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Safety and Immunogenicity Study of a DNA Priming and MVA Boosting Strategy of HIV Vaccine

Primary Purpose

HIV Infections

Status
Completed
Phase
Phase 1
Locations
Mozambique
Study Type
Interventional
Intervention
DNA HIVIS and MVA-CMDR
DNA HIVIS and MVA-CMDR
Saline solution
Saline solution
Sponsored by
Instituto Nacional de Saúde, Mozambique
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for HIV Infections focused on measuring HIV, Vaccine, DNA, Prevention

Eligibility Criteria

18 Years - 26 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  1. Age: 18 to 26 years
  2. Willing to undergo HIV (Human Immunodeficiency Virus) counseling and testing
  3. Have a negative antigen/antibody or antibody ELISA for HIV infection
  4. Able to give informed consent
  5. Satisfactory completion of an assessment of understanding prior to enrolment defined as 89% correct answers after three opportunities to take the test
  6. Basic abilities to read and write
  7. Resident in Maputo, and willing to remain so for the duration of the study
  8. At low risk of HIV infection, defined as the absence of an identifiable risk factor/ behavior (their presence is therefore an exclusion criteria):

    • sexual partner with HIV
    • sexual partner with unknown HIV serostatus who is also unwilling to use protective condoms consistently in all sexual relations
    • sexual partner is known to be at high risk for HIV
    • more than one sexual partner in the last 6 months
    • history of being an alcoholic [as medically defined or more than 35 units /week]
    • history of Sexually Transmitted Infection (STI) within past 6 months
  9. Verbal assurances that adequate birth control methods are used not to conceive/father a child during the study and up to 3 months after the last vaccine injection.
  10. Women shall have a negative urine pregnancy test
  11. Be willing to practice safe sex for the duration of the study to avoid sexually transmitted infections including HIV
  12. Good health as determined by medical history, physical examination, clinical judgment and by key laboratory parameters as judged by the study physician.
  13. Laboratory criteria:

    • Hemoglobin >10.5g/dl
    • White blood cell count <13,000/mm3
    • Neutrophils >1,300/mm3
    • Lymphocytes >1.000/ mm3
    • Platelets >120,000/ mm3
    • Random Blood Glucose < 6.44 mmol/L; if elevated, then a Fasting Blood Glucose < 6.11mmol/L (according to DAIDS Table for Lab Criteria)
    • Bilirubin <1.25 x uln
    • Alanine transaminase (ALT) <1.25 x uln
    • Urine dipstick for protein and blood: negative or trace. (If either is ¿ 1+, complete urinalysis (UA) will be performed.

Exclusion Criteria:

  1. At risk of HIV infection as mentioned above in the inclusion criteria
  2. Active tuberculosis or other systemic infectious process elicited by review of systems, physical examination and laboratory detection
  3. A history of immunodeficiency, chronic illness requiring continuous or frequent medical intervention
  4. Autoimmune disease by history and physical examination
  5. Hives or recurrent hives and severe eczema
  6. A history of psychiatric, medical (including traditional medicine) and/or substance abuse problems during the past 6 months that the investigator believes would adversely affect the volunteer's ability to participate in the trial
  7. History of epilepsy, or currently taking anti-epileptics
  8. Received blood or blood products or immunoglobulins in the past 3 months
  9. Receiving immunosuppressive therapy such as systemic corticosteroids or cancer chemotherapy
  10. Use of experimental therapeutic agents within 30 days of study entry
  11. Reception of any live, attenuated vaccine within 60 days of study entry.
  12. Abnormality in Electrocardiogram (ECG) that could indicate risk or make interpretation of vaccine effects difficult according to the study operating procedures
  13. Previously received an HIV vaccine candidate
  14. History of severe local or general reaction to vaccination defined as:

    • Local: Extensive, indurate redness and swelling involving most of the major circumference of the arm, not resolving within 72 hours
    • General: Fever >= 39.5 0C within 48 hours; anaphylaxis; bronchospasm; laryngeal edema; collapse; convulsions or encephalopathy within 72 hours
  15. Being a lactating mother
  16. Study site employees who are involved in the protocol and may have direct access to the immunogenicity results
  17. Unlikely to comply with protocol as judged by the principal investigator or his designate.

