This is an early phase research study looking at whether an experimental gene transfer, LVsh5/C46 (also known as Cal-1), is safe and if it can protect the immune system from the effects of HIV without the use of antiretroviral drugs. Cal-1 is an experimental gene transfer agent designed to inhibit HIV infection through 2 active parts: 1. Removing a protein named CCR5 from bone marrow and white blood cells 2. Producing a protein named C46 on bone marrow and white blood cells
It is estimated that 33 million individuals are currently infected with HIV. HIV/AIDS is a disease that impairs immune function, primarily by decreasing CD4+ T lymphocytes. The progression can be contained by daily dosing with antiretroviral therapy (ART) but there are side effects that can be treatment limiting, and the development of HIV drug resistance can force the physician to modify the ART regimen. There are no effective vaccines currently available for HIV. LVsh5/C46 (also known as Cal-1) is a dual therapeutic, self-inactivating lentiviral vector that encodes for both a short hairpin RNA against the HIV-1 co-receptor CCR5 (sh5) and a HIV-1 fusion inhibitor, C46 and inhibits two processes required for HIV-1 infection: 1. Binding of the virus to the cellular CCR5 co-receptor and 2. Fusion of the virus with the host cell The rationale is that Cal-1 introduced into hematopoietic progenitor/stem cells (HSPC) and mature CD4+ T lymphocytes will protect these cells and their progeny cells from HIV-1 infection and its pathogenic sequelae. This may provide a continuous means of controlling HIV-1 after a single or infrequent dose(s), thereby decreasing or delaying (partially or completely) the need for antiretroviral drug therapy.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
13
Intravenous busulfan
Hematopoietic progenitor/stem cells (HSPC) modified with LVsh5/C46 (Cal-1)
CD4+ T lymphocytes modified with LVsh5/C46 (Cal-1)
UCLA CARE Center
Los Angeles, California, United States
Quest Clinical Research
San Francisco, California, United States
Number of Participants With Severe and Life-threatening Adverse Events (AEs)
Time frame: Up to 48 weeks
Number of Participants With Severe or Life-threatening AEs Related to CSL202
Time frame: Up to 48 weeks
Number of Participants With the Presence of Replication-competent Retrovirus
Time frame: Up to 48 weeks
Number of Participants With Predominant Integration Site Analysis
Vector Integration Site Analysis performed only when Cal-1 Marking is \>= 1%.
Time frame: Up to 48 weeks
Mean Cell Dose for CD4+ Cells (Ttn)
Time frame: Up to 48 weeks
Mean Cell Dose for CD34+ Cells (HSPCtn)
Time frame: Up to 48 weeks
Percent Transduction Efficiency of CD4+ Cells (Ttn) and CD34+ Cells (HSPCtn) of Final Cell Product
Time frame: Up to 48 weeks
Total Area Under the Curve (AUC) for Busulfan
Cohort 3: Total AUC = first dose AUC value + second dose AUC value
Time frame: Up to 48 weeks
Percent Cal-1 Marking in Peripheral Blood
Time frame: Up to 48 weeks
Cal-1 Marking in Gut-associated Lymphoid Tissue (GALT) (10-15 cm)
Samples were collected via endoscopic biopsy from the sigmoid colon: 10-15 cm from the anal margin
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Time frame: Up to 48 weeks
Cal-1 Marking in GALT (25-35 cm)
Samples were collected via endoscopic biopsy from the sigmoid colon: 25-35 cm from the anal margin
Time frame: Up to 48 weeks
Cal-1 Marking in Bone Marrow
Time frame: Up to 48 weeks
Cal-1 C46 Expression in Peripheral Blood
C46 relative expression will be analyzed by reverse transcriptase-quantitative polymerase chain reaction (RT-qPCR) and normalized to the expression of β2-microglobulin (β2M) mRNA
Time frame: Up to 48 weeks
Cal-1 sh5 Expression in Peripheral Blood
sh5 relative expression will be analyzed by RT-qPCR and normalized to the expression of RNU38B microRNA
Time frame: Up to 48 weeks
HIV Viral Load at Baseline Screening and Week 48 or at Anti-retroviral Therapy (ART) Re-commencement
Time frame: Up to 48 weeks
CD4+ Count at Baseline Screening and Week 48 or at ART Re-commencement
Time frame: Up to 48 weeks
Number of Participants With HIV-1 Tropism Shift
Shift from R5 to X4 or dual/mixed tropism
Time frame: Up to 48 weeks