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Characterisation of a New Wild-Type H3N2 Virus for the Human Viral Challenge Model

Primary Purpose

Influenza

Status
Completed
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
Infectious titre 1 (H3N2)
Infectious titre 2 (H3N2)
Infectious titre 3 (H3N2)
Infectious titre 4 (H3N2)
Infectious titre 5 (H3N2) (Subjects aged 18 to 45 years old)
Infectious titre 5 (H3N2) (Subjects aged 46 to 64 years old)
Sponsored by
Hvivo
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional basic science trial for Influenza focused on measuring Flu, Influenza, Human Viral Challenge Model, Wild-Type, H3N2, Universal Influenza Vaccine, Intra-seasonal vaccines, Antiviral

Eligibility Criteria

18 Years - 64 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • In good health with no history of major medical conditions.
  • A total body weight ≥ 50 kg and a BMI of >18.
  • Acceptable forms of effective contraception.
  • An informed consent document signed and dated by the subject and Investigator.
  • Sero-suitable for Challenge Virus.

Exclusion Criteria:

  • Subjects who have a significant history of any tobacco use at any time (≥ total 10 pack year history, e.g. one pack a day for 10 years).
  • Subjects who have been pregnant within six months prior to the study, or who have a positive pregnancy test at any point in the study.
  • Any history or evidence of any clinically significant medical conditions (cardiovascular, gastrointestinal, endocrinological, haematological, hepatic, immunological, metabolic, urological, neurological, psychotic, renal, and/or other major disease or malignancy).
  • History or evidence of autoimmune disease or known immunodeficiency of any cause.
  • Subjects with any history of asthma, COPD, pulmonary hypertension, reactive airway disease, or chronic lung condition of any aetiology.
  • Positive human immunodeficiency virus (HIV), Hepatitis A (HAV), B (HBV), or C (HCV) test.
  • Any significant abnormality altering the anatomy of the nose or nasopharynx.
  • Any clinically significant history of epistaxis (nose bleeds).
  • Any nasal or sinus surgery within six months of inoculation.
  • Recurrent history of clinically significant autonomic dysfunction.
  • Any abnormal laboratory test or ECG.
  • Confirmed positive test for drugs of abuse.
  • Venous access deemed inadequate for the phlebotomy and cannulation.
  • Any known allergies to the excipients in the Challenge Virus inoculums.
  • Health care workers who work in units with severely immuno-compromised patients.
  • Evidence of vaccinations within the four weeks prior to Human Viral Challenge or intention to receive travel vaccination before the last study visit.
  • Receipt of blood or blood products, or loss (including blood donations) of 450 mL or more of blood, during the 3 months prior to inoculations.
  • Presence of significant respiratory symptoms existing on the day of challenge or between admission to the unit and inoculation with virus.
  • History suggestive of respiratory infection within 14 days prior to admission to the unit.
  • Use within 28 days prior to Human Viral Challenge (Day 0) of nasal steroids * Use within seven days of any other medication or product (prescription or over-the-counter), for symptoms of hay fever, rhinitis, nasal congestion or respiratory tract infection.
  • Receipt of systemic: glucocorticoids, antiviral drugs, or immunoglobulins (Igs) or any other cytotoxic or immunosuppressive drug.
  • Receipt of any systemic chemotherapy agent at any time.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm 3

    Arm 4

    Arm 5

    Arm 6

    Arm Type

    Experimental

    Experimental

    Experimental

    Experimental

    Experimental

    Experimental

    Arm Label

    Infectious titre 1

    Infectious titre 2

    Infectious titre 3

    Infectious titre 4

    Infectious titre 5 (age 18 to 45 y)

    Infectious titre 5 (age 46 to 64 y)

    Arm Description

    6 participants aged 18 to 45 were inoculated with 1mL containing 2.8 x 10*3 TCID50 of virus

    6 participants aged 18 to 45 were inoculated with 1mL containing 2.5 x 10*4 TCID50 of virus

    6 participants aged 18 to 45 were inoculated with 1mL containing 3.6 x 10*5 TCID50 of virus

    6 participants aged 18 to 45 were inoculated with 1mL containing 4.7 x 10*6 TCID50 of virus

    6 participants aged 18 to 45 were inoculated with 1mL containing 3.5 x 10*5 TCID50 of virus.

    16 participants aged 46 to 64 were inoculated with 1mL containing 3.5 x 10*5 TCID50 of virus.