Sites / Locations

  • Centro de Investigação e Treino em Saúde de Polana Caniço

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Active Comparator

Placebo Comparator

Active Comparator

Placebo Comparator

Arm Label

IA

IB

IIA

IIB

Arm Description

600 µg i.d. (separate plasmids pools) of DNA priming at weeks 0, 4 and 12 108 pfu i.m. MVA boosting at weeks 24 and 36

2 x 0.1 ml of saline solution i.d at weeks 0, 4 and 12 saline solution i.m at weeks 24 and 36

1200 µg i.d. (separate plasmids pools) of DNA priming at weeks 0, 4 and 12;108 pfu i.m. MVA boosting at weeks 24 and 36

2 x 0.2 ml of saline solution i.d at weeks 0, 4 and 12 ; saline solution i.m at weeks 24 and 36

Outcomes

Primary Outcome Measures

Adverse events (local and system reactogenicity)
The safety of immunization will be assessed by clinical features and standard clinical chemistry and hematological tests. Safety endpoints: Adverse events will be assessed using a standard format for soliciting local and systemic reactogenicity to the vaccine and collection of unsolicited adverse events. Solicited reactogenicity will be evaluated for 7 days following each vaccination. All other AE will be collected from the time of first injection until the end of the study follow-up period.
Immunogenicity
The primary immunogenicity endpoint will be determined by the interferon gamma (IFN-gama) enzyme linked immunospot (ELISPOT) assay. Secondary immunogenicity endpoints will include cellular immune responses determined by intracellular cytokine staining and T cell proliferation assays as well as binding antibody and neutralizing antibody responses.

Secondary Outcome Measures

Full Information

First Posted
August 1, 2011
Last Updated
December 3, 2013
Sponsor
Instituto Nacional de Saúde, Mozambique
Collaborators
Swedish Institute for Communicable Disease Control, Sweden, European and Developing Countries Clinical Trials Partnership (EDCTP)
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1. Study Identification

Unique Protocol Identification Number
NCT01407497
Brief Title
Safety and Immunogenicity Study of a DNA Priming and MVA Boosting Strategy of HIV Vaccine
Official Title
A Phase I Trial to Assess Safety and Immunogenicity of i.d. DNA Priming and i.m. MVA Boosting in Healthy Volunteers in Mozambique and to Develop Further HIV Vaccine Trial Capacity Building in Mozambique
Study Type
Interventional

2. Study Status

Record Verification Date
December 2013
Overall Recruitment Status
Completed
Study Start Date
August 2011 (undefined)
Primary Completion Date
March 2013 (Actual)
Study Completion Date
August 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Instituto Nacional de Saúde, Mozambique
Collaborators
Swedish Institute for Communicable Disease Control, Sweden, European and Developing Countries Clinical Trials Partnership (EDCTP)

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
While antiretroviral drugs have shown great promise in reducing HIV replication and thus in reducing HIV/AIDS associated morbi-mortality and HIV transmission, the cost is substantial and side effects are a potentially limiting factor. Development of an effective safe-affordable vaccine is likely to be the best way to stop further virus spread. The study aims to determine safety and immunogenicity of the DNA-vaccine at a dose of 600µg and 1200µg delivered id in combination with MVA-CMDR boost im.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HIV Infections
Keywords
HIV, Vaccine, DNA, Prevention

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
25 (Actual)

