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Determining Responses to Two Different Vaccines in HIV and HCV Infected Individuals

Primary Purpose

HIV Infections, Hepatitis C

Status
Completed
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
Twinrix
Decavac
Sponsored by
National Institute of Allergy and Infectious Diseases (NIAID)
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for HIV Infections focused on measuring Treatment Experienced, Treatment Naive, Immunizations

Eligibility Criteria

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

Inclusion Criteria for Arm A Participants:

  • HCV-infected
  • HIV-uninfected

Inclusion Criteria for Arm B Participants:

  • HIV-infected
  • HCV-uninfected
  • CD4 count greater than or equal to 300 cells/mm3 within 60 days prior to study entry

Inclusion Criteria for Arm C Participants:

  • HIV-infected
  • HCV-infected

Inclusion Criteria for All Participants:

  • Documented hepatitis B virus (HBV) antibody status. If anti-HBV core antibody positive, documented HBV negative test within 30 days prior to study entry is required.
  • Willing to use acceptable forms of contraception for the duration of the study and for 24 weeks after the last vaccination

Exclusion Criteria for Arm A Participants:

  • Concurrent or recent treatment for HCV infection (within the past three months)

Exclusion Criteria for Arm B Participants:

  • Current, prior, or clinical need for antiretroviral therapy (within the past three months prior to study entry)
  • Opportunistic infection other than HCV

Exclusion Criteria for Arm C Participants:

  • Concurrent or recent treatment for HCV infection (within the past three months)
  • Current, prior, or clinical need for antiretroviral therapy (within the past three months prior to study entry). More information on this criterion can be found in the protocol.
  • Opportunistic infection other than HCV

Exclusion Criteria for All Participants:

  • History of exposure to hepatitis A vaccine, hepatitis B vaccine, or combined hepatitis A-hepatitis B vaccines
  • Immunomodulatory agents for 7 days or more within 30 days prior to study entry. More information on this criterion can be found in the protocol.
  • Concurrent immunizations (e.g., influenza, pneumococcal, other vaccine)within 3 days prior to study entry
  • Active or recent (in the last six months prior to study entry) CDC Category C event. More information on this criterion can be found in the protocol
  • Systemic anticancer chemotherapy or radiation within 24 weeks prior to study entry, or anticipated need to begin such treatment
  • Past or current immunologically-mediated disease. More information on this criterion can be found in the protocol.
  • Current bacterial infection requiring treatment, therapy, or hospitalization within 1 week prior to study entry
  • Serious illness requiring systemic treatment and/or hospitalization. Participants who complete therapy or are clinically stable on therapy for at least 14 days prior to study entry are not excluded.
  • Current uncontrolled seizure disorders
  • Active bleeding varices, or Child's B or C cirrhosis. More information on this criterion can be found in the protocol.
  • Serious bleeding disorder that poses a risk to a participant for intramuscular injections
  • Known allergy or sensitivity to study vaccines or their formulations
  • Current drug or alcohol use that, in the opinion of the investigator, interferes with study participation
  • Pregnant or breastfeeding
  • Use of systemic investigational agents within 30 days prior to entry
  • History of any hepatitis A vaccine within one year

Sites / Locations

  • UCSD Antiviral Research Center CRS
  • Ucsf Aids Crs
  • University of Colorado Hospital CRS
  • IHV Baltimore Treatment CRS
  • Massachusetts General Hospital Clinical Research Site (MGH CRS) CRS
  • Columbia P&S CRS
  • Duke Univ. Med. Ctr. Adult CRS
  • Case CRS
  • MetroHealth CRS
  • The Ohio State University Medical Center
  • Trinity Health and Wellness Center CRS
  • Puerto Rico AIDS Clinical Trials Unit CRS

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

A

B

C

Arm Description

HCV-infected defined as a positive result using polymerase chain reaction (PCR) without previous HCV-based therapy and without the presence of Child's B or C cirrhosis. These participants will be HIV-uninfected.

HIV-infected and ARV naive, with a CD4 cell count of 300 cells/mm3 or greater, with no prior or current opportunistic infection, and with no indication for HIV therapy. These participants will be HCV-uninfected.

HCV/HIV-coinfected as defined above in Arms A and B.

Outcomes

Primary Outcome Measures

B-cell humoral responses
T-cell responses as reflected by hepatitis B and tetanus antibody titers
Dendritic cell, B-cell, and T-cell functional markers

Secondary Outcome Measures

B-cell functional marker
T-cell responses to hepatitis A, hepatitis B, and tetanus antigens
Longitudinal serum antibody titers to hepatitis A, hepatitis B, and tetanus (B-cell responses)
CD4/CD8 and HCV genotype
Baseline antibody status for hepatitis B core antigen (anti-HBc)

Full Information

First Posted
October 25, 2006
Last Updated
October 28, 2021
Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)
Collaborators
AIDS Clinical Trials Group
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1. Study Identification

