HIV Clinical Trial
Official title:
A Randomized Phase I/II Study to Assess the Safety and Immunogenicity of the DNA-GTU Vaccine Administered by Two Novel Routes Compared to Placebo in HIV-infected Patients on Antiretroviral Therapy
CUT*HIVTHER 001 is a randomised placebo-controlled Phase I/II study aimed at exploring the
safety and immunogenicity of two different modes of delivery of a GTU® DNA plasmid vaccine
(GTU®-multiHIV B clade) in HIV infected volunteers on antiretroviral therapy (ART):
- Transcutaneous (TC) delivery to enhance intramuscular delivery and
- Electroporation (EP) enhanced intramuscular delivery Participants will be randomised
1:1:1 to TC:EP:saline for the purposes of analysis. Half the saline group will receive
TC saline and half will receive EP saline.
30 HIV infected male and female volunteers aged 18-45 years, who have been on ART for
at least 6 months with 2 or more HIV plasma viral load measurements < 50 copies HIV
RNA/ml prior to enrolment.
The investigational HIV-1 vaccine GTU®-MultiHIV B clade encodes for a MultiHIV antigen which
is a synthetic fusion protein consisting of full-length polypeptides of Rev, Nef, Tat, p17
and p24 and containing more than 20 Th and CTL epitopes of protease, reverse transcriptase
(RT) and gp160 regions of the HAN2 HIV-1 B clade.
Vaccine is provided in sealed vials at 2mg/ml, and a single 1ml IM injection of 2mg
GTU®-MultiHIV DNA IM (into the thigh) is required to deliver a 2mg dose. Individuals in
Group 2 will receive a further 0.4mg GTU®-MultiHIV DNA in 0.2ml administered by TC, a novel
needle-free method of vaccine delivery.
The investigators are exploring combination regimens with the overall aims of (i) optimising
immune responses and (ii) developing safe and well tolerated strategies which will favour
the development of T-cell responses that may enhance anti-HIV HIV therapy with the forward
looking goal of working towards functional eradication of infection. The investigator
proposes to combine the previously used IM and TC methods because preclinical data suggest
that the combination of methods will favour the development of CD8 T cell responses. All
groups will receive 6.0mg of the vaccine IM given in 3 doses over 12 weeks. Group 1 will
receive the 6.0mg IM with electroporation (EP) and Group 2 will receive the 6.0mg IM without
EP but together with an additional 1.2mg vaccine TC. The primary immunogenicity endpoint
will be to determine whether either intervention group augments the cellular responses to
vaccine specific peptides in relation to baseline. It is anticipated that none of subjects
receiving saline placebo would have an increase in vaccine specific responses relative to
those at baseline. Therefore if the differences between the active groups and saline placebo
are sufficiently large, for example 80% responders in a GTU®-MultiHIV DNA active group, <10%
in the control group, this would be significant.
Should the regimes prove safe, acceptable and induce significant immunogenicity then the
intention is to move one or both regimes into a larger study powered to determine their
potential long-term impact on therapy when used in combination with conventional ARV
regimens. Proof of concept that DNA vaccination can induce de novo HIV specific responses
that are associated with control of viral replication, would justify further investigation
of their use in immunotherapies combined with ART intensification and/or anti-latency drugs.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Outcomes Assessor), Primary Purpose: Prevention
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