People infected with HIV may have low levels of the virus in their body, even if they are taking HIV medications. This study will evaluate the safety, pharmacokinetics (PK) (which is how the body interacts with drugs), and immune response to BMS-936559, a drug that will be administered by an intravenous (IV) infusion, in HIV-infected people receiving combination antiretroviral therapy (cART) who have viral load levels below the limit of detection.
People infected with HIV who are taking cART and have low viral load levels may still have reservoirs of HIV remaining in their body. BMS-936559 is a drug that has been studied in previous clinical trials to treat various types of cancer. The purpose of this study is to evaluate the safety, PK, and immunotherapeutic activity of a single dose of BMS-936559 (administered by an IV infusion) in HIV-infected people who are receiving cART and who have viral loads below the limit of detection. Researchers will also evaluate whether BMS-936559 can reduce hidden reservoirs of HIV. Participants will be enrolled in four cohorts. Within each cohort, participants will be randomly assigned to receive BMS-936559 (Cohort 1: 0.3 mg/kg; Cohort 2: 1 mg/kg; Cohort 3: 3 mg/kg; or Cohort 4: 10 mg/kg) or placebo. The four cohorts will be enrolled sequentially, with researchers reviewing safety data of the cohort before enrolling participants in the next cohort. Prior to study entry, all participants must have an eye exam and an electrocardiogram (ECG). At study entry, participants will undergo a medical and medication history review, physical examination, an eye exam, and a blood collection. Some female participants will have a pregnancy test. All participants will then receive a single IV infusion of their assigned dose of BMS-936559 or placebo. The infusion will occur over a period of 60 minutes, and participants will remain in the clinic for observation for an additional 12 hours. Additional study visits will occur at Days 3, 7, 14, 28, and Weeks 10, 16, 24, 36, and 48. These study visits may include a physical examination, blood collection, adherence assessments, and PK evaluations. Some participants may have additional eye exams during the study, on an as-needed basis.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
0.3 mg/kg, 1 mg/kg, 3 mg/kg, or 10 mg/kg of BMS-936559, depending on which cohort participants are enrolled in, administered as an intravenous (IV) infusion
Sodium chloride for injection 0.9%, USP, administered as an IV infusion
University of Colorado Hospital CRS
Aurora, Colorado, United States
Washington University Therapeutics (WT) CRS
St Louis, Missouri, United States
Chapel Hill CRS
Chapel Hill, North Carolina, United States
Cincinnati Clinical Research Site
Cincinnati, Ohio, United States
Occurrence of a Grade 3 or greater adverse event (AE), including sign/symptom, lab toxicity, or clinical event that is definitely, probably, or possibly related to study treatment
As judged by the core team, blinded to treatment arm; any time from study treatment administration until 28 days after the administration.
Time frame: Measured through Day 28
Occurrence of a Grade 1 or > AE of all incident adrenal insufficiency or adrenal crisis (confirmed), myocarditis, pneumonitis, uveitis, immune-mediated hyperthyroidism or hypothyroidism, that is definitely, probably, or possibly related to study
As judged by the core team, blinded to treatment arm; any time from study treatment administration until 28 days after the administration. (Pneumonitis is Category A, B, or C)
Time frame: Measured through Day 28
Frequency of HIV-1 Gag-specific CD8 T-cells by intracellular staining for interferon (IFN)-gamma at baseline and after treatment (through Day 28)
Time frame: Measured through Day 28
HIV-1 RNA by single copy assay (SCA) at baseline and after treatment (through Day 28)
Time frame: Measured through Day 28
PK parameters from non-compartmental analysis (area under curve [AUC], Cmax, V, Tmax, CL/F, t1/2)
Time frame: Measured through Week 48
Exploratory pharmacodynamic parameters (Emax, EC50)
Time frame: Measured through Week 48
HIV-1 DNA at baseline and after treatment
Time frame: Measured through Week 48
Programmed cell death 1 ligand 1 (PD-L1) receptor occupancy
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Masking
QUADRUPLE
Enrollment
8
Vanderbilt Therapeutics (VT) CRS
Nashville, Tennessee, United States
Time frame: Measured through Week 48
Proportion of total and HIV-1 gag-specific CD8 T-cells expressing programmed cell death 1 (PD-1), PD-L1, and other exhaustion markers
Time frame: Measured through Week 48
CD107a mobilization and carboxyfluorescein diacetate succinimidyl ester (CFSE) dilution of HIV-1 gag-specific CD8 T-cells
Time frame: Measured through Week 48
Polyfunctionality of HIV-1 specific CD8 and CD4 T-cells
Time frame: Measured through Week 48
CD38 and human leukocyte antigen-DR (HLA-DR) expression on CD8 T-cells
Time frame: Measured through Week 48
Gene expression profiles in whole blood
Time frame: Measured through Week 48
Detection of antibody to study treatment in plasma
Time frame: Measured through Week 48
Occurrence of a Grade 3 or greater AE, including sign/symptom, lab toxicity, or clinical event that is definitely, probably, or possibly related to study treatment
As judged by the core team, blinded to treatment arm; any time greater than or equal to 29 days after the study treatment administration
Time frame: Measured through Week 48
Occurrence of a Grade 1 or > AE of all incident adrenal insufficiency or adrenal crisis (confirmed), myocarditis, pneumonitis, uveitis, immune mediated hyperthyroidism or hypothyroidism, that is definitely, probably, or possibly related to study
As judged by the core team, blinded to treatment arm; any time greater than or equal to 29 days after the study treatment administration
Time frame: Measured through Week 48
2-long terminal repeat (2LTR) circle DNA at baseline and after treatment
Time frame: Measured through Week 48
Cell-associated HIV-1 RNA at baseline and after treatment
Time frame: Measured through Week 48
RNA/DNA ratios in total CD4 cells at baseline and after treatment
Time frame: Measured through Week 48
Expression of programmed cell death 1 ligand 2 (PD-L2) on dendritic cells and monocyte-derived macrophages
Time frame: Measured through Week 48