    Outcomes

    Primary Outcome Measures

    Area Under the Curve of Virus Load
    Area under the curve (AUC) of the Challenge Viral load, measured by nasopharyngeal swab quantitative polymerase chain reaction [qPCR], from Day 1 to Day 8 post-Viral Challenge. Nasopharyngeal swabs are collected up to 3 times per day ( every 8 hours +/- 30mins)

    Secondary Outcome Measures

    Full Information

    First Posted
    August 6, 2015
    Last Updated
    January 23, 2020
    Sponsor
    Hvivo
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    1. Study Identification

    Unique Protocol Identification Number
    NCT02525055
    Brief Title
    Characterisation of a New Wild-Type H3N2 Virus for the Human Viral Challenge Model
    Official Title
    A Randomised, Double Blind Study To Characterise Influenza A/Perth/16/2009(H3N2) Virus
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    January 2020
    Overall Recruitment Status
    Completed
    Study Start Date
    January 2014 (undefined)
    Primary Completion Date
    August 11, 2014 (Actual)
    Study Completion Date
    August 11, 2014 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Hvivo

    4. Oversight

    Data Monitoring Committee
    Yes

    5. Study Description

    Brief Summary
    The study will characterise Influenza A/Perth/16/2009(H3N2) virus in healthy participants using the viral challenge model. The study includes two cohorts. Cohort 1: A randomised, double-blind study of 4 titres of Challenge Virus to determine the optimum titre. Cohort 2: An open-label extension arm in which all participants will receive the 'optimum' titre as identified from Cohort 1.
    Detailed Description
    Influenza and its associated diseases are a major cause of morbidity and mortality. The United States Advisory Committee on Immunization Practices recommends influenza vaccination for everyone over 6 months of age. The failure of the flu vaccine in 2014-2015 demonstrates the need for a model that allows the rapid development of novel antivirals, universal/intra-seasonal vaccines, immunomodulators, monoclonal antibodies and other novel treatments. Studies using experimental influenza virus infection in human participants have demonstrated that adult volunteers can be infected by nasal inoculation, and experimental infection is safe and not associated with transmission to contacts. The experimental virus is manufactured in compliance with Good Manufacturing Practice for use in the Human Viral Challenge Model. The investigators chose an H3N2 influenza subtype given that this strain has the most substantial impact in terms of morbidity or mortality annually as described by the Centre for Disease Control . The investigators first subjected the virus batch to rigorous adventitious agent testing, then confirmed the virus to be wild-type by Sanger sequencing and finally determined the virus titres appropriate for human use via the established ferret model. hVIVO team built on its previous experience with other H3N2 and H1N1 viruses to develop this unique model. The first part of study (Cohort 1) was to determine the safety and optimal virus titre in healthy adult volunteers using our unique clinical quarantine facility in London, UK. After the first part of the study was completed, the study was amended to add an older population group (45-64 years old) in order to characterise the course of infection in an age group better representing the at-risk population.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Influenza
    Keywords
    Flu, Influenza, Human Viral Challenge Model, Wild-Type, H3N2, Universal Influenza Vaccine, Intra-seasonal vaccines, Antiviral

    7. Study Design

    Primary Purpose
    Basic Science
    Study Phase
    Not Applicable
    Interventional Study Model
    Parallel Assignment
    Masking
    ParticipantInvestigator
    Masking Description
    Cohort 1 (including 4 arms) is double blinded. Cohort 2 (including 1 arm divided in 2 separate age comparison groups) is open labelled. In order to allow for an age comparison between subjects aged 18 to 45 and subjects aged 56 to 64, data from Cohort 2 (Infectious Titre 5) will be presented in 2 separate reporting groups.
    Allocation
    Randomized
    Enrollment
    46 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Infectious titre 1
    Arm Type
    Experimental
    Arm Description
    6 participants aged 18 to 45 were inoculated with 1mL containing 2.8 x 10*3 TCID50 of virus
    Arm Title
    Infectious titre 2
    Arm Type
    Experimental
    Arm Description
    6 participants aged 18 to 45 were inoculated with 1mL containing 2.5 x 10*4 TCID50 of virus
    Arm Title
    Infectious titre 3
    Arm Type
    Experimental
    Arm Description
    6 participants aged 18 to 45 were inoculated with 1mL containing 3.6 x 10*5 TCID50 of virus
    Arm Title
    Infectious titre 4
    Arm Type
    Experimental
    Arm Description
    6 participants aged 18 to 45 were inoculated with 1mL containing 4.7 x 10*6 TCID50 of virus
    Arm Title
    Infectious titre 5 (age 18 to 45 y)
    Arm Type
    Experimental
    Arm Description
    6 participants aged 18 to 45 were inoculated with 1mL containing 3.5 x 10*5 TCID50 of virus.
    Arm Title
    Infectious titre 5 (age 46 to 64 y)
    Arm Type
    Experimental
    Arm Description
    16 participants aged 46 to 64 were inoculated with 1mL containing 3.5 x 10*5 TCID50 of virus.
    Intervention Type
    Other
    Intervention Name(s)
    Infectious titre 1 (H3N2)
    Intervention Description
    Infectious titre 1: 2.8 x 10*3 TCID50/mL
    Intervention Type
    Other
    Intervention Name(s)
    Infectious titre 2 (H3N2)
    Intervention Description
    Infectious titre 2: 2.5 x 10*4 TCID50/mL
    Intervention Type
    Other
    Intervention Name(s)
    Infectious titre 3 (H3N2)
    Intervention Description
    Infectious titre 3: 3.6 x 10*5 TCID50/mL
    Intervention Type
    Other
    Intervention Name(s)
    Infectious titre 4 (H3N2)
    Intervention Description
    Infectious titre 4: 4.7 x 10*6 TCID50/mL
    Intervention Type
    Other
    Intervention Name(s)
    Infectious titre 5 (H3N2) (Subjects aged 18 to 45 years old)
    Intervention Description
    Infectious titre 5: 3.5 x 10*5 TCID50/mL
    Intervention Type
    Other
    Intervention Name(s)
    Infectious titre 5 (H3N2) (Subjects aged 46 to 64 years old)
    Intervention Description
    Infectious titre 5: 3.5 x 10*5 TCID50/mL
    Primary Outcome Measure Information:
    Title
    Area Under the Curve of Virus Load
    Description
    Area under the curve (AUC) of the Challenge Viral load, measured by nasopharyngeal swab quantitative polymerase chain reaction [qPCR], from Day 1 to Day 8 post-Viral Challenge. Nasopharyngeal swabs are collected up to 3 times per day ( every 8 hours +/- 30mins)
    Time Frame
    8 days
    Other Pre-specified Outcome Measures:
    Title
    Incidence (Number and Percentage [%]) of Viral Challenge Emergent Adverse Events
    Time Frame
    8 days

