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Safety and Virologic Effect of a Human Monoclonal Antibody (VRC01) Administered Intravenously to Adults During Early Acute HIV Infection

Primary Purpose

HIV Infections

Status
Completed
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
VRC01
Placebo for VRC01
Antiretroviral therapy (ART) (regimen will vary within countries and by patient)
Sponsored by
National Institute of Allergy and Infectious Diseases (NIAID)
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for HIV Infections

Eligibility Criteria

18 Years - 50 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Able and willing to complete the informed consent process
  • Passes Test of Understanding
  • 18 to 50 years of age
  • Experiencing early acute HIV-1 infection as defined by blood samples on at least two separate days positive by nucleic acid testing within 21 days of a negative nucleic acid HIV-1 test OR by a positive nucleic acid test or a positive 4th generation enzyme immunoassay (EIA) in the context of a negative 2nd or negative 3rd generation HIV EIA test
  • No history of antiretroviral therapy for any indication in the last 30 days.
  • In general good health
  • Willing to have blood samples collected and stored
  • Able to participate for 25 weeks for study visits
  • Willing to have photo or fingerprint taken for identification purposes

Female-Specific Criteria:

  • Agrees not to become pregnant from the time of study enrollment until the last study visit. If a woman has no history of hysterectomy, tubal ligation or menopause, she must agree to use an effective birth control method: abstinence; male or female condoms; diaphragm or cervical cap with spermicide; intrauterine device; contraceptive hormones delivered by pills, patch, injections, or vaginally; and hormonal implants under the skin; or a male partner who has previously undergone a vasectomy.
  • Negative beta-human chorionic gonadotropin (HCG) pregnancy test (urine or serum) on day of enrollment for any woman unless she is post-menopause for 24 consecutive months or has undergone a surgical procedure that precludes pregnancy

Exclusion Criteria:

  • Weight less than 46 kg or greater than 115 kg
  • Previous receipt of humanized or human monoclonal antibody whether licensed or investigational
  • Ongoing AIDS-related opportunistic infection (including oral thrush or active tuberculosis)
  • Severe acute retroviral syndrome (as defined in Appendix I of the protocol) or clinical condition (other than HIV infection) constituting an indication for immediate antiretroviral therapy per local country guidelines
  • Active injection drug use within previous 12 months
  • History of a severe allergic reaction with generalized urticaria, angioedema, or anaphylaxis in the 2 years prior to enrollment
  • History of chronic urticaria
  • Physical finding on examination considered indicative of significant disease such as murmur (other than functional), hepatosplenomegaly, focal neurological deficit
  • Hypertension that is not well controlled by medication
  • Positive hepatitis B surface antigen at any time in the past
  • History of hepatitis C infection
  • Untreated syphilis infection
  • Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) greater than 2 times the upper limit of normal (ULN).
  • Absolute neutrophil count (ANC) less than 740 cells/mm^3
  • Estimated glomerular filtration rate (GFR) less than 50 ml/min within the past 90 days
  • Breastfeeding
  • Pregnancy
  • Receipt of licensed vaccine or other investigational study agent within 28 days prior to enrollment or past participation in an investigational HIV vaccine study with receipt of active product
  • Current or planned participation in another interventional clinical trial during the study period
  • Chronic or recurrent use of medications that modify host immune response, e.g., oral or parenteral steroids, cancer chemotherapy
  • Any other chronic or clinically significant medical condition that in the opinion of investigator would jeopardize the safety or rights of the volunteer. Including, but not limited to: diabetes mellitus type I, chronic hepatitis, renal failure; OR clinically significant forms of: drug or alcohol abuse, mental illness, severe asthma, autoimmune disease, psychiatric disorders, heart disease, or cancer.
  • Study site employee

Sites / Locations

  • Kenya Med. Research Inst./Walter Reed Project, Clinical Research Centre, Off Hospital Road. Kericho
  • National Institute for Medical Research (NIMR)-Mbeya Medical Research Center (MMRC) Non-Network CRS
  • SEARCH Thai Red Cross AIDS Research Centre Non-Network CRS
  • ECHO Center Non-Network CRS
  • Makerere University Walter Reed Project (MUWRP)

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

Group 1: immediate ART and placebo infusion

Group 2: immediate ART and VRC01 infusion

Group 3: immediate VRC01 infusion and subsequent ART

Arm Description

Participants will start ART and will receive a single infusion of placebo at Day 0.