8. Arms, Groups, and Interventions

Arm Title
IA
Arm Type
Active Comparator
Arm Description
600 µg i.d. (separate plasmids pools) of DNA priming at weeks 0, 4 and 12 108 pfu i.m. MVA boosting at weeks 24 and 36
Arm Title
IB
Arm Type
Placebo Comparator
Arm Description
2 x 0.1 ml of saline solution i.d at weeks 0, 4 and 12 saline solution i.m at weeks 24 and 36
Arm Title
IIA
Arm Type
Active Comparator
Arm Description
1200 µg i.d. (separate plasmids pools) of DNA priming at weeks 0, 4 and 12;108 pfu i.m. MVA boosting at weeks 24 and 36
Arm Title
IIB
Arm Type
Placebo Comparator
Arm Description
2 x 0.2 ml of saline solution i.d at weeks 0, 4 and 12 ; saline solution i.m at weeks 24 and 36
Intervention Type
Biological
Intervention Name(s)
DNA HIVIS and MVA-CMDR
Intervention Description
600 µg i.d. (separate plasmids pools) of DNA priming at weeks 0, 4 and 12; 108 pfu i.m. MVA boosting at weeks 24 and 36
Intervention Type
Biological
Intervention Name(s)
DNA HIVIS and MVA-CMDR
Intervention Description
1200 µg i.d. (separate plasmids pools) of DNA priming at weeks 0, 4 and 12 ; 108 pfu i.m. MVA boosting at weeks 24 and 36
Intervention Type
Biological
Intervention Name(s)
Saline solution
Intervention Description
2 x 0.1 ml of saline solution i.d at weeks 0, 4 and 12 ; saline solution i.m at weeks 24 and 36
Intervention Type
Biological
Intervention Name(s)
Saline solution
Intervention Description
2 x 0.2 ml of saline solution i.d at weeks 0, 4 and 12 ; saline solution i.m at weeks 24 and 36
Primary Outcome Measure Information:
Title
Adverse events (local and system reactogenicity)
Description
The safety of immunization will be assessed by clinical features and standard clinical chemistry and hematological tests. Safety endpoints: Adverse events will be assessed using a standard format for soliciting local and systemic reactogenicity to the vaccine and collection of unsolicited adverse events. Solicited reactogenicity will be evaluated for 7 days following each vaccination. All other AE will be collected from the time of first injection until the end of the study follow-up period.
Time Frame
44 weeks
Title
Immunogenicity
Description
The primary immunogenicity endpoint will be determined by the interferon gamma (IFN-gama) enzyme linked immunospot (ELISPOT) assay. Secondary immunogenicity endpoints will include cellular immune responses determined by intracellular cytokine staining and T cell proliferation assays as well as binding antibody and neutralizing antibody responses.
Time Frame
44 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
26 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Age: 18 to 26 years Willing to undergo HIV (Human Immunodeficiency Virus) counseling and testing Have a negative antigen/antibody or antibody ELISA for HIV infection Able to give informed consent Satisfactory completion of an assessment of understanding prior to enrolment defined as 89% correct answers after three opportunities to take the test Basic abilities to read and write Resident in Maputo, and willing to remain so for the duration of the study At low risk of HIV infection, defined as the absence of an identifiable risk factor/ behavior (their presence is therefore an exclusion criteria): sexual partner with HIV sexual partner with unknown HIV serostatus who is also unwilling to use protective condoms consistently in all sexual relations sexual partner is known to be at high risk for HIV more than one sexual partner in the last 6 months history of being an alcoholic [as medically defined or more than 35 units /week] history of Sexually Transmitted Infection (STI) within past 6 months Verbal assurances that adequate birth control methods are used not to conceive/father a child during the study and up to 3 months after the last vaccine injection. Women shall have a negative urine pregnancy test Be willing to practice safe sex for the duration of the study to avoid sexually transmitted infections including HIV Good health as determined by medical history, physical examination, clinical judgment and by key laboratory parameters as judged by the study physician. Laboratory criteria: Hemoglobin >10.5g/dl White blood cell count <13,000/mm3 Neutrophils >1,300/mm3 Lymphocytes >1.000/ mm3 Platelets >120,000/ mm3 Random Blood Glucose < 6.44 mmol/L; if elevated, then a Fasting Blood Glucose < 6.11mmol/L (according to DAIDS Table for Lab Criteria) Bilirubin <1.25 x uln Alanine transaminase (ALT) <1.25 x uln Urine dipstick for protein and blood: negative or trace. (If either is ¿ 1+, complete urinalysis (UA) will be performed. Exclusion Criteria: At risk of HIV infection as mentioned above in the inclusion criteria Active tuberculosis or other systemic infectious process elicited by review of systems, physical examination and laboratory detection A history of immunodeficiency, chronic illness requiring continuous or frequent medical intervention Autoimmune disease by history and physical examination Hives or recurrent hives and severe eczema A history of psychiatric, medical (including traditional medicine) and/or substance abuse problems during the past 6 months that the investigator believes would adversely affect the volunteer's ability to participate in the trial History of epilepsy, or currently taking anti-epileptics Received blood or blood products or immunoglobulins in the past 3 months Receiving immunosuppressive therapy such as systemic corticosteroids or cancer chemotherapy Use of experimental therapeutic agents within 30 days of study entry Reception of any live, attenuated vaccine within 60 days of study entry. Abnormality in Electrocardiogram (ECG) that could indicate risk or make interpretation of vaccine effects difficult according to the study operating procedures Previously received an HIV vaccine candidate History of severe local or general reaction to vaccination defined as: Local: Extensive, indurate redness and swelling involving most of the major circumference of the arm, not resolving within 72 hours General: Fever >= 39.5 0C within 48 hours; anaphylaxis; bronchospasm; laryngeal edema; collapse; convulsions or encephalopathy within 72 hours Being a lactating mother Study site employees who are involved in the protocol and may have direct access to the immunogenicity results Unlikely to comply with protocol as judged by the principal investigator or his designate.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ilesh Jani, PhD
Organizational Affiliation
Instituto Nacional de Saúde
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Nafissa Osman, MD, PhD
Organizational Affiliation
Hospital Central de Maputo
Official's Role
Principal Investigator
Facility Information:
Facility Name
Centro de Investigação e Treino em Saúde de Polana Caniço
City
Maputo
Country
Mozambique

12. IPD Sharing Statement

Citations:
PubMed Identifier
28969431
Citation
Viegas EO, Tembe N, Nilsson C, Meggi B, Maueia C, Augusto O, Stout R, Scarlatti G, Ferrari G, Earl PL, Wahren B, Andersson S, Robb ML, Osman N, Biberfeld G, Jani I, Sandstrom E. Intradermal HIV-1 DNA Immunization Using Needle-Free Zetajet Injection Followed by HIV-Modified Vaccinia Virus Ankara Vaccination Is Safe and Immunogenic in Mozambican Young Adults: A Phase I Randomized Controlled Trial. AIDS Res Hum Retroviruses. 2018 Feb;34(2):193-205. doi: 10.1089/AID.2017.0121. Epub 2017 Nov 27.
Results Reference
derived

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Safety and Immunogenicity Study of a DNA Priming and MVA Boosting Strategy of HIV Vaccine

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