) are not exclusionary, but should be given at least 4 weeks away from anti-HIV immunizations];
  15. Use of investigational agents within 90 days prior to study entry;
  16. Participation in another experimental protocol within 6 months prior to pre-study screening;
  17. Prior receipt of HIV vaccine in a previous HIV vaccine trial;
  18. Receipt of blood products or immunoglobulin in the past 6 months;
  19. Pregnant or lactating women.

Sites / Locations

  • Policlinico di Modena, Divisione di Malattie Infettive
  • Azienda Ospedaliera San Gerardo, Divisione di Malattie Infettive
  • IFO - S. Gallicano, Dermatologia Infettiva

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Active Comparator

Active Comparator

Active Comparator

Arm Label

HIV-1 Tat/delta-V2 Env combined vaccine

HIV-1 delta-V2 Env vaccine

HIV-1 Tat vaccine 7.5 microg

HIV-1 Tat vaccine 30 microg

Arm Description

Tat 7.5 microg and delta-V2 Env 100 microg associated proteins administered i.d. (priming) at week 0, 4 and 8 or i.m. (boosting) at weeks 24 and 36

delta-V2 Env 100 microg administered i.d. (priming) at week 0, 4 and 8 or i.m. (boosting) at week 24 and 36

Tat 7.5 microg administered i.d. (priming) at week 0, 4 and 8 or i.m. (boosting) at week 24 and 36

Tat 30 microg administered i.d. at week 0, 4 and 8

Outcomes

Primary Outcome Measures

Safety and immunogenicity
To qualify the vaccine candidate as safe and immunogenic by evaluating the number of local and systemic adverse events, including any significant change in hematological/biochemical/coagulation laboratory parameters, and the frequency of anti-Tat and anti-delta-V2 Env humoral and cellular immune responses

Secondary Outcome Measures

Full Information

First Posted
September 26, 2011
Last Updated
March 3, 2016
Sponsor
Barbara Ensoli, MD
Collaborators
Novartis Vaccines
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1. Study Identification

Unique Protocol Identification Number
NCT01441193
Brief Title
A Phase I Safety and Immunogenicity Preventive Vaccine Trial Based on the HIV-1 Tat and V2-deleted Env Proteins (ISS P-002)
Official Title
A Phase I, Open Label, Safety and Immunogenicity Vaccine Trial Based on the Association of Recombinant HIV-1 Biologically Active Tat and V2-deleted Env Proteins in HIV Uninfected Healthy Adult Volunteers.
Study Type
Interventional

2. Study Status

Record Verification Date
March 2016
Overall Recruitment Status
Terminated
Why Stopped
Enrollments were suspended due to delta-V2 Env unavailability, following the EMA/CHMP/BWP/534898/2008 guideline, not allowing the use of a retest date
Study Start Date
September 2011 (undefined)
Primary Completion Date
February 2014 (Actual)
Study Completion Date
February 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Barbara Ensoli, MD
Collaborators
Novartis Vaccines

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This Phase I study was directed at evaluating the safety profile and the immunogenicity of the vaccination with recombinant HIV-1 Tat and V2-deleted Env (delta-V2 Env) proteins administered in association in healthy, immunologically competent adults, compared to delta-V2 Env or Tat alone.
Detailed Description
Since the inexorable spreading of HIV pandemic is unabated, the urgency of designing an effective, safe, inexpensive and easily administrable vaccine to protect people from HIV and/or AIDS is an absolute priority. Considering the array of functions sequentially exerted by the regulatory and the structural gene products in supporting the setting of a primary HIV infection, it is expected that vaccines combining early and late viral products (combined vaccines) should be superior to the single antigens approaches since they target multiple viral proteins which are necessary at different key steps of the virus life cycle, including cell-to-cell virus transmission and systemic virus propagation. A combined vaccine strategy based on the early regulatory protein Tat in association with the late structural protein Env modified to increase its immunogenicity (delta-V2Env) has been evaluated in pre-clinical studies in both small animals and monkeys. The results of these studies indicated that the combination of Tat with delta-V2Env is superior in inducing specific immune responses against both Tat and delta-V2Env antigens and in protecting or containing virus replication more efficiently than vaccination with the single antigens alone, confirming that these proteins represent optimal co-antigens for a combined vaccine strategy. This study was a multicentric, open label, randomized phase I trial, directed to qualify the safety and the immunogenicity of the vaccine based on the association of HIV-1 biologically active Tat and oligomeric ΔV2 Env proteins in healthy, immunologically competent adult volunteers, compared to the single compounds. Tat and delta-V2 Env proteins either in association or as single compounds were administered by a prime-boost regimen, consisting of 3 intradermal priming doses followed by 2 intramuscular boosting injections. Of note, phase I trials have already been successfully conducted with the 2 single components, at the doses proposed in this trial, in healthy individuals.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HIV Infection
Keywords
HIV, preventive vaccine, Tat, Env

