This is a study of HIV vaccines. A vaccine is a medical product given to prevent certain diseases. The vaccine may educate the body to form a defensive response to try to prevent the disease from the beginning, or preventing it from taking hold of the body. This defensive response is called the immune response. The experimental vaccines in this study are Env-C Plasmid DNA and HIV Env gp145 C690 protein, given with different adjuvants. An adjuvant is a substance added to vaccines that can help make the vaccine more effective by improving the immune response, or by causing the immune response to last longer than it would without the adjuvant. The adjuvants are mixed with the vaccines and injected into muscle or placed on top of the skin. The HIV vaccines contain a piece of genetic material or a protein copied drom the HIV virus cover (Env), but they do not contain the virus itself. The vaccines cannot cause HIV infection or Acquired Immune Deficiency Syndrome (AIDS). The purpose of this study is to find out if the study vaccines with adjuvants cause side effects and are tolerable, whether humans respond (develop immune responses) to the vaccines, and how ling the effects of the study vaccines last. The study will also compare the effects of the study vaccines with adjuvants and adjuvant patch to those of placebo injections and placebo patch. The placebo will consist of saline (sterile saltwater) and will look like study vaccines, be given in the same way, but will have no active vaccine or adjuvant in it. A total of 126 participants will take part in the study and each will have up to 26 clinic visits and will be followed-up for a total of 108 weeks.
Antibodies are the most commonly recognized correlate of vaccine protection from infection; however the possible protective HIV antibody levels, which were induced by the modestly protective RV144 vaccine regimen with alum, rapidly decayed. Potentially, a novel, highly selective adjuvant combined with the correctly sequenced HIV antigen could slow antibody decay, increase antibody magnitude and induce antibodies of appropriate functional response. RV460 is an exploratory study that will assess the safety, tolerability, and immunogenicity of a vaccine regimen consisting of priming with an Env-C Plasmid DNA vaccine (with or without novel adjuvants) when given with or without adjuvanted HIV Env gp145 C.6980 protein vaccine and boosting with adjuvanted gp145 C.6980 protein with or without the gp120 DNA vaccine. The study will be carried out in Kericho, Kenya. 126 healthy adults will ben enrolled. Participants will be randomized into one of seven groups which have 15/3 vaccine/placebo recipients per group. Each participant will receive six injections (prim at week 0, 4, 12; boost at week 20, 32 and 56) and will be followed-up for a total of 108 weeks.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
DOUBLE
Enrollment
143
2 mg per dose. Administered by intramuscular injection.
100 µg per dose. Administered by intramuscular injection.
Adjuvant. Aluminum hydroxide fluid gel. 500 µg per dose. Administered by intramuscular injection.
Adjuvant. Army Liposome Formulation-43% Cholesterol. 200 µg per dose. Administered by intramuscular injection.
Adjuvant. Recombinant double mutant Escherichia coli heat labile toxin. 50 µg per dose. Transcutaneous application (needle-free skin patch). 1 mL diluted dmLT added to gauze pad at site of injection.
0.9% sodium chloride (sterile saline). Administered by intramuscular injection.
Transcutaneous application (needle-free skin patch). 0.9% sodium chloride (sterile saline) added to gauze pad at site of injection.
Kenya Medical Research Institute/Walter Reed Project, Clinical Research Centre, Off Hospital Road
Kericho, Kenya
Number of Solicited Local Events Post Vaccination 1 by Priming Dose Group (Outcome 1)
Incidence (number and percentage of participants) of local reactogenicity events post dose 1 by symptom, maximum severity, and priming dose group
Time frame: Day 1-Day 7 Post Vaccination 1
Number of Solicited Local Events Post Vaccination 2 by Priming Dose Group (Outcome 2)
Incidence (number and percentage of participants) of local reactogenicity events post dose 2 by symptom, maximum severity, and priming dose group
Time frame: Day 1-Day 7 Post Vaccination 2
Number of Solicited Local Events Post Vaccination 3 by Priming Dose Group (Outcome 3)
Incidence (number and percentage of participants) of local reactogenicity events post dose 3 by symptom, maximum severity, and vaccination group.
