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Repeated Controlled Human Hookworm Infection (ReCHHI1)

Primary Purpose

Necator Americanus Infection

Status
Completed
Phase
Not Applicable
Locations
Netherlands
Study Type
Interventional
Intervention
50 Necator americanus L3 larvae
100 Necator americanus L3 larvae
150 Necator americanus L3 larvae
Sponsored by
Meta Roestenberg
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional diagnostic trial for Necator Americanus Infection focused on measuring hookworm, controlled human infection model

Eligibility Criteria

18 Years - 45 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  1. Subject is aged ≥ 18 and ≤ 45 years and in good health.
  2. Subject has adequate understanding of the procedures of the study and agrees to abide strictly thereby.
  3. Subject is able to communicate well with the investigator, is available to attend all study visits.
  4. Subject agrees to refrain from blood donation to Sanquin or for other purposes throughout the study period.
  5. For female subjects: subject agrees to use adequate contraception and not to breastfeed for the duration of study.
  6. Subject has signed informed consent.

Exclusion Criteria:

  1. Any history, or evidence at screening, of clinically significant symptoms, physical signs or abnormal laboratory values suggestive of systemic conditions, such as cardiovascular, pulmonary, renal, hepatic, neurological, dermatological, endocrine, malignant, haematological, infectious, immune-deficient, psychiatric and other disorders, which could compromise the health of the volunteer during the study or interfere with the interpretation of the study results. These include, but are not limited to, any of the following:

    • Body Mass Index (BMI) <18.0 or >30.0 kg/m2 at screening;
    • positive HIV, HBV or HCV screening tests;
    • the use of immune modifying drugs within three months prior to study onset (inhaled and topical corticosteroids and oral anti-histamines exempted) or expected use of such during the study period;
    • having one of the following laboratory abnormalities: ferritine <10 ug/L, transferrine <2.04 g/L or Hb <7.0 mmol/L for females or <8.0 mmol/L for males;
    • history of malignancy of any organ system (other than localized basal cell carcinoma of the skin), treated or untreated, within the past 5 years;
    • any history of treatment for severe psychiatric disease by a psychiatrist in the past year;
    • history of drug or alcohol abuse interfering with normal social function in the period of one year prior to study onset.
  2. Known hypersensitivity to or contra-indications for use of albendazole, including co-medication known to interact with albendazole metabolism (e.g. carbamazepine, phenobarbital, phenytoin, cimetidine, theophylline, dexamethasone)
  3. Known allergy to amphotericin B or gentamicin
  4. For female subjects: positive urine pregnancy test at screening
  5. Positive faecal qPCR or Kato-Katz for hookworm at screening, any known history of hookworm infection or treatment for hookworm infection or possible exposure to hookworm in the past
  6. Being an employee or student of the department of parasitology of the LUMC
  7. Current or past scars, tattoos, or other disruptions of skin integrity at the intended site of larval application
  8. Subjects with planned travel to hookworm endemic areas during this trial
  9. Receipt of a vaccine within 4 weeks prior to the study initiation
  10. Known food allergy

Sites / Locations

  • Leiden University Medical Center

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

A: 50 Necator americanus L3 larvae

B: 100 Necator americanus L3 larvae

C: 150 Necator americanus L3 larvae

Arm Description

Mock infections with water at week 0 and 2, infection with 50 Necator americanus L3 larvae at week 4

Mock infections with water at week 0, infection with 50 Necator americanus L3 larvae at week 2 and 4

Infection with 50 Necator americanus L3 larvae at week 0, 2 and 4

Outcomes

Primary Outcome Measures

Frequency of adverse events
Frequency of adverse events as compared between study groups A, B and C.
Magnitude of adverse events
Magnitude of adverse events as compared between study groups A, B and C.