Unique Protocol Identification Number
NCT00393276
Brief Title
Determining Responses to Two Different Vaccines in HIV and HCV Infected Individuals
Official Title
Optimizing Vaccine Responsiveness in HIV-1 and HCV Infections by Identifying Determinants of Responsiveness: A Pilot Study
Study Type
Interventional

2. Study Status

Record Verification Date
October 2021
Overall Recruitment Status
Completed
Study Start Date
August 2007 (undefined)
Primary Completion Date
July 2009 (Actual)
Study Completion Date
July 2009 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)
Collaborators
AIDS Clinical Trials Group

4. Oversight

5. Study Description

Brief Summary
Infection with either HIV or hepatitis C virus (HCV) affects immune system responses. The purpose of this study is to investigate the immune responses to two different vaccine formulations in HIV-infected, HCV-infected, and HCV/HIV- coinfected individuals.
Detailed Description
Individuals with HCV and HIV coinfection are especially hard to treat, and as a result, account for a high rate of deaths each year. Because HCV and HIV share transmission routes, HCV/HIV coinfection is common. Liver disease has emerged as a significant cause of death in individuals coinfected with HCV and HIV. Currently, the mechanisms by which HCV and HIV interact in HCV/HIV-coinfected individuals, including how these infections affect immune responses, are poorly understood. Research suggests that vaccination may prevent other comorbidities associated with HCV/HIV coinfection; however, responses to new vaccine antigens have been shown to be impaired in HCV or HIV-infected individuals. The purpose of this study is to identify the innate and adaptive immune defects present in HCV-infected, HIV-infected, and HCV/HIV-coinfected individuals. This study will evaluate whether these innate and adaptive immune defects predict responses to HBV neoantigen in the form of both a diphtheria/tetanus toxoid immunization (Decavac)and a hepatitis A-hepatitis B immunization (Twinrix). This study will last approximately 24 weeks. Participants will be stratified to one of three arms, based on their HCV and HIV status: Arm A will enroll HCV-infected individuals who are HIV-uninfected Arm B will enroll HIV-infected individuals who are HCV-uninfected Arm C will enroll HCV/HIV-coinfected individuals Arms B and C will open for enrollment before Arm A. Opening of enrollment for Arm A will be determined by the accrual progress of Arms B and C as evaluated by the ACTG Scientific Agenda Steering committee. All participants will receive Decavac vaccination on Day 0, and a Twinrix vaccination on Days 0, 7, and 21. Study visits will occur around Days 0, 7, and 21, and at Weeks 6, 8, 12, and 24; all visits will include medical and medication history, blood collection, and a physical exam. Medication to treat HCV or HIV will not be provided by the study.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HIV Infections, Hepatitis C
Keywords
Treatment Experienced, Treatment Naive, Immunizations

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
29 (Actual)

8. Arms, Groups, and Interventions

Arm Title
A
Arm Type
Experimental
Arm Description
HCV-infected defined as a positive result using polymerase chain reaction (PCR) without previous HCV-based therapy and without the presence of Child's B or C cirrhosis. These participants will be HIV-uninfected.
Arm Title
B
Arm Type
Experimental
Arm Description
HIV-infected and ARV naive, with a CD4 cell count of 300 cells/mm3 or greater, with no prior or current opportunistic infection, and with no indication for HIV therapy. These participants will be HCV-uninfected.
Arm Title
C
Arm Type
Experimental
Arm Description
HCV/HIV-coinfected as defined above in Arms A and B.
Intervention Type
Biological
Intervention Name(s)
Twinrix
Intervention Description
Combined hepatitis A and hepatitis B immunization
Intervention Type
Biological
Intervention Name(s)
Decavac
Intervention Description
Diphtheria and tetanus toxoid vaccine
Primary Outcome Measure Information:
Title
B-cell humoral responses
Time Frame
At Week 8
Title
T-cell responses as reflected by hepatitis B and tetanus antibody titers
Time Frame
At Week 8
Title
Dendritic cell, B-cell, and T-cell functional markers
Time Frame
At Study Entry
Secondary Outcome Measure Information:
Title
B-cell functional marker
Time Frame
At Week 6
Title
T-cell responses to hepatitis A, hepatitis B, and tetanus antigens
Time Frame
At Weeks 3 and 8
Title
Longitudinal serum antibody titers to hepatitis A, hepatitis B, and tetanus (B-cell responses)
Time Frame
At Study Entry and Weeks 1, 3, 6, 8, 12, and 24
Title
CD4/CD8 and HCV genotype
Time Frame
At Study entry
Title
Baseline antibody status for hepatitis B core antigen (anti-HBc)
Time Frame
At Study entry