Participants will start ART and receive a single infusion of VRC01 at Day 0.

Participants will receive a single infusion of VRC01 on Day 0 followed by ART initiation on Day 7.

Outcomes

Primary Outcome Measures

Number of grade 3 or greater mAb-related reactogenicity and mAb-related adverse events (AEs)
Plasma viral load change from Day 0 to Day 7

Secondary Outcome Measures

Time to virologic suppression (less than 50 copies/ml) in plasma
Number of total viremic copy days (area under viral load curve) from Day 0 to Week 24
Measurement of plasma viremia including single copy HIV RNA quantification
In samples with HIV RNA less than 50 copies/ml at Day 7, Day 14, and Week 24
Measurement of cell-associated HIV RNA and DNA in the peripheral compartment
Percentage of participants experiencing acute retroviral syndrome
Percentage of participants experiencing a hospitalization
Percentage of participants experiencing opportunistic infections
Percentage of participants experiencing non-AIDS-related conditions
Measurement of CD4 + T cells
Decrease from baseline to nadir, increase from nadir to Week 24, and overall change from baseline to Week 24
Measurement of VRC01 levels in peripheral blood

Full Information

First Posted
October 28, 2015
Last Updated
November 23, 2021
Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)
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1. Study Identification

Unique Protocol Identification Number
NCT02591420
Brief Title
Safety and Virologic Effect of a Human Monoclonal Antibody (VRC01) Administered Intravenously to Adults During Early Acute HIV Infection
Official Title
Safety and Virologic Effect of a Human Monoclonal Antibody, VRC-HIVMAB060-00-AB (VRC01), With Broad HIV-1 Neutralizing Activity, Administered Intravenously to Adults During Early Acute HIV Infection
Study Type
Interventional

2. Study Status

Record Verification Date
November 2021
Overall Recruitment Status
Completed
Study Start Date
April 2016 (undefined)
Primary Completion Date
March 15, 2021 (Actual)
Study Completion Date
March 15, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This study will evaluate the safety and virologic effect of an experimental human monoclonal antibody (mAb), VRC-HIVMAB060-00-AB (VRC01), alone or in combination with antiretroviral therapy (ART), in adults during early acute HIV infection.
Detailed Description
Human monoclonal antibodies (mAbs) may have the potential to treat HIV infection by preventing the spread of the virus. This study will evaluate an experimental mAB known as VRC-HIVMAB060-00-AB (VRC01). The purpose of this study is to evaluate the safety and virologic effect of VRC01, alone or in combination with ART, in adults with early acute HIV infection. Researchers will also evaluate the effect of VRC01 on the establishment of an HIV reservoir during early acute HIV infection. This study will enroll participants who are diagnosed with early acute HIV infection. Participants will be randomly assigned to one of three groups: Group 1 will begin ART and receive a single infusion of placebo at Day 0. Group 2 will begin ART and receive a single infusion of VRC01 at Day 0. Group 3 will receive a single infusion of VRC01 on Day 0 and begin ART on Day 7. ART will vary by country and will consist of country guideline-recommended, available first line combination therapy: currently either efavirenz 600 mg/emtricitabine 200 mg/tenofovir disoproxil fumarate 300 mg or efavirenz 600 mg/lamivudine 300 mg/tenofovir disoproxil fumarate 300 mg. This initial ART regimen may be adjusted or switched to an alternate regimen as clinically indicated for regimen intolerance or failure. Study visits will occur at Days 0, 1, 3, 7, 10, 14, 18, 21, 25, 28, 42, 56, 84, 112, 168, and 175. Visits will include a physical examination, medical history review, and blood collection. Neurocognitive testing will take place on Day 168. Some participants may take part in optional study procedures at various time points during the study including mucosal secretion collection, rectosigmoid biopsy, lymph node biopsy, leukapheresis, and lumbar puncture.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HIV Infections

