The HIV Vaccine Trials Network (HVTN) is doing a study to test 2 experimental HIV vaccines in combination with 2 licensed vaccines for tetanus and hepatitis B. HIV is the virus that causes AIDS. Tetanus is an infection that causes muscular spasms. Hepatitis B is a virus that can cause liver failure. About 100 people will take part in this study at multiple sites. The US National Institutes of Health (NIH) is paying for the study. We are doing this study to answer several questions. * Are the HIV study vaccines safe to give to people? * Are people able to take the HIV study vaccines without becoming too uncomfortable? * How do people's immune systems respond to the HIV study vaccines? (Your immune system protects you from disease.) * Can people's immune responses to a tetanus or hepatitis B vaccines help us understand how their immune systems might respond to the HIV study vaccines? * Is there a common immune response to licensed vaccines like the tetanus and hepatitis B vaccines?
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
DOUBLE
Enrollment
202
Formulated as a lyophilized vaccine for injection and is reconstituted with 1.05 mL of sterile Sodium Chloride solution (0.4% NaCl) for a single 1 mL dose of \>1.0 x 106 CCID50/mL, to administer intramuscularly (IM).
300 mcg of subtype B (MN) HIV gp120 glycoprotein and 300 mcg of subtype E (A244) HIV gp120 glycoprotein adsorbed onto 600 mcg of aluminum hydroxide gel adjuvant. Each vial contains 1.2 mL of sterile suspension, to administer 1 mL IM.
A sterile, lyophilized product that consists of a mixture of virus stabilizer, and freeze drying medium and is reconstituted with 1.05 mL of sterile Sodium Chloride (0.4% NaCl) for a single 1 mL dose, to administer IM.
Sodium Chloride for Injection, 0.9% administered IM.
Each 1 mL dose contains 20 mcg of hepatitis B surface antigen (HBsAg) adsorbed onto 500 mcg aluminum as aluminum hydroxide, to administer IM.
The active ingredient is tetanus toxoid (≥ 40 I.U. / 0.5 mL) adsorbed on aluminium hydroxide dihydrate (600 mcg of aluminium), to administer IM.
Sodium Chloride for Injection, 0.9% administered IM.
Sodium Chloride for Injection, 0.9% administered IM.
Emavundleni Desmond Tutu HIV Centre CRS
Cape Town, Western Cape, South Africa
Aurum Institute for Health Research
Klerksdorp, South Africa
Perinatal HIV Research Unit
Soweto, South Africa
Frequency of local and systemic reactogenicity signs and symptoms, laboratory measures of safety, and a line listing of all AEs meeting DAIDS criteria for expedited reporting.
Time frame: 13.5 months
HIV-specific total IgG and IgA binding antibody responses as assessed by multiplex assay
Time frame: 2 weeks following the final vaccination of ALVAC-HIV + AIDSVAX B/E.
Neutralizing antibody magnitude and breadth against tier 1 and tier 2 HIV-1 isolates as assessed by area under the magnitude-breadth curves
Time frame: 2 weeks following the final vaccination of ALVAC-HIV + AIDSVAX B/E.
Magnitude and frequency of HIV-specific CD4+ and CD8+ T-cell responses as assessed by flow cytometry at 2 weeks following the final vaccination of ALVACHIV + AIDSVAX B/E.
Time frame: 2 weeks post final vaccination of ALVACHIV + AIDSVAX B/E
Frequency of severe local and systemic reactogenicity signs and symptoms (pain, tenderness, erythema, induration, fever, malaise/fatigue, myalgia, headache, nausea, vomiting, chills, arthralgia)
Time frame: 3 days after each vaccine dose
Frequency of AEs by body system, Medical Dictionary for Regulatory Activities (MedDRA) preferred term, severity, and assessed relationship to study products
Time frame: 30 days after each vaccine dose
Frequency of SAEs, adverse events of special interest (AESIs; Appendix K), and new chronic conditions (requiring medical intervention for ≥ 30 days) throughout the study
Time frame: 19.5 months
Composite of safety laboratory measures: white blood cells, neutrophils, lymphocytes, hemoglobin, platelets, alanine aminotransferase, aspartate aminotransferase, alkaline phosphate, and creatinine at baseline and following vaccinations
Time frame: 19.5 months
Frequency of AEs leading to early participant withdrawal or early discontinuation of study products administration throughout the study.
