The purpose of this study was to evaluate the safety and antiviral activity to promote clearance of HIV-1 infected cells of VRC01 in infants with HIV beginning combination antiretroviral therapy (cART).
VRC01 is an experimental human immunoglobulin G1 (IgG1) monoclonal antibody. The purpose of this study was to evaluate the safety and antiviral activity to promote clearance of HIV-1 infected cells of VRC01 received within 12 weeks of birth in infants with HIV initiating cART. All infants were required to have initiated cART within 14 days before or at study entry. Infants were randomly assigned to either receive VRC01 (VRC01, Arm 1) or not receive VRC01 (No-VRC01, Arm 2). Randomization was stratified by whether the initial cART regimen included an integrase inhibitor. Infants in the VRC01 arm received VRC01 injections at study entry (Week 0) and Weeks 2, 6, and 10. Infants in the No-VRC01 arm received no study product. Infants attended study visits at Weeks 1, 2, 3, 6, 7, 10, 11, 14, 16, 20, 24, 36, and 48. Visits included physical examinations, blood and urine collection. Infants' mothers could optionally be enrolled in the study for one-time specimen collection for exploratory evaluations. Maternal study participation was not required for infant study participation. The study was closed to enrollment prematurely on March 19, 2020 due to the outbreak of coronavirus disease 2019 (COVID-19) and after enrolling 61 of the targeted 68 infants.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
61
40 mg/kg of VRC01 administered by subcutaneous injection.
All infants received non-study provided cART selected by their primary care provider and supplied through non-study sources (i.e., cART not provided through the study).
Molepolole CRS
Molepolole, Kweneng District, Botswana
Gaborone CRS
Gaborone, South-East District, Botswana
Hosp. Geral De Nova Igaucu Brazil NICHD CRS
Rio de Janeiro, Brazil
Hospital Federal dos Servidores do Estado NICHD CRS
Rio de Janeiro, Brazil
Percentage of Infants Experiencing at Least One Grade 3 or Higher Adverse Event (AE)
Includes reactogenicity outcomes, abnormal laboratory test results, signs, symptoms, and diagnoses. Adverse event severity grading was based on the Division of AIDS Table for Grading the Severity of Adult and Pediatric Adverse Events. Two-sided exact 95% Clopper-Pearson confidence intervals were calculated.
Time frame: From Week 0 to Week 14
Change in HIV-1 DNA Concentration in Peripheral Blood Mononuclear Cells (PBMCs) From Week 0 to Week 14
Mean changes (Week 14 - Week 0) were calculated on log10-transformed HIV-1 DNA concentration. Values below the assay detection limit were set to half the lower assay limit of 4.09 copies/million PBMCs. Values above the detection limit were set to the upper limit of 10,000 copies/million PBMCs.
Time frame: Week 0 and Week 14
Median Pre-dose VRC01 Concentrations in the Plasma (VRC01 Arm Only)
Median (mcg/ml) pre-dose VRC01 concentrations in the plasma (VRC01 Arm only)
Time frame: Weeks 2, 6, 10, 14, and 16
Geometric Mean of Pre-dose VRC01 Concentrations in the Plasma (VRC01 Arm Only)
Geometric mean (mcg/ml) of pre-dose VRC01 concentrations with 90% confidence intervals
Time frame: Weeks 2, 6, 10, 14, and 16
Percentage of Infants With Pre-dose VRC01 Concentrations >= 20 mcg/ml in the Plasma (VRC01 Arm Only)
Percentage of infants with pre-dose VRC01 concentrations \>= 20 mcg/ml in the plasma (VRC01 Arm only)
Time frame: Weeks 2, 6, 10, 14, 16
Percentage of Infants With Pre-dose VRC01 Concentrations >= 50 mcg/ml in the Plasma (VRC01 Arm Only)
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Malawi CRS
Lilongwe, Central Region, Malawi
Blantyre CRS
Blantyre, Malawi
Harare Family Care CRS
Harare, Zimbabwe
Percentage of infants with pre-dose VRC01 concentrations \>= 50 mcg/ml in the plasma (VRC01 Arm only)
Time frame: Weeks 2, 6, 10, 14, 16