This study will evaluate the safety and virologic effect of an experimental human monoclonal antibody (mAb), VRC-HIVMAB060-00-AB (VRC01), alone or in combination with antiretroviral therapy (ART), in adults during early acute HIV infection.
Human monoclonal antibodies (mAbs) may have the potential to treat HIV infection by preventing the spread of the virus. This study will evaluate an experimental mAB known as VRC-HIVMAB060-00-AB (VRC01). The purpose of this study is to evaluate the safety and virologic effect of VRC01, alone or in combination with ART, in adults with early acute HIV infection. Researchers will also evaluate the effect of VRC01 on the establishment of an HIV reservoir during early acute HIV infection. This study will enroll participants who are diagnosed with early acute HIV infection. Participants will be randomly assigned to one of three groups: Group 1 will begin ART and receive a single infusion of placebo at Day 0. Group 2 will begin ART and receive a single infusion of VRC01 at Day 0. Group 3 will receive a single infusion of VRC01 on Day 0 and begin ART on Day 7. ART will vary by country and will consist of country guideline-recommended, available first line combination therapy: currently either efavirenz 600 mg/emtricitabine 200 mg/tenofovir disoproxil fumarate 300 mg or efavirenz 600 mg/lamivudine 300 mg/tenofovir disoproxil fumarate 300 mg. This initial ART regimen may be adjusted or switched to an alternate regimen as clinically indicated for regimen intolerance or failure. Study visits will occur at Days 0, 1, 3, 7, 10, 14, 18, 21, 25, 28, 42, 56, 84, 112, 168, and 175. Visits will include a physical examination, medical history review, and blood collection. Neurocognitive testing will take place on Day 168. Some participants may take part in optional study procedures at various time points during the study including mucosal secretion collection, rectosigmoid biopsy, lymph node biopsy, leukapheresis, and lumbar puncture.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
24
40 mg/kg of VRC01 will be administered as an intravenous infusion over 30 to 60 minutes using a volumetric pump
Administered as an intravenous infusion over 30 to 60 minutes using a volumetric pump
ART is provided by the study sites and consists of country guideline-recommended, available first line once-daily oral combination therapy: currently either efavirenz 600 mg/emtricitabine 200 mg/tenofovir disoproxil fumarate 300 mg or efavirenz 600 mg/lamivudine 300 mg/tenofovir disoproxil fumarate 300 mg. This initial ART regimen may be adjusted or switched to an alternate regimen as clinically indicated for regimen intolerance or failure.
Kenya Med. Research Inst./Walter Reed Project, Clinical Research Centre, Off Hospital Road. Kericho
Kericho, Kenya
National Institute for Medical Research (NIMR)-Mbeya Medical Research Center (MMRC) Non-Network CRS
Mbeya, Tanzania
SEARCH Thai Red Cross AIDS Research Centre Non-Network CRS
Bangkok, Thailand
ECHO Center Non-Network CRS
Chon Buri, Thailand
Number of Participants With Grade 3 or Greater mAb-related Reactogenicity and mAb-related Adverse Events (AEs)
This outcome is the combined total number of grade 3 or higher mAb-related reactogenicity events and mAb-related adverse events for each group. Only grade 3 reactogenicity events/AEs that are determined by the study physicians to be related to mAb are included. Adverse events, including reactogenicity events, are graded according to the Division of AIDS (DAIDS) Table for Grading the Severity of Adult and Pediatric Adverse Events v2.0 dated November 2014. This outcome is the total number of solicited adverse events (reactogenicity events) that had a severity of grade 3 or higher and were related to the mAb. Note that higher grades indicate worse severity.
Time frame: Measured through Week 24
Plasma Viral Load Change From Day 0 to Day 7
Time frame: Measured through Day 7
Time to Virologic Suppression (Less Than 50 Copies/ml) in Plasma
Time frame: Measured through Week 24
Number of Total Viremic Copy Days (Area Under Viral Load Curve) From Day 0 to Week 24
Time frame: Measured through Week 24
Measurement of Plasma Viremia Including Single Copy HIV RNA Quantification
In samples with HIV RNA less than 50 copies/ml at Day 7, Day 14, and Week 24
Time frame: Measured through Week 24
Measurement of Cell-associated HIV RNA and DNA in the Peripheral Compartment
Time frame: Measured through Week 24 (Day 168)
Percentage of Participants Experiencing Acute Retroviral Syndrome
Time frame: Measured through Week 24
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Makerere University Walter Reed Project (MUWRP)
Kampala, Uganda
Percentage of Participants Experiencing a Hospitalization
Time frame: Measured through Week 24
Percentage of Participants Experiencing Opportunistic Infections
Time frame: Measured through Week 24
Percentage of Participants Experiencing Non-AIDS-related Conditions
Time frame: Measured through Week 24
Measurement of CD4 + T Cells
Decrease from baseline to nadir, increase from nadir to Week 24, and overall change from baseline to Week 24
Time frame: Measured through Week 24
Measurement of VRC01 Levels in Peripheral Blood
Time frame: Measured through Week 24