HIV Infections Clinical Trial
Official title:
Evaluation of Quantitative and Qualitative Antibody Responses to Streptococcus Pneumoniae and Haemophilus Influenzae Type b Conjugate Vaccines Amongst HIV-1-Exposed-Infected Children That Are Receiving Vs. Those Not Receiving Antiretroviral Therapy, as Well as Among HIV-1-Exposed-Uninfected Children and HIV-1-Unexposed-Uninfected Children
Infection by Streptococcal pneumoniae is a common invasive bacterial infection in HIV infected children. The purpose of this study is to determine the safety of and immune response to a pneumococcal polysaccharide-protein conjugate vaccine (PncCV) in HIV infected and uninfected children. The study will also determine the safety of and immune response to Haemophilus influenzae vaccine (HibCV) in these children. Recruitment for this study will occur at two hospitals in South Africa, and all HIV infected infants participating in this study must also be coenrolled in the CIPRA SA-Project 2 study.
HIV infected children are at high risk for invasive pneumococcal disease (IPD) caused by the
bacterium Streptococcus pneumoniae. Chemoprophylaxis has been used in children with certain
diseases for the prevention of IPD, but drug resistance may develop with this prevention
strategy. In contrast, a vaccine to prevent IPD would have fewer negative implications on
future treatment options than chemoprophylaxis. This study will evaluate the safety of and
immune response to PncCV in South African HIV infected and uninfected children. This study
will also evaluate the safety of and immune response to HibCV in these children.
This study will last 5.5 years. There will be 5 groups in this study. Group 1 will be HIV
uninfected infants born to HIV uninfected mothers. Group 2 will be HIV infected infants in
CDC Disease Category 1 who were randomly assigned to the delayed therapy arm (Arm 1) of
CIPRA SA-Project 2. Group 3 will be HIV infected infants in CDC Disease Category 1 who were
randomly assigned to the first early therapy arm (Arm 2) of CIPRA SA-Project 2. Group 4 will
be HIV infected infants in CDC Disease Category 2 or 3 who were randomly assigned to the
second early therapy arm (Arm 3) of CIPRA SA-Project 2. Group 5 will be HIV uninfected
infants born to HIV infected mothers; Group 5 infants will undergo repeat HIV testing at 4
to 8 months of age, 9 to 11 months of age, and approximately 18 months of age.
There will be 13 study visits; medical history assessment, a physical examination, and blood
collection will occur at each visit. At each of 3 study visits before age 24 weeks, all
participants will receive an injection of PncCV and an injection of routine pediatric
vaccines, including HibCV. Previously vaccinated HIV infected participants will only receive
those vaccines they need to complete the South African series of routine pediatric
vaccinations. Within each group, participants will be randomly assigned to receive a booster
shot of either PncCV or HibCV between 64 and 76 weeks of age. Participants will also receive
two measles vaccinations between 38 and 76 weeks of age. Parents or guardians will be asked
to complete a diary card after each vaccination and report any adverse effects occurring
within the 72 hours post-vaccination.
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Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Prevention
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