This is a randomized, placebo-controlled, multi-site, double-blind trial of V920 (rVSVΔG-ZEBOV-GP) Ebola Virus vaccine candidate in subjects with HIV infection to be conducted in conformance with Good Clinical Practices. The study will take place at 2 Canadian sites (Centre Hospitalier de l'Université de Montréal and Ottawa General Hospital) and 2 African sites (Centre MURAZ, Burkina Faso and Centre Hospitalier National Aristide Le Dantec, Dakar, Senegal). The Duration of Study: 365 days for each participant not including screening.
The study will enroll approximately 250 participants, \~100 at 2 sites in Canada and \~100 at 2 sites in Africa. Overall \~200 participants will receive the study vaccine and 50 will receive a placebo . Sequential enrollment of five study cohorts will occur over time at each study site according to CD4 T-cell counts: Group 1 will include adult subjects with CD4 ≥ 500 cells/mm3, Group 2 CD4 \> 350 and \< 500 cells/mm3, Group 3 CD4 ≥ 200 and ≤ 350 cells/mm3, Group 4 adolescents CD4 ≥ 200 cells/mm3, and Group 5 adults and adolescents CD4 ≥ 200 cells/mm3. Enrolment and vaccine administration will begin with the group with the highest CD4 count. When the D42 post-vaccination period is completed for all subjects in Group 1, and the Data Safety Monitoring Board (DSMB) has reviewed the safety data and determined that there are no concerns, enrolment and vaccination of the next CD4 cohort may begin. Similarly, when the D42 safety data for Group 2 has been reviewed/approved by the DSMB, enrolment and vaccination of participants in Group 3 may begin. Adolescents 13-17 years of age (inclusive) with CD4 ≥ 200 will be enrolled after D42 safety is reviewed in adults with CD4 ≥ 200. Adolescents 13-17 years of age (inclusive) and adults with CD4 ≥ 200 will be enrolled after D42 safety is reviewed in adolescents with CD4 ≥ 200.Within each group, participants will be randomly assigned to receive one dose of ≥2 x 107 pfu of the study vaccine or the placebo in a ratio of 4 to 1 (160:40). Participants will complete memory aids for 42 days following vaccination. Specific procedures to be performed during the trial, as well as their prescribed times and associated visit windows, are outlined in the Trial Flow Chart - Section 6.0. Details of each procedure are provided in Section 7.0 - Trial Procedures. This trial will use an adaptive design based on pre-specified criteria, using an independent, external DSMB to monitor safety and immunogenicity. There will be 3 formal safety analyses performed by the DSMB. Data for at least 75% of participants must be available for each analysis. The first safety analysis will be conducted when the first group (CD4 ≥ 500 cells/mm3) will have completed 42 days of follow-up post vaccination. The second safety analysis will be conducted when the second group (CD4 \> 350 and \< 500 cells/mm3) will have completed 42 days of follow-up post vaccination. The third safety analysis will be conducted when the third group (Adults CD4 ≥ 200 and ≤ 350 cells/mm3) will have completed 42 days of follow-up post vaccination. The fourth safety analysis will be conducted when the fourth group (Adolescents CD4 ≥ 200) will have completed 42 days of follow-up post vaccination. Results of the safety analysis will be reviewed by the DSMB, which will make recommendations to the Sponsor to continue, modify or end the trial according to the plan described briefly in Section 2.2 - Trial Diagram and in detail in Section 8.0 - Statistical Analysis Plan. In case of an outbreak of Ebola Zaire the DSMB may recommend to vaccinate subjects randomized to receive placebo with V920 provided at least 84 days of SAE follow-up is conducted.
The rVSVΔG-ZEBOV-GP vaccine is a live attenuated recombinant virus consisting of a single recombinant VSV isolate (11481 nt, strain Indiana) with the gene for the Zaire ebolavirus GP (ZEBOV GP), Kikwit strain replacing the gene for the VSV GP, which has been deleted. This results in a VSV backbone with the ZEBOV GP constituting the envelope of the virus.
Normal saline (0.9%) has been chosen as an inert substance to serve as placebo control.
CHUM
Montreal, Quebec, Canada
Number of Participants With Solicited Adverse Events Following V920 Vaccination
The number of participants with general solicited local (at the injection site) and systemic adverse events following vaccination will be summarized. Local AES include: pain at injection site, redness at injection site, swelling at injection site Systemic AEs include: fever, arthritis, arthralgia, rash and blisters/vesicular lesions.
Time frame: From vaccine administration up to day 14 following vaccination
Number of Participants With Solicited Adverse Events Following V920 Vaccination
The number of participants with solicited systemic adverse events following vaccination that include arthralgia, blister, joint swelling, pyrexia and rash
Time frame: From vaccine administration up to 42 days postvaccination
Number of Participants With Unsolicited Adverse Events Following V920 Vaccination
The number of participants with unsolicited adverse events following vaccination. These include the following disorders: Blood and lymphatic system disorders, cardiac disorders, ear and labyrinth disorders, eye disorders, gastrointestinal disorders, general disorders and administration site conditions, infections and infestations, injury, poisoning and procedural complications, metabolism and nutrition disorders, musculoskeletal and connective tissue disorders, nervous system disorders, psychiatric disorders, reproductive system and breast disorders, respiratory, thoracic and mediastinal disorders, skin and subcutaneous tissue disorders,vascular disorders.
Time frame: From vaccine administration up to day 42 postvaccination
Number of Participants With Serious Adverse Events Following V920 Vaccination
The number of participants with solicited vaccine-related serious adverse events following V920 vaccination.
Time frame: From vaccine administration up to day 365 following vaccination
Geometric Mean Titers Induced by V920
Geometric Mean Titers (GMTs) for ZEBOV-specific antibodies at Day 28 were calculated for each treatment group, along with two-sided 95% CIs, by exponentiating the corresponding log-transformed mean and two-sided 95% confidence limits. Cohorts 1-5.
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Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
DOUBLE
Enrollment
251
Time frame: Day 28 postvaccination
Geometric Mean Titers Induced by V920
Geometric Mean Titers (GMTs) for ZEBOV-specific antibodies at Day 28 were calculated for each treatment group, along with two-sided 95% CIs, by exponentiating the corresponding log-transformed mean and two-sided 95% confidence limits Only Cohort 5 received 2 doses of vaccine.
Time frame: 28 days after LAST (second) dose of vaccine