The AELIX-002 trial has been conducted on a cohort of individuals who started cART within the first 6 months after the primary VIH infection, thus increasing the likelihood of observing a certain rate of post-treatment controls (PTC), regardless of treatment efficacy. Although the kinetics of HIV rebound should allow observing differences between placebo and control regarding the post treatment controls rate in case of efficacy of the IMPs, assessing the length and determinants of a post-intervention control (PIC) (i.e., associated with vaccination) beyond 24 weeks is crucial for developing a curative approach to HIV infection. In this regard, an extension of the ATI phase for those individuals with pVL less than 2,000 copies/mL after 24 weeks of ATI in the AELIX-002 offers an unique research opportunity to better understand relevant aspects of the mechanisms involved in the different phenotypes of a PIC and PTC.
The AELIX-002 trial has been conducted on a cohort of individuals who started cART within the first 6 months after the primary VIH infection, thus increasing the likelihood of observing a certain rate of post-treatment controls (PTC), regardless of treatment efficacy. Although the kinetics of HIV rebound should allow observing differences between placebo and control regarding the post treatment controls rate in case of efficacy of the IMPs, assessing the length and determinants of a post-intervention control (PIC) (i.e., associated with vaccination) beyond 24 weeks is crucial for developing a curative approach to HIV infection. In this regard, an extension of the ATI phase for those individuals with pVL less than 2,000 copies/mL after 24 weeks of ATI in the AELIX-002 offers an unique research opportunity to better understand relevant aspects of the mechanisms involved in the different phenotypes of a PIC and PTC. This trial will enrol participants of the AELIX-002 clinical trial regardless of whether they received vaccines or placebo, who reach 24 weeks of ATI with pVL \<2,000 cop/ml and are willing to remain off cART. After accepting participation, subjects will undergo a one-year extension \[48 weeks\] of ATI monitoring (total duration of ATI envisioned will be of 72 weeks \[24 weeks in AELIX-002 study + 48 weeks in current study\]), followed by 24 weeks of safety follow-up after cART is resumed. The primary objective of this study is to assess the safety and durability of viral control after AELIX-002 clinical trial intervention beyond 6 months of ATI. Furthermore, the study will collect biological samples to be stored for further investigational studies.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
DOUBLE
Enrollment
6
During the AELIX-002 trial participants received the following: DNA.HTI at weeks 0, 4, and 8 and MVA.HTI at weeks 12 and 20 (DDDMM) followed by ChAdOx1.HTI at weeks 0 and 12 and MVA.HTI at week 24 (CCM), starting at least 24 weeks after MVA.HTI week 20. After that, on ATI\_extension trial, ATI will be extended for 48 weeks.
During the AELIX-002 trial participants received the following: Normal saline solution at weeks 0, 4, 8, 12, and 20 (PPPPP) followed by normal saline solution at weeks 0, 12 and 24 (PPP), starting at least 24 weeks after week 20 administration. After that, on ATI\_extension trial, ATI will be extended for 48 weeks.
Germans Trias i Pujol Hospital
Badalona, Barcelona, Spain
Percentage of participants with viral remission
Percentage of participants with viral remission, defined as plasma viral load (pVL) \<50 copies/ml at 72 weeks after start of ATI.
Time frame: week 72
Percentage of participants with viral control
Percentage of participants with viral control, defined as a pVL \<2,000 copies/ml at 72?weeks after start of ATI.
Time frame: week 72
Time to viral detection
Time to viral detection up to 72 weeks after start of ATI, defined as the time from ATI start to first occurrence of detectable pVL (≥50 copies/ml).
Time frame: up to 72weeks after start of ATI
Time to viral rebound
Time to viral rebound up to 72 weeks after start of ATI, defined as the time from ATI start to first occurrence of ≥ 2,000 copies/ml.
Time frame: up to 72 weeks after start of ATI
Percentage of participants who remain off cART
Percentage of participants who remain off cART at 72 weeks after ATI start.
Time frame: Week 72
Time off cART
Time off cART, defined as time to cART resumption from ATI start.
Time frame: From ATI start to week 72
Phenotypes characterization
Different phenotypes will be characterized by the description of pVL and CD4 dynamics of each participant, and grouping according to their profile (non-rebounders, late-rebounders, post-rebound controllers, …).
Time frame: From ATI start to week 72
Change in a score for ATI psychological impact
Acceptability and the psychological impact of a longer ATI will be assessed by the change in a score of a questionnaire administered at weeks 24, 48 and at week 4 post cART resumption (or at the End of ATI visit in case of early withdrawal).
Time frame: At weeks 24, 48 and at week 4 post cART resumption (or at the End of ATI visit in case of early withdrawal).
The proportion of participants who develop symptoms compatible with acute retroviral syndrome.
The proportion of participants who develop symptoms compatible with acute retroviral syndrome.
Time frame: From ATI start to week 72
The proportion of participants who suppress pVL to <50 copies/ml
The proportion of participants who suppress pVL to \<50 copies/ml 24 weeks after cART resumption
Time frame: 24 weeks after cART resumption
The proportion of participants who develop new mutations not present in the pre-cART genotype
The proportion of participants who develop new mutations not present in the pre-cART genotype conferring clinically-significant resistance to antiretroviral drugs (out of the individuals not reaching viral re-suppression 24 weeks after cART resumption).
Time frame: 24 weeks after cART resumption
Description of participants who develop AEs related to the prime- boost regimen during this extension of ATI period.
Description of participants who develop AEs related to the prime-boost regimen during this extension of ATI period.
Time frame: From ATI_extension start to week 72
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