This research study is being carried out to study a new way to possibly treat HIV. As part of this study, doctors will take some of your own white blood cells, called T-cells, and modify them so that they can identify and target your HIV cells. The purpose of the study is to evaluate the safety of these modified T cells and determine whether they have any effect on HIV infection.
Step 1: Subject is screened, undergoes leukaphereses, and optional rectal biopsy, and safety evaluations before dosing. The University of Pennsylvania manufactures the study product. Step 2: Subjects receive a single infusion of 0.5-1x10(10) CD4 CAR+CCR5 ZFN modified T cells. Cohort 2 participants undergo a mini-leukapheresis and optional rectal biopsy at the end of step 2. The duration of Step 2 will be: * Cohort 1: 1 day * Cohort 2: 8 weeks Step 3: All subjects will participate in a 16 week analytical treatment interruption (ATI). ATI will be less than 16 weeks if patient's viral load is sustained \>100,000 or CD4 count \<350 or less than 50% of baseline. At the end of step 3 all participants will undergo mini-leukapheresis and optional rectal biopsy. Step 4: Participants who have HIV viral loads ≤1000 copies/ml will continue in an extension of the analytical treatment interruption until viral load is sustained \>100,000 or CD4 count \<350 or less than 50% of baseline. Step 5: Reinitiation of antiretroviral therapy with monthly visits until the HIV RNA is below the limit of quantification. All participants undergo a mini-leukapheresis and optional rectal biopsy at the end of the step 5. Step 6 (Secondary Follow-up): All subjects will be followed for safety for up to 5 years post-infusion.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
12
A dual cohort, open-label, randomized study of the safety and tolerability of a single infusion of autologous T cells genetically modified to express a CD4 chimeric antigen receptor while also having zinc finger nuclease-mediated disruption of the CCR5 gene
University of Pennsylvania
Philadelphia, Pennsylvania, United States
Number of subjects with treatment related adverse events.
Time frame: After subjects have received infusion and up to 5 years from Day 0 infusion.
Compare the percentage of enriched modified CD4 CAR+ CCR5 ZFN cells and their subsets.
Time frame: 2 weeks post infusion, prior to prior to analytical treatment interruption (ATI), 6-9 months post infusion.
Compare the change in CD4 count.
Time frame: Baseline, week 2 post infusion, prior to ATI, weeks 8, 12, 16 of ATI.
Compare viral set point log 10 HIV RNA level.
Time frame: Baseline and 6-9 months post infusion
Percentage of cells producing cytokines in response to HIV antigen/peptide as assessed by flow cytometry
Time frame: Baseline and 6-9 months post infusion
Size of latent HIV reservoir as assessed by quantification of integrated copies of replication competent HIV
Time frame: Baseline, pre-treatment interruption, prior to ART reinitiation, 6-9 months post infusion, and end of primary follow up (8-12 months)
Sequence of HIV envelope genes and coreceptor usage in breakthrough HIV infections
Time frame: Baseline through 1 year.
Number of participants who control HIV replication that have similar gene expression patterns as determined by RNA quantification
Time frame: Baseline through 1 year.
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