An Hepatitis B Vaccine Model for HIV Vaccine Trials in Drug Users

HIV Infection Clinical Trial

Official title:

An Hepatitis B Vaccine Model for HIV Vaccine Trials in Drug Users

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT00841477
• Other study ID #: DESPR DA017505
• Status: Completed
• Phase: Phase 3
• First received: February 10, 2009
• Last updated: January 10, 2017
• Start date: January 2004
• Est. completion date: December 2009

Study information

• Verified date: April 2015
• Source: National Institute on Drug Abuse (NIDA)
• Contact: n/a
• Is FDA regulated: No
• Health authority: United States: Federal Government
• Study type: Interventional

Clinical Trial Summary

The goal of the proposed study is to use the HBV vaccine as a model for a future HIV vaccine trial, examining the efficacy of community-based outreach intervention as well as an accelerated vaccine schedule as a method for increasing acceptance/adherence with HBV vaccination protocols among not-in-treatment drug users. This study will also examine the effect of HBV vaccination coupled with community-based outreach intervention on reducing the incidence of HIV, HBV and HCV infections and the frequency of needle use and sexual risk behaviors related to these viral transmissions. A secondary purpose will be to assess the antibody response after HBV vaccination as a measurement of immunological response in drug users.

Description:

This project will evaluate an HBV vaccination program as a model for future HIV vaccine efficacy trials in a community-based study of drug users. Two components will be analyzed in an effort to increase vaccine acceptance/adherence - behavioral intervention & an accelerated vaccine schedule. The study also will examine the effect of these variables on risk behaviors and incidence of HIV, HBV, & HCV infections. To accomplish these objectives, we propose a randomized behavioral intervention field trial. We will enroll 1600 current cocaine or heroin users negative for HBV & HIV markers from two closely matched, low-income, high drug endemic communities in Houston. All participants will be offered HBV vaccination and follow-up viral testing. One community will be randomly assigned to receive an outreach behavioral intervention designed to increase vaccine awareness and vaccine compliance. The other community will receive standard care. Participants electing to be vaccinated will be randomized to either a 0,1,6 month or a 0,1,2, month vaccine schedule. Groups will be followed for two years to determine rates of HBV vaccine acceptance/adherence to the 3-dose protocol. We also will measure any changes in risk behaviors & incidence of HIV/HBV/HCV infections as well as HBV vaccine immune response, if vaccinated. Drug users are the largest group of newly diagnosed HIV cases and so creating a model for an HIV vaccine's acceptance and adherence in this population is an important public health goal. This study will serve as a model for future HIV vaccine trials and will provide information on the effectiveness of outreach programs for increasing immunization among drug users. Unless an effective model based upon empirical experience is developed, any attempt to implement a HIV vaccination program among drug users is likely to be frustrated. If HBV vaccination coupled with outreach intervention can reduce risk behaviors and decrease the incidence of HIV/HCV infection, then this study will have a tremendous impact on the current HBV/HIV/HCV prevention strategy.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 1260
• Est. completion date: December 2009
• Est. primary completion date: June 2007
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• using cocaine/heroin in last 7 days, age over 18 years old from two matched in population size, income and demographic communities, known with high rate of drug using and STD; competent to consent for urine drug screening and viral markers (anti-HIV, HBsAg/anti-HBs, anti-HCV) testing; those negative for HIV/HBV will be contacted for HB vaccination study.

Exclusion Criteria:

• age under 18 or not from the target communities, negative for urine drug test.

Study Design

Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Factorial Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Prevention

Related Conditions & MeSH terms

• Communicable Diseases
• Hepatitis
• Hepatitis A
• Hepatitis B
• Hepatitis B Infection
• Hepatitis C
• Hepatitis C Infection
• HIV Infection
• HIV Infections
• Infection

Intervention

Biological:
• hepatitis B vaccine 3 dose schedule (0,1,2 month)
hepatitis B (HB) vaccine: Engerix-B (GlaxoSmithKline) (20 µg/dose) accelerated HB vaccine schedule (0,1,2 month),vs, standard HB vaccine schedule (0,1,6 m)

Behavioral:
• HBV Vaccination Self-Efficacy Intervention
HB Vaccination Intervention consists of 4 sessions - Sessions 1, 2: at screening and enrollment after intake, vs regular risk reduction education Sessions 3, 4: coincide with the vaccination schedule ions 4 before 3rd dose

Locations

Country	Name	City	State
United States	University of Texas-HSC at Houston, School of Public Health	Houston	Texas

Sponsors (1)

Lead Sponsor	Collaborator
National Institute on Drug Abuse (NIDA)

Country where clinical trial is conducted

United States, 

References & Publications (6)

Grimes CZ, Hwang LY, Wei P, Shah DP, Volcik KA, Brown EL. Differentially regulated gene expression associated with hepatitis C virus clearance. J Gen Virol. 2013 Mar;94(Pt 3):534-42. doi: 10.1099/vir.0.047738-0. — View Citation

Hwang LY, Grimes CZ, Tran TQ, Clark A, Xia R, Lai D, Troisi C, Williams M. Accelerated hepatitis B vaccination schedule among drug users: a randomized controlled trial. J Infect Dis. 2010 Nov 15;202(10):1500-9. doi: 10.1086/656776. — View Citation

Kamath GR, Shah DP, Hwang LY. Immune response to hepatitis B vaccination in drug using populations: a systematic review and meta-regression analysis. Vaccine. 2014 Apr 25;32(20):2265-74. doi: 10.1016/j.vaccine.2014.02.072. Review. — View Citation

Lu-Yu. Hwang*, Carolyn. Grimes "Human Immunodeficiency Virus, hepatitis B and C Virus infections among injecting and non-injecting drug users from inner city neighborhoods " Insight and Control of Infectious Disease in Global Scenario, Priti Kumar Roy (Ed

Shah DP, Grimes CZ, Brown E, Hwang LY. Demographics, socio-behavioral factors, and drug use patterns: what matters in spontaneous HCV clearance? J Med Virol. 2012 Feb;84(2):235-41. doi: 10.1002/jmv.22271. — View Citation

Tran TQ, Grimes CZ, Lai D, Troisi CL, Hwang LY. Effect of age and frequency of injections on immune response to hepatitis B vaccination in drug users. Vaccine. 2012 Jan 5;30(2):342-9. doi: 10.1016/j.vaccine.2011.10.084. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	compliance (adherence) for 3 doses hepatitis vaccination		Jan, 2004 - June 2008	No
Secondary	incidence of HIV and HCV infection and change of risk behaviors		Jan, 2004- June 2009	No
Secondary	immunological response		Feb 2004 - June 2008	No