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 for Arm A Participants: HCV-infected HIV-uninfected Inclusion Criteria for Arm B Participants: HIV-infected HCV-uninfected CD4 count greater than or equal to 300 cells/mm3 within 60 days prior to study entry Inclusion Criteria for Arm C Participants: HIV-infected HCV-infected Inclusion Criteria for All Participants: Documented hepatitis B virus (HBV) antibody status. If anti-HBV core antibody positive, documented HBV negative test within 30 days prior to study entry is required. Willing to use acceptable forms of contraception for the duration of the study and for 24 weeks after the last vaccination Exclusion Criteria for Arm A Participants: Concurrent or recent treatment for HCV infection (within the past three months) Exclusion Criteria for Arm B Participants: Current, prior, or clinical need for antiretroviral therapy (within the past three months prior to study entry) Opportunistic infection other than HCV Exclusion Criteria for Arm C Participants: Concurrent or recent treatment for HCV infection (within the past three months) Current, prior, or clinical need for antiretroviral therapy (within the past three months prior to study entry). More information on this criterion can be found in the protocol. Opportunistic infection other than HCV Exclusion Criteria for All Participants: History of exposure to hepatitis A vaccine, hepatitis B vaccine, or combined hepatitis A-hepatitis B vaccines Immunomodulatory agents for 7 days or more within 30 days prior to study entry. More information on this criterion can be found in the protocol. Concurrent immunizations (e.g., influenza, pneumococcal, other vaccine)within 3 days prior to study entry Active or recent (in the last six months prior to study entry) CDC Category C event. More information on this criterion can be found in the protocol Systemic anticancer chemotherapy or radiation within 24 weeks prior to study entry, or anticipated need to begin such treatment Past or current immunologically-mediated disease. More information on this criterion can be found in the protocol. Current bacterial infection requiring treatment, therapy, or hospitalization within 1 week prior to study entry Serious illness requiring systemic treatment and/or hospitalization. Participants who complete therapy or are clinically stable on therapy for at least 14 days prior to study entry are not excluded. Current uncontrolled seizure disorders Active bleeding varices, or Child's B or C cirrhosis. More information on this criterion can be found in the protocol. Serious bleeding disorder that poses a risk to a participant for intramuscular injections Known allergy or sensitivity to study vaccines or their formulations Current drug or alcohol use that, in the opinion of the investigator, interferes with study participation Pregnant or breastfeeding Use of systemic investigational agents within 30 days prior to entry History of any hepatitis A vaccine within one year
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Donald D. Anthony, MD, PhD
Organizational Affiliation
Case Western Reserve University
Official's Role
Study Chair
First Name & Middle Initial & Last Name & Degree
Benigno Rodriguez, MD
Organizational Affiliation
Division of Infectious Diseases, University Hospital of Cleveland
Official's Role
Study Chair
Facility Information:
Facility Name
UCSD Antiviral Research Center CRS
City
San Diego
State/Province
California
ZIP/Postal Code
92103
Country
United States
Facility Name
Ucsf Aids Crs
City
San Francisco
State/Province
California
ZIP/Postal Code
94110
Country
United States
Facility Name
University of Colorado Hospital CRS
City
Aurora
State/Province
Colorado
ZIP/Postal Code
80045
Country
United States
Facility Name
IHV Baltimore Treatment CRS
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21201
Country
United States
Facility Name
Massachusetts General Hospital Clinical Research Site (MGH CRS) CRS
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02114
Country
United States
Facility Name
Columbia P&S CRS
City
New York
State/Province
New York
ZIP/Postal Code
10032-3732
Country
United States
Facility Name
Duke Univ. Med. Ctr. Adult CRS
City
Durham
State/Province
North Carolina
ZIP/Postal Code
27710
Country
United States
Facility Name
Case CRS
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44106-5083
Country
United States
Facility Name
MetroHealth CRS
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44109
Country
United States
Facility Name
The Ohio State University Medical Center
City
Columbus
State/Province
Ohio
ZIP/Postal Code
43210
Country
United States
Facility Name
Trinity Health and Wellness Center CRS
City
Dallas
State/Province
Texas
Country
United States
Facility Name
Puerto Rico AIDS Clinical Trials Unit CRS
City
San Juan
Country
Puerto Rico

12. IPD Sharing Statement

Citations:
PubMed Identifier
12174359
Citation
Maier I, Wu GY. Hepatitis C and HIV co-infection: a review. World J Gastroenterol. 2002 Aug;8(4):577-9. doi: 10.3748/wjg.v8.i4.577.
Results Reference
background
PubMed Identifier
14562859
Citation
Rockstroh JK. Management of hepatitis B and C in HIV co-infected patients. J Acquir Immune Defic Syndr. 2003 Sep;34 Suppl 1:S59-65. doi: 10.1097/00126334-200309011-00009.
Results Reference
background
PubMed Identifier
10770916
Citation
Sulkowski MS, Mast EE, Seeff LB, Thomas DL. Hepatitis C virus infection as an opportunistic disease in persons infected with human immunodeficiency virus. Clin Infect Dis. 2000 Apr;30 Suppl 1:S77-84. doi: 10.1086/313842.
Results Reference
background

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Determining Responses to Two Different Vaccines in HIV and HCV Infected Individuals

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