Time frame: Day 1-Day 7 Post Vaccination 3
Number of Solicited Local Events Post Vaccination 4 by Vaccination Group (Outcome 4)
Incidence (number and percentage of participants) of local reactogenicity events post dose 4 by symptom, maximum severity, and vaccination group
Time frame: Day 1-Day 7 Post Vaccination 4
Number of Solicited Local Events Post Vaccination 5 by Vaccination Group (Outcome 5)
Incidence (number and percentage of participants) of local reactogenicity events post dose 5 by symptom, maximum severity, and priming dose group
Time frame: Day 1-Day 7 Post Vaccination 5
Number of Solicited Local Events Post Vaccination 6 by Vaccination Group (Outcome 6)
Incidence (number and percentage of participants) of local reactogenicity events post dose 6 by symptom, maximum severity, and vaccination group
Time frame: Day 1-Day 7 Post Vaccination 6
Number of Solicited Systemic Events Post Vaccination 1 by Priming Dose Group (Outcome 7)
Incidence (number and percentage of participants) of systemic reactogenicity events post dose 1 by symptom, maximum severity, and priming dose group
Time frame: Day 1-Day 7 Post Vaccination 1
Number of Solicited Systemic Events Post Vaccination 2 by Priming Dose Group (Outcome 8)
Incidence (number and percentage of participants) of systemic reactogenicity events post dose 2 by symptom, maximum severity, and priming dose group
Time frame: Day 1-Day 7 Post Vaccination 2
Number of Solicited Systemic Events Post Vaccination 3 by Priming Dose Group (Outcome 9)
Incidence (number and percentage of participants) of systemic reactogenicity events post dose 3 by symptom, maximum severity, and vaccination group
Time frame: Day 1-Day 7 Post Vaccination 3
Number of Solicited Systemic Events Post Vaccination 4 by Vaccination Group (Outcome 10)
Incidence (number and percentage of participants) of systemic reactogenicity events post dose 4 by symptom, maximum severity, and vaccination group
Time frame: Day 1-Day 7 Post Vaccination 4
Number of Solicited Systemic Events Post Vaccination 5 by Vaccination Group (Outcome 11)
Incidence (number and percentage of participants) of systemic reactogenicity events post dose 5 by symptom, maximum severity, and priming dose group
Time frame: Day 1-Day 7 Post Vaccination 5
Number of Solicited Systemic Events Post Vaccination 6 by Vaccination Group (Outcome 12)
Incidence (number and percentage of participants) of systemic reactogenicity events post dose 6 by symptom, maximum severity, and vaccination group
Time frame: Day 1-Day 7 Post Vaccination 6
Number of Related Unsolicited AEs (Outcome 13)
Incidence (number and percentage of participants) of related unsolicited AEs by maximum severity and vaccination group.
Time frame: Day 1-Day 728
Number of SAEs (Outcome 14)
Incidence (number and percentage of participants) of SAEs by maximum severity and vaccination group
Time frame: Day 1-Day 728
Magnitude of Plasma IgG Binding Antibodies in Response to Differing DNA Priming Regimens
Measured by binding antibody assays.
Time frame: Thru Week 105
Durability of Plasma IgG Binding Antibodies in Response to Differing DNA Priming Regimens
Measured by binding antibody assays.
Time frame: Thru Week 105
Area Under the Curve (AUC) for Plasma IgG Binding Antibodies in Response to Differing DNA Priming Regimens
Measured by binding antibody assays.
Time frame: Thru Week 105
Magnitude of Plasma IgG Binding Antibodies Between Groups With and Without Rehydragel® After HIV Env gp145 C.6980 Protein Boosting
Measured by binding antibody assays.
Time frame: Thru Week 105
Durability of Plasma IgG Binding Antibodies Between Groups With and Without Rehydragel® After HIV Env gp145 C.6980 Protein Boosting
Measured by binding antibody assays.
Time frame: Thru Week 105
AUC for Plasma IgG Binding Antibodies Between Groups With and Without Rehydragel® After HIV Env gp145 C.6980 Protein Boosting
Measured by binding antibody assays.
Time frame: Thru Week 105
Presence of Plasma IgG Binding Antibodies
Functional antibodies assessed using rapid fluorometric Antibody-dependent Cell-Mediated Cytotoxicity (ADCC) Assay, Antibody-dependent Cell-mediated Phagocytosis (ADCP), Antibody-dependent Complement (ADC) activation assays, or other functional assays. Neutralizing antibodies assessed using cell line-based and PBMC assays with a panel of viruses from different HIV subtypes, including A, B, C, D, and other circulating recombinant forms (CRFs) such as AE and AG.
Time frame: Thru Week 105
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Presence of Plasma IgA Binding Antibodies
Functional antibodies assessed using rapid fluorometric Antibody-dependent Cell-Mediated Cytotoxicity (ADCC) Assay, Antibody-dependent Cell-mediated Phagocytosis (ADCP), Antibody-dependent Complement (ADC) activation assays, or other functional assays. Neutralizing antibodies assessed using cell line-based and PBMC assays with a panel of viruses from different HIV subtypes, including A, B, C, D, and other circulating recombinant forms (CRFs) such as AE and AG.
Time frame: Thru Week 105
Types of Cell-mediated Immune Responses
Cryopreserved PBMC and lymph nodes will be stimulated with HIV-1-specific antigens and tested using standard (but not limited to) cellular immune assays which may include but are not limited to Intracellular cytokine Staining, ELISPOT, Lymphoproliferation assays, B-cell analysis, T-follicular helper cell and innate immune cell analysis.
Time frame: Thru Week 105
Level of Cell-mediated Immune Responses
Cryopreserved PBMC and lymph nodes will be stimulated with HIV-1-specific antigens and tested using standard (but not limited to) cellular immune assays which may include but are not limited to Intracellular cytokine Staining, ELISPOT, Lymphoproliferation assays, B-cell analysis, T-follicular helper cell and innate immune cell analysis.
Time frame: Thru Week 105
Types of Mucosal Humoral Responses
Including, but not limited to, plasma IgG and IgA binding antibodies to HIV Env proteins, IgG and IgA subclass, and functional assays.
Time frame: Thru Week 104