Secondary Outcome Measures

Variability in egg secretion
Variability in egg secretion by Kato-Katz from week 16 to 20
Lowest dose at which there is 100% patent hookworm infection
The lowest dose at which there is 100% patent hookworm infection, as defined by a positive Kato-Katz at any time between week 16 to 20
Comparison of the average number of eggs secreted
Comparison of the average number of eggs secreted by Kato-Katz and qPCR between different groups in weeks 16-20 after the infection

Full Information

First Posted
August 10, 2017
Last Updated
November 16, 2020
Sponsor
Meta Roestenberg
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1. Study Identification

Unique Protocol Identification Number
NCT03257072
Brief Title
Repeated Controlled Human Hookworm Infection
Acronym
ReCHHI1
Official Title
Repeated Controlled Human Hookworm Infection in Healthy Dutch Volunteers
Study Type
Interventional

2. Study Status

Record Verification Date
November 2020
Overall Recruitment Status
Completed
Study Start Date
January 10, 2018 (Actual)
Primary Completion Date
August 30, 2018 (Actual)
Study Completion Date
August 30, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Meta Roestenberg

4. Oversight

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

5. Study Description

Brief Summary
Twenty-four healthy hookworm-naive volunteers will be exposed to 50 L3 Necator americanus larvae for a maximum of three times.
Detailed Description
Twenty-four volunteers will be allocated equally into three groups (i.e. group A, B, C). Group A, B, and C will have one, two, and three infections respectively. Every infection will be performed with 50 L3 Necator americanus larvae. Group A will receive infection at week 4 only. Group B will be infected at week 2 and week 4. Group C will be infected at week 0, 2 and 4. To maintain blinding, group A and B will receive mock infections with water at week 0 and week 0 and 2 respectively. The interval between each CHHI is 2 weeks. Before every infection, the safety will be assessed by a review of adverse events data with a local safety monitor. Sixteen weeks after the last infection (week 20), all volunteers will be offered treatment with a 3-day regimen of albendazole to abrogate infection. Volunteers with average egg counts >250 eggs per gram will be asked if they would be willing to keep their infection for a maximum of two years (chronic donors). No more than four volunteers will be selected to be chronic donors. Six months after the last infection (or after the last donation for the chronic donors) volunteers will undergo their last visit.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Necator Americanus Infection
Keywords
hookworm, controlled human infection model

7. Study Design

Primary Purpose
Diagnostic
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Model Description
double-blind, placebo-controlled, dose-escalation trial
Masking
ParticipantCare ProviderInvestigator
Masking Description
double-blind
Allocation
Randomized
Enrollment
24 (Actual)