Time frame: 19.5 months
Occurrence and level of vaccine-induced IgG binding Ab to gp120 and V1V2 scaffold
Time frame: 2 week sand 6 months post first-boost
Anti-V1/V2 IgG binding antibody responses as assessed by multiplex assay
Time frame: 2 weeks following the final vaccination of ALVAC-HIV + AIDSVAX B/E
Titers of antibody-dependent cellular cytotoxicity (ADCC) or antibody-dependent cellular viral inhibition (ADCVI)-mediating antibodies
Time frame: 2 weeks following the final vaccination of ALVAC-HIV + AIDSVAX B/E.
HIV-specific IgG subclass (IgG1-IgG4) characterization as determined by HIV-1 multiplex Ab assay
Time frame: 2 weeks following the final vaccination of ALVAC-HIV + AIDSVAX B/E.
Avidity indices for Env-specific antibodies
Time frame: 2 weeks following the final vaccination of ALVAC-HIV + AIDSVAX B/E.
HIV-capturing non-neutralizing antibodies as assessed by competitive virus capture assay
Time frame: 2 weeks following the final vaccination of ALVAC-HIV + AIDSVAX B/E.
B-cell ELISpot to quantify Env-specific antibody-producing B cells
Time frame: 2 weeks following the final vaccination of ALVAC-HIV + AIDSVAX B/E.
Expression of cytokines (eg, IL-10, IL-13) by multiplex bead array following antigen-specific stimulation of peripheral blood mononuclear cells (PBMC)
Time frame: 2 weeks following the final vaccination of ALVAC-HIV + AIDSVAX B/E.
Changes in PBMC gene expression relative to prevaccine levels of key genes expected to change.
Time frame: 19.5 months
Concentrations of cytokines and chemokines in serum and/or plasma samples.
Time frame: 19.5 months
Cell phenotype assessed by flow cytometric analysis of PBMC subsets.
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Time frame: 19.5 months
HIV-specific humoral and cellular responses 6 months following the final vaccination of ALVAC-HIV + AIDSVAX B/E.
Time frame: 6 months following the final vaccination of ALVAC-HIV + AIDSVAX B/E.
HIV-specific humoral and cellular responses 2 weeks following the final vaccination of ALVAC-HIV + AIDSVAX B/E.
Time frame: 2 weeks following the final vaccination of ALVAC-HIV + AIDSVAX B/E.
Occurrence and level of vaccine-induced IgG binding Ab to gp120 and V1V2 scaffold
Time frame: 2 weeks and 6 months post second-boost as assessed by multiplex assay
Occurrence, magnitude, character and breadth of systemic HIV-specific binding antibody responses as assessed by multiplex assay
Time frame: baseline (Time 0 prior to first boost), at 2 weeks and at 6 months following each boost, and at 12 months following the first boost including subtype, subclass and IgG binding Ab to V3 epitopes
HIV-specific systemic CD4+ and CD8+ T-cell responses
Time frame: baseline (Time 0 prior to first boost), at 2 weeks and at 6 months following each boost, and at 12 months following the first boost
Systemic neutralizing antibody magnitude and breadth against tier 1 and, if applicable, tier 2 HIV-1 isolates as assessed by area under the magnitude-breadth curves
Time frame: 2 weeks following each boost
Functional humoral immune responses including ADCC and HIV virus capture
Time frame: 19.5 months
Additional immunogenicity assays may be performed on blood and mucosal samples, including on samples from other timepoints, based on the HVTN Laboratory Assay Algorithm.
Time frame: 19.5 months