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
11 (Actual)

8. Arms, Groups, and Interventions

Arm Title
HIV-1 Tat/delta-V2 Env combined vaccine
Arm Type
Experimental
Arm Description
Tat 7.5 microg and delta-V2 Env 100 microg associated proteins administered i.d. (priming) at week 0, 4 and 8 or i.m. (boosting) at weeks 24 and 36
Arm Title
HIV-1 delta-V2 Env vaccine
Arm Type
Active Comparator
Arm Description
delta-V2 Env 100 microg administered i.d. (priming) at week 0, 4 and 8 or i.m. (boosting) at week 24 and 36
Arm Title
HIV-1 Tat vaccine 7.5 microg
Arm Type
Active Comparator
Arm Description
Tat 7.5 microg administered i.d. (priming) at week 0, 4 and 8 or i.m. (boosting) at week 24 and 36
Arm Title
HIV-1 Tat vaccine 30 microg
Arm Type
Active Comparator
Arm Description
Tat 30 microg administered i.d. at week 0, 4 and 8
Intervention Type
Biological
Intervention Name(s)
HIV-1 Tat/delta-V2 Env combined vaccine
Intervention Type
Biological
Intervention Name(s)
HIV-1 delta-V2 Env vaccine
Intervention Type
Biological
Intervention Name(s)
HIV-1 Tat vaccine 7.5 microg
Intervention Type
Biological
Intervention Name(s)
HIV-1 Tat vaccine 30 microg
Primary Outcome Measure Information:
Title
Safety and immunogenicity
Description
To qualify the vaccine candidate as safe and immunogenic by evaluating the number of local and systemic adverse events, including any significant change in hematological/biochemical/coagulation laboratory parameters, and the frequency of anti-Tat and anti-delta-V2 Env humoral and cellular immune responses
Time Frame
up to week 68

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
55 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Age: 18 to 55 years; Negative blood pregnancy test for women of childbearing potential at screening evaluation (a urine dipstick test will be repeated just before each vaccination), and use of an acceptable mean of contraception by both men and women, since one month prior to immunization (only for women) and until at least 6 months after the last immunization; Blood pressure, heart rate and ECG within normal ranges or with mild alterations acknowledged as non clinically significant by the site clinician; Haematological and biochemical parameters within the clinical site normal ranges or with mild alterations acknowledged by the site clinician as non clinically significant; Normal urine dipstick with esterase and nitrite; Normal thyroid function; Negative for HIV infection and for anti-Tat antibodies; Good physical and mental health status; Availability for the planned study duration; Signed informed consent. Exclusion Criteria: Concomitant neoplastic diseases; History of malignant neoplastic diseases; History of encephalopathy, neuropathy or unstable CNS pathology, immunodeficiency, autoimmune disease, angina or cardiac arrhythmias, or any other clinically significant medical problems; History of anaphylaxis or serious adverse reactions to vaccines as well as serum IgE levels exceeding 1,000 U.I./mL; History of serious allergic reaction to any substance, requiring hospitalization or emergency medical care; Chest radiography showing evidence of active or acute cardiac or pulmonary disease; Any unstable cardiovascular disease; Active syphilis by TPHA and RPR tests [NOTE: If the serology is documented to be a false positive or due to an adequately treated infection, the volunteer is eligible]; Active tuberculosis by cutaneous TB diagnostic test [NOTE: Volunteers with a positive PPD and a normal chest X-ray showing no evidence of TB and not requiring specific therapy are eligible]; Medical or psychiatric condition or occupational responsibilities which preclude subject compliance with the protocol. Persons with psychotic disorders, major affective disorders or suicidal ideation are specifically excluded; Current use of psychotropic drugs; Drug and/or alcohol abuse; Current or prior therapy with immunomodulators or immunosuppressive drugs and anticoagulant drugs within 30 days prior to study medication administration; Live attenuated vaccines within 60 days prior to study entry [NOTE: Medically indicated sub-unit or killed vaccines (e.g, influenza, pneumococcal, hepatitis A and B) are not exclusionary, but should be given at least 4 weeks away from anti-HIV immunizations]; Use of investigational agents within 90 days prior to study entry; Participation in another experimental protocol within 6 months prior to pre-study screening; Prior receipt of HIV vaccine in a previous HIV vaccine trial; Receipt of blood products or immunoglobulin in the past 6 months; Pregnant or lactating women.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Barbara Ensoli, MD
Organizational Affiliation
Istituto Superiore di Sanità
Official's Role
Study Director
Facility Information:
Facility Name
Policlinico di Modena, Divisione di Malattie Infettive
City
Modena
ZIP/Postal Code
41100
Country
Italy
Facility Name
Azienda Ospedaliera San Gerardo, Divisione di Malattie Infettive
City
Monza
ZIP/Postal Code
20052
Country
Italy
Facility Name
IFO - S. Gallicano, Dermatologia Infettiva
City
Rome
ZIP/Postal Code
00153
Country
Italy