8. Arms, Groups, and Interventions

Arm Title
A: 50 Necator americanus L3 larvae
Arm Type
Experimental
Arm Description
Mock infections with water at week 0 and 2, infection with 50 Necator americanus L3 larvae at week 4
Arm Title
B: 100 Necator americanus L3 larvae
Arm Type
Experimental
Arm Description
Mock infections with water at week 0, infection with 50 Necator americanus L3 larvae at week 2 and 4
Arm Title
C: 150 Necator americanus L3 larvae
Arm Type
Experimental
Arm Description
Infection with 50 Necator americanus L3 larvae at week 0, 2 and 4
Intervention Type
Biological
Intervention Name(s)
50 Necator americanus L3 larvae
Intervention Description
1x50 Necator americanus L3 larvae
Intervention Type
Biological
Intervention Name(s)
100 Necator americanus L3 larvae
Intervention Description
2x50 Necator americanus L3 larvae
Intervention Type
Biological
Intervention Name(s)
150 Necator americanus L3 larvae
Intervention Description
3x50 Necator americanus L3 larvae
Primary Outcome Measure Information:
Title
Frequency of adverse events
Description
Frequency of adverse events as compared between study groups A, B and C.
Time Frame
28 weeks
Title
Magnitude of adverse events
Description
Magnitude of adverse events as compared between study groups A, B and C.
Time Frame
28 weeks
Secondary Outcome Measure Information:
Title
Variability in egg secretion
Description
Variability in egg secretion by Kato-Katz from week 16 to 20
Time Frame
20 weeks
Title
Lowest dose at which there is 100% patent hookworm infection
Description
The lowest dose at which there is 100% patent hookworm infection, as defined by a positive Kato-Katz at any time between week 16 to 20
Time Frame
20 weeks
Title
Comparison of the average number of eggs secreted
Description
Comparison of the average number of eggs secreted by Kato-Katz and qPCR between different groups in weeks 16-20 after the infection
Time Frame
20 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
45 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Subject is aged ≥ 18 and ≤ 45 years and in good health. Subject has adequate understanding of the procedures of the study and agrees to abide strictly thereby. Subject is able to communicate well with the investigator, is available to attend all study visits. Subject agrees to refrain from blood donation to Sanquin or for other purposes throughout the study period. For female subjects: subject agrees to use adequate contraception and not to breastfeed for the duration of study. Subject has signed informed consent. Exclusion Criteria: Any history, or evidence at screening, of clinically significant symptoms, physical signs or abnormal laboratory values suggestive of systemic conditions, such as cardiovascular, pulmonary, renal, hepatic, neurological, dermatological, endocrine, malignant, haematological, infectious, immune-deficient, psychiatric and other disorders, which could compromise the health of the volunteer during the study or interfere with the interpretation of the study results. These include, but are not limited to, any of the following: Body Mass Index (BMI) <18.0 or >30.0 kg/m2 at screening; positive HIV, HBV or HCV screening tests; the use of immune modifying drugs within three months prior to study onset (inhaled and topical corticosteroids and oral anti-histamines exempted) or expected use of such during the study period; having one of the following laboratory abnormalities: ferritine <10 ug/L, transferrine <2.04 g/L or Hb <7.0 mmol/L for females or <8.0 mmol/L for males; history of malignancy of any organ system (other than localized basal cell carcinoma of the skin), treated or untreated, within the past 5 years; any history of treatment for severe psychiatric disease by a psychiatrist in the past year; history of drug or alcohol abuse interfering with normal social function in the period of one year prior to study onset. Known hypersensitivity to or contra-indications for use of albendazole, including co-medication known to interact with albendazole metabolism (e.g. carbamazepine, phenobarbital, phenytoin, cimetidine, theophylline, dexamethasone) Known allergy to amphotericin B or gentamicin For female subjects: positive urine pregnancy test at screening Positive faecal qPCR or Kato-Katz for hookworm at screening, any known history of hookworm infection or treatment for hookworm infection or possible exposure to hookworm in the past Being an employee or student of the department of parasitology of the LUMC Current or past scars, tattoos, or other disruptions of skin integrity at the intended site of larval application Subjects with planned travel to hookworm endemic areas during this trial Receipt of a vaccine within 4 weeks prior to the study initiation Known food allergy
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Meta Roestenberg, MD. PhD.
Organizational Affiliation
LUMC
Official's Role
Principal Investigator
Facility Information:
Facility Name
Leiden University Medical Center
City
Leiden
ZIP/Postal Code
2333 ZA
Country
Netherlands

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
32645714
Citation
Hoogerwerf MA, Koopman JPR, Janse JJ, Langenberg MCC, van Schuijlenburg R, Kruize YCM, Brienen EAT, Manurung MD, Verbeek-Menken P, van der Beek MT, Westra IM, Meij P, Visser LG, van Lieshout L, de Vlas SJ, Yazdanbakhsh M, Coffeng LE, Roestenberg M. A Randomized Controlled Trial to Investigate Safety and Variability of Egg Excretion After Repeated Controlled Human Hookworm Infection. J Infect Dis. 2021 Mar 3;223(5):905-913. doi: 10.1093/infdis/jiaa414.
Results Reference
result

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Repeated Controlled Human Hookworm Infection

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