This study is to test a therapeutic HIV-1 vaccine (HIVAX™) in HIV-1 infected subjects. The safety and immune responses will be studied in vaccine recipients. The anti-viral effect of HIVAX vaccine will be monitored during a 12-week treatment interruption phase.
This is a randomized, placebo-controlled dose-escalation clinical trial to evaluate the safety and the immunogenicity of two doses of a replication defective HIV-1 vaccine (HIVAX™) in subjects receiving stable highly active antiretroviral therapy (HAART) who have an HIV-1 RNA \<50 copies/ml and CD4 cell count \>500 cells/mm3. Following the randomized placebo-controlled vaccination phase subjects who received active vaccine and who meet eligibility will undergo a 12-week analytical antiretroviral treatment interruption followed by reinstitution of antiretroviral therapy (or continued interruption) with follow up through week 48.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
30
Vaccine 1.0 ml SQ lower dose (10\^8 TU) at weeks 0, 8 and 16.
Saline solution 1.0 ml SQ at weeks 0, 8 and 16.
Vaccine 1.0 ml SQ higher dose (10\^9 TU) at weeks 0, 8 and 16.
University of Miami School of Medicine, AIDS Clinical Research unit
Miami, Florida, United States
• To evaluate the safety of a replication-defective HIV-1 vaccine (HIVAX™) in HIV-1 infected subjects on highly active antiretroviral therapy.
Frequency and severity of adverse events, laboratory abnormalities, and local and systemic reactogenicity signs and symptoms following vaccinations.
Time frame: 48 weeks
• To evaluate the potential immunogenicity of a replication-defective HIV-1 vaccine (HIVAX™) as determined by IFN-γ and IL-2 ELISPOT to pooled gag and env HIV peptides.
Magnitude of IFN-γ \& IL-2 producing CD4+ and CD8+ T cells to pooled gag and env HIV peptides at 4 weeks post vaccinations.
Time frame: 48 weeks
To explore the potential effectiveness of a replication-defective HIV-1 vaccine as a therapeutic vaccine
* Changes in CD4+ and CD8+ T-cell counts between the vaccine and placebo groups. * Changes in functional and phenotypic specific HIV gag and env induced T cell responses including in CD8 and CD4 T subsets. * HIV-1 RNA viral set point following antiretroviral treatment interruption, defined as the average of HIV-1 RNA values during the last two study visits of the antiretroviral treatment interruption. * Time to virologic rebound (HIV-1 RNA ≥ 5,000 copies/ml). * Breadth of HV-1 specific CD8+ T cell responses as determined by IFN-γ ELISPOT using overlapping HIV peptides for gag and env.
Time frame: 48 weeks
To monitor the impact of antiretroviral treatment interruption on viral resistance among subjects with virologic rebound (HIV-1 RNA ≥5,000 copies/ml) following resumption of antiretroviral treatment.
Treatment interruption: the number and percentage: 1)meet HIV-1 RNA (\>2.0 fold above nadir and \>5,000 copies/mL on two consecutive measurements verified at least one week apart) and CD4+ criteria (\<400 cell/mm3 or 50% decreases from baseline in CD4 cell count on two consecutive measurements verified at least one week apart) to re-institute treatment before 12 wks; 2)genotypic resistance in re-emergent virus. Treatment resumption: the number and percentage: 1)meet criteria for virologic failure; 2)genotypic resistance in patients with virologic failure.
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Time frame: 16 weeks