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Group 1: immediate ART and placebo infusion
Arm Type
Experimental
Arm Description
Participants will start ART and will receive a single infusion of placebo at Day 0.
Arm Title
Group 2: immediate ART and VRC01 infusion
Arm Type
Experimental
Arm Description
Participants will start ART and receive a single infusion of VRC01 at Day 0.
Arm Title
Group 3: immediate VRC01 infusion and subsequent ART
Arm Type
Experimental
Arm Description
Participants will receive a single infusion of VRC01 on Day 0 followed by ART initiation on Day 7.
Intervention Type
Biological
Intervention Name(s)
VRC01
Other Intervention Name(s)
VRC-HIVMAB060-00-AB
Intervention Description
40 mg/kg of VRC01 will be administered as an intravenous infusion over 30 to 60 minutes using a volumetric pump
Intervention Type
Biological
Intervention Name(s)
Placebo for VRC01
Intervention Description
Administered as an intravenous infusion over 30 to 60 minutes using a volumetric pump
Intervention Type
Drug
Intervention Name(s)
Antiretroviral therapy (ART) (regimen will vary within countries and by patient)
Intervention Description
ART is provided by the study sites and consists of country guideline-recommended, available first line once-daily oral combination therapy: currently either efavirenz 600 mg/emtricitabine 200 mg/tenofovir disoproxil fumarate 300 mg or efavirenz 600 mg/lamivudine 300 mg/tenofovir disoproxil fumarate 300 mg. This initial ART regimen may be adjusted or switched to an alternate regimen as clinically indicated for regimen intolerance or failure.
Primary Outcome Measure Information:
Title
Number of grade 3 or greater mAb-related reactogenicity and mAb-related adverse events (AEs)
Time Frame
Measured through Week 24
Title
Plasma viral load change from Day 0 to Day 7
Time Frame
Measured through Day 7
Secondary Outcome Measure Information:
Title
Time to virologic suppression (less than 50 copies/ml) in plasma
Time Frame
Measured through Week 24
Title
Number of total viremic copy days (area under viral load curve) from Day 0 to Week 24
Time Frame
Measured through Week 24
Title
Measurement of plasma viremia including single copy HIV RNA quantification
Description
In samples with HIV RNA less than 50 copies/ml at Day 7, Day 14, and Week 24
Time Frame
Measured through Week 24
Title
Measurement of cell-associated HIV RNA and DNA in the peripheral compartment
Time Frame
Measured through Week 24
Title
Percentage of participants experiencing acute retroviral syndrome
Time Frame
Measured through Week 24
Title
Percentage of participants experiencing a hospitalization
Time Frame
Measured through Week 24
Title
Percentage of participants experiencing opportunistic infections
Time Frame
Measured through Week 24
Title
Percentage of participants experiencing non-AIDS-related conditions
Time Frame
Measured through Week 24
Title
Measurement of CD4 + T cells
Description
Decrease from baseline to nadir, increase from nadir to Week 24, and overall change from baseline to Week 24
Time Frame
Measured through Week 24
Title
Measurement of VRC01 levels in peripheral blood
Time Frame
Measured through Week 24

