The purpose of this study is to assess whether Mycobacterium bovis rBCGΔureC::hly (VPM1002) vaccination and Mycobacterium bovis bacille Calmette-Guérin (BCG) revaccination are safe and immunogenic in pre-adolescents with and without HIV and with and without Mycobacterium tuberculosis (M.tb) sensitization.
Phase I/II, double-blinded, placebo-controlled, randomized (1:1:1) multi-center study. Randomization will be stratified by HIV status and M.tb sensitization status. The study will enroll approximately 480 pre-adolescents (8-14 years of age inclusive) with or without HIV and with or without M.tb sensitization who received BCG vaccination at birth. Participants with HIV will be immunocompetent and virologically suppressed on antiretroviral therapy. Participants will be randomized to one of three study product arms: VPM1002 Vaccine, BCG Vaccine, or Placebo. Each participant will receive a single intradermal injection of the assigned study product.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
QUADRUPLE
0.1 mL (2-8x10\^5 CFU)
0.1mL (0.075 Mycobacterium bovis)
0.1 mL (sodium chloride for injection 0.9%)
Soweto IMPAACT CRS
Johannesburg, Gauteng, South Africa
Setshaba Research Centre CRS
Soshanguve, Gauteng, South Africa
Isipingo CRS
Soshanguve, KwaZulu-Natal, South Africa
Klerksdorp CRS
Klerksdorp, North West, South Africa
All adverse events
Proportion of participants, based on the Division of AIDS Table for Grading the Severity of Adult and Pediatric Adverse Events (DAIDS AE Grading Table), Corrected Version 2.1, dated July 2017
Time frame: Through Week 48
Solicited adverse events
Proportion of participants, based on the Division of AIDS Table for Grading the Severity of Adult and Pediatric Adverse Events (DAIDS AE Grading Table), Corrected Version 2.1, dated July 2017
Time frame: Through Week 16
Grade 3 or higher adverse events
Proportion of participants, based on the Division of AIDS Table for Grading the Severity of Adult and Pediatric Adverse Events (DAIDS AE Grading Table), Corrected Version 2.1, dated July 2017
Time frame: Through Week 48
Serious adverse events
Proportion of participants, based on the Division of AIDS Table for Grading the Severity of Adult and Pediatric Adverse Events (DAIDS AE Grading Table), Corrected Version 2.1, dated July 2017
Time frame: Through Week 48
Adverse pregnancy outcomes
Proportion of participants, based on the Division of AIDS Table for Grading the Severity of Adult and Pediatric Adverse Events (DAIDS AE Grading Table), Corrected Version 2.1, dated July 2017
Time frame: Through Week 48 or delivery or other pregnancy outcome, whichever occurs later
Frequency and response of VPM1002-specific and BCG-specific CD4+ and CD8+ T cells expressing Th1 and/or Th17 cytokines
Measured by ICS and flow cytometry on cryopreserved PBMCs
Time frame: Through Week 10
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Desmond Tutu TB Centre - Stellenbosch University (SU) CRS
Cape Town, Western Cape, South Africa
Emavundleni CRS
Cape Town, Western Cape, South Africa
Umlazi CRS
Durban, South Africa
Wits RHI Shandukani Research CRS
Johannesburg, South Africa
Family Clinical Research Unit (FAM-CRU) CRS
Tygerberg Hills, South Africa
Frequency and response of VPM1002-specific and BCG-specific CD4+ and CD8+ T cells expressing Th1 and/or Th17 cytokines
Measured by ICS and flow cytometry on cryopreserved PBMC
Time frame: Weeks 24 and 48
Mycobacteria-specific IgA, IgG, and IgM binding antibodies
Measured using BAMA
Time frame: Entry and Weeks 4, 10, 24, and 48
Association of HIV and IGRA with primary safety outcomes (All AEs, solicitated AEs, grade 3 or higher AEs, serious adverse events, adverse pregnancy outcomes).
Based on the Division of AIDS Table for Grading the Severity of Adult and Pediatric Adverse Events (DAIDS AE Grading Table), Corrected Version 2.1, dated July 2017
Time frame: Through Week 48 or delivery or other pregnancy outcome, whichever occurs later
Cellular immunogenicity outcome measures associated with HIV and IGRA status
VPM1002-specific and BCG-specific CD4+ and CD8+ T cells expressing Th1 and/or Th17 cytokines, measured by ICS and flow cytometry on cryopreserved PBMCs
Time frame: Through Week 48
Humoral immunogenicity outcome measures associated with HIV and IGRA status
Mycobacteria-specific IgA, IgG