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    64 Years
    Accepts Healthy Volunteers
    Accepts Healthy Volunteers
    Eligibility Criteria
    Inclusion Criteria: In good health with no history of major medical conditions. A total body weight ≥ 50 kg and a BMI of >18. Acceptable forms of effective contraception. An informed consent document signed and dated by the subject and Investigator. Sero-suitable for Challenge Virus. Exclusion Criteria: Subjects who have a significant history of any tobacco use at any time (≥ total 10 pack year history, e.g. one pack a day for 10 years). Subjects who have been pregnant within six months prior to the study, or who have a positive pregnancy test at any point in the study. Any history or evidence of any clinically significant medical conditions (cardiovascular, gastrointestinal, endocrinological, haematological, hepatic, immunological, metabolic, urological, neurological, psychotic, renal, and/or other major disease or malignancy). History or evidence of autoimmune disease or known immunodeficiency of any cause. Subjects with any history of asthma, COPD, pulmonary hypertension, reactive airway disease, or chronic lung condition of any aetiology. Positive human immunodeficiency virus (HIV), Hepatitis A (HAV), B (HBV), or C (HCV) test. Any significant abnormality altering the anatomy of the nose or nasopharynx. Any clinically significant history of epistaxis (nose bleeds). Any nasal or sinus surgery within six months of inoculation. Recurrent history of clinically significant autonomic dysfunction. Any abnormal laboratory test or ECG. Confirmed positive test for drugs of abuse. Venous access deemed inadequate for the phlebotomy and cannulation. Any known allergies to the excipients in the Challenge Virus inoculums. Health care workers who work in units with severely immuno-compromised patients. Evidence of vaccinations within the four weeks prior to Human Viral Challenge or intention to receive travel vaccination before the last study visit. Receipt of blood or blood products, or loss (including blood donations) of 450 mL or more of blood, during the 3 months prior to inoculations. Presence of significant respiratory symptoms existing on the day of challenge or between admission to the unit and inoculation with virus. History suggestive of respiratory infection within 14 days prior to admission to the unit. Use within 28 days prior to Human Viral Challenge (Day 0) of nasal steroids * Use within seven days of any other medication or product (prescription or over-the-counter), for symptoms of hay fever, rhinitis, nasal congestion or respiratory tract infection. Receipt of systemic: glucocorticoids, antiviral drugs, or immunoglobulins (Igs) or any other cytotoxic or immunosuppressive drug. Receipt of any systemic chemotherapy agent at any time.
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Bryan Muray, MD
    Organizational Affiliation
    Hvivo
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Citations:
    PubMed Identifier
    27280602
    Citation
    Fullen DJ, Noulin N, Catchpole A, Fathi H, Murray EJ, Mann A, Eze K, Balaratnam G, Borley DW, Gilbert A, Lambkin-Williams R. Correction: Accelerating Influenza Research: Vaccines, Antivirals, Immunomodulators and Monoclonal Antibodies. The Manufacture of a New Wild-Type H3N2 Virus for the Human Viral Challenge Model. PLoS One. 2016 Jun 9;11(6):e0157211. doi: 10.1371/journal.pone.0157211. eCollection 2016.
    Results Reference
    result
    PubMed Identifier
    26761707
    Citation
    Fullen DJ, Noulin N, Catchpole A, Fathi H, Murray EJ, Mann A, Eze K, Balaratnam G, Borley DW, Gilbert A, Lambkin-Williams R. Accelerating Influenza Research: Vaccines, Antivirals, Immunomodulators and Monoclonal Antibodies. The Manufacture of a New Wild-Type H3N2 Virus for the Human Viral Challenge Model. PLoS One. 2016 Jan 13;11(1):e0145902. doi: 10.1371/journal.pone.0145902. eCollection 2016. Erratum In: PLoS One. 2016;11(6):e0157211.
    Results Reference
    derived

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    Characterisation of a New Wild-Type H3N2 Virus for the Human Viral Challenge Model

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