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Able and willing to complete the informed consent process Passes Test of Understanding 18 to 50 years of age Experiencing early acute HIV-1 infection as defined by blood samples on at least two separate days positive by nucleic acid testing within 21 days of a negative nucleic acid HIV-1 test OR by a positive nucleic acid test or a positive 4th generation enzyme immunoassay (EIA) in the context of a negative 2nd or negative 3rd generation HIV EIA test No history of antiretroviral therapy for any indication in the last 30 days. In general good health Willing to have blood samples collected and stored Able to participate for 25 weeks for study visits Willing to have photo or fingerprint taken for identification purposes Female-Specific Criteria: Agrees not to become pregnant from the time of study enrollment until the last study visit. If a woman has no history of hysterectomy, tubal ligation or menopause, she must agree to use an effective birth control method: abstinence; male or female condoms; diaphragm or cervical cap with spermicide; intrauterine device; contraceptive hormones delivered by pills, patch, injections, or vaginally; and hormonal implants under the skin; or a male partner who has previously undergone a vasectomy. Negative beta-human chorionic gonadotropin (HCG) pregnancy test (urine or serum) on day of enrollment for any woman unless she is post-menopause for 24 consecutive months or has undergone a surgical procedure that precludes pregnancy Exclusion Criteria: Weight less than 46 kg or greater than 115 kg Previous receipt of humanized or human monoclonal antibody whether licensed or investigational Ongoing AIDS-related opportunistic infection (including oral thrush or active tuberculosis) Severe acute retroviral syndrome (as defined in Appendix I of the protocol) or clinical condition (other than HIV infection) constituting an indication for immediate antiretroviral therapy per local country guidelines Active injection drug use within previous 12 months History of a severe allergic reaction with generalized urticaria, angioedema, or anaphylaxis in the 2 years prior to enrollment History of chronic urticaria Physical finding on examination considered indicative of significant disease such as murmur (other than functional), hepatosplenomegaly, focal neurological deficit Hypertension that is not well controlled by medication Positive hepatitis B surface antigen at any time in the past History of hepatitis C infection Untreated syphilis infection Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) greater than 2 times the upper limit of normal (ULN). Absolute neutrophil count (ANC) less than 740 cells/mm^3 Estimated glomerular filtration rate (GFR) less than 50 ml/min within the past 90 days Breastfeeding Pregnancy Receipt of licensed vaccine or other investigational study agent within 28 days prior to enrollment or past participation in an investigational HIV vaccine study with receipt of active product Current or planned participation in another interventional clinical trial during the study period Chronic or recurrent use of medications that modify host immune response, e.g., oral or parenteral steroids, cancer chemotherapy Any other chronic or clinically significant medical condition that in the opinion of investigator would jeopardize the safety or rights of the volunteer. Including, but not limited to: diabetes mellitus type I, chronic hepatitis, renal failure; OR clinically significant forms of: drug or alcohol abuse, mental illness, severe asthma, autoimmune disease, psychiatric disorders, heart disease, or cancer. Study site employee
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
LTC Julie Ake, MD
Organizational Affiliation
U.S. Military HIV Research Program (MHRP)/Henry M. Jackson Foundation for the Advancement of Military Medicine (HJF)
Official's Role
Study Chair
First Name & Middle Initial & Last Name & Degree
Merlin Robb, MD
Organizational Affiliation
US Military HIV Research Program
Official's Role
Study Chair
Facility Information:
Facility Name
Kenya Med. Research Inst./Walter Reed Project, Clinical Research Centre, Off Hospital Road. Kericho
City
Kericho
ZIP/Postal Code
20200
Country
Kenya
Facility Name
National Institute for Medical Research (NIMR)-Mbeya Medical Research Center (MMRC) Non-Network CRS
City
Mbeya
Country
Tanzania
Facility Name
SEARCH Thai Red Cross AIDS Research Centre Non-Network CRS
City
Bangkok
ZIP/Postal Code
10330
Country
Thailand
Facility Name
ECHO Center Non-Network CRS
City
Chonburi
Country
Thailand
Facility Name
Makerere University Walter Reed Project (MUWRP)
City
Kampala
Country
Uganda

12. IPD Sharing Statement

Learn more about this trial

Safety and Virologic Effect of a Human Monoclonal Antibody (VRC01) Administered Intravenously to Adults During Early Acute HIV Infection

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