12. IPD Sharing Statement

Citations:
PubMed Identifier
21085635
Citation
Ensoli B, Bellino S, Tripiciano A, Longo O, Francavilla V, Marcotullio S, Cafaro A, Picconi O, Paniccia G, Scoglio A, Arancio A, Ariola C, Ruiz Alvarez MJ, Campagna M, Scaramuzzi D, Iori C, Esposito R, Mussini C, Ghinelli F, Sighinolfi L, Palamara G, Latini A, Angarano G, Ladisa N, Soscia F, Mercurio VS, Lazzarin A, Tambussi G, Visintini R, Mazzotta F, Di Pietro M, Galli M, Rusconi S, Carosi G, Torti C, Di Perri G, Bonora S, Ensoli F, Garaci E. Therapeutic immunization with HIV-1 Tat reduces immune activation and loss of regulatory T-cells and improves immune function in subjects on HAART. PLoS One. 2010 Nov 11;5(11):e13540. doi: 10.1371/journal.pone.0013540.
Results Reference
background
PubMed Identifier
20028332
Citation
Bellino S, Francavilla V, Longo O, Tripiciano A, Paniccia G, Arancio A, Fiorelli V, Scoglio A, Collacchi B, Campagna M, Lazzarin A, Tambussi G, Din CT, Visintini R, Narciso P, Antinori A, D'Offizi G, Giulianelli M, Carta M, Di Carlo A, Palamara G, Giuliani M, Laguardia ME, Monini P, Magnani M, Ensoli F, Ensoli B. Parallel conduction of the phase I preventive and therapeutic trials based on the Tat vaccine candidate. Rev Recent Clin Trials. 2009 Sep;4(3):195-204. doi: 10.2174/157488709789957529.
Results Reference
background
PubMed Identifier
19879233
Citation
Ensoli B, Fiorelli V, Ensoli F, Lazzarin A, Visintini R, Narciso P, Di Carlo A, Tripiciano A, Longo O, Bellino S, Francavilla V, Paniccia G, Arancio A, Scoglio A, Collacchi B, Ruiz Alvarez MJ, Tambussi G, Tassan Din C, Palamara G, Latini A, Antinori A, D'Offizi G, Giuliani M, Giulianelli M, Carta M, Monini P, Magnani M, Garaci E. The preventive phase I trial with the HIV-1 Tat-based vaccine. Vaccine. 2009 Dec 11;28(2):371-8. doi: 10.1016/j.vaccine.2009.10.038. Epub 2009 Oct 29.
Results Reference
background
PubMed Identifier
19811313
Citation
Caputo A, Gavioli R, Bellino S, Longo O, Tripiciano A, Francavilla V, Sgadari C, Paniccia G, Titti F, Cafaro A, Ferrantelli F, Monini P, Ensoli F, Ensoli B. HIV-1 Tat-based vaccines: an overview and perspectives in the field of HIV/AIDS vaccine development. Int Rev Immunol. 2009;28(5):285-334. doi: 10.1080/08830180903013026.
Results Reference
background
PubMed Identifier
19208456
Citation
Longo O, Tripiciano A, Fiorelli V, Bellino S, Scoglio A, Collacchi B, Alvarez MJ, Francavilla V, Arancio A, Paniccia G, Lazzarin A, Tambussi G, Din CT, Visintini R, Narciso P, Antinori A, D'Offizi G, Giulianelli M, Carta M, Di Carlo A, Palamara G, Giuliani M, Laguardia ME, Monini P, Magnani M, Ensoli F, Ensoli B. Phase I therapeutic trial of the HIV-1 Tat protein and long term follow-up. Vaccine. 2009 May 26;27(25-26):3306-12. doi: 10.1016/j.vaccine.2009.01.090. Epub 2009 Feb 7.
Results Reference
background
PubMed Identifier
17117011
Citation
Ensoli B, Fiorelli V, Ensoli F, Cafaro A, Titti F, Butto S, Monini P, Magnani M, Caputo A, Garaci E. Candidate HIV-1 Tat vaccine development: from basic science to clinical trials. AIDS. 2006 Nov 28;20(18):2245-61. doi: 10.1097/QAD.0b013e3280112cd1. No abstract available.
Results Reference
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PubMed Identifier
16275150
Citation
Barnett SW, Srivastava IK, Ulmer JB, Donnelly JJ, Rappuoli R. Development of V2-deleted trimeric envelope vaccine candidates from human immunodeficiency virus type 1 (HIV-1) subtypes B and C. Microbes Infect. 2005 Nov;7(14):1386-91. doi: 10.1016/j.micinf.2005.07.018. Epub 2005 Sep 20.
Results Reference
background
PubMed Identifier
16243561
Citation
Ensoli B, Cafaro A, Caputo A, Fiorelli V, Ensoli F, Gavioli R, Ferrantelli F, Cara A, Titti F, Magnani M. Vaccines based on the native HIV Tat protein and on the combination of Tat and the structural HIV protein variant DeltaV2 Env. Microbes Infect. 2005 Nov;7(14):1392-9. doi: 10.1016/j.micinf.2005.07.016. Epub 2005 Sep 15.
Results Reference
background
PubMed Identifier
18243435
Citation
Caputo A, Brocca-Cofano E, Castaldello A, Voltan R, Gavioli R, Srivastava IK, Barnett SW, Cafaro A, Ensoli B. Characterization of immune responses elicited in mice by intranasal co-immunization with HIV-1 Tat, gp140 DeltaV2Env and/or SIV Gag proteins and the nontoxicogenic heat-labile Escherichia coli enterotoxin. Vaccine. 2008 Feb 26;26(9):1214-27. doi: 10.1016/j.vaccine.2007.12.030. Epub 2008 Jan 15.
Results Reference
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PubMed Identifier
24961156
Citation
Bellino S, Tripiciano A, Picconi O, Francavilla V, Longo O, Sgadari C, Paniccia G, Arancio A, Angarano G, Ladisa N, Lazzarin A, Tambussi G, Nozza S, Torti C, Foca E, Palamara G, Latini A, Sighinolfi L, Mazzotta F, Di Pietro M, Di Perri G, Bonora S, Mercurio VS, Mussini C, Gori A, Galli M, Monini P, Cafaro A, Ensoli F, Ensoli B. The presence of anti-Tat antibodies in HIV-infected individuals is associated with containment of CD4+ T-cell decay and viral load, and with delay of disease progression: results of a 3-year cohort study. Retrovirology. 2014 Jun 24;11:49. doi: 10.1186/1742-4690-11-49.
Results Reference
background
PubMed Identifier
25250026
Citation
Ensoli B, Cafaro A, Monini P, Marcotullio S, Ensoli F. Challenges in HIV Vaccine Research for Treatment and Prevention. Front Immunol. 2014 Sep 8;5:417. doi: 10.3389/fimmu.2014.00417. eCollection 2014.
Results Reference
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PubMed Identifier
25924841
Citation
Ensoli F, Cafaro A, Casabianca A, Tripiciano A, Bellino S, Longo O, Francavilla V, Picconi O, Sgadari C, Moretti S, Cossut MR, Arancio A, Orlandi C, Sernicola L, Maggiorella MT, Paniccia G, Mussini C, Lazzarin A, Sighinolfi L, Palamara G, Gori A, Angarano G, Di Pietro M, Galli M, Mercurio VS, Castelli F, Di Perri G, Monini P, Magnani M, Garaci E, Ensoli B. HIV-1 Tat immunization restores immune homeostasis and attacks the HAART-resistant blood HIV DNA: results of a randomized phase II exploratory clinical trial. Retrovirology. 2015 Apr 29;12:33. doi: 10.1186/s12977-015-0151-y.
Results Reference
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Citation
Cafaro A, Tripiciano A, Sgadari C, Bellino S, Picconi O, Longo O, Francavilla V, Butto S, Titti F, Monini P, Ensoli F, Ensoli B. Development of a novel AIDS vaccine: the HIV-1 transactivator of transcription protein vaccine. Expert Opin Biol Ther. 2015;15 Suppl 1:S13-29. doi: 10.1517/14712598.2015.1021328. Epub 2015 Jun 22.
Results Reference
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Links:
URL
http://www.hiv1tat-vaccines.info
Description
Click here for a description of the efforts by the Italian National AIDS Center at the Italian National Institute of Health to develop preventive and therapeutic HIV vaccines based on the HIV-1 Tat protein

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A Phase I Safety and Immunogenicity Preventive Vaccine Trial Based on the HIV-1 Tat and V2-deleted Env Proteins (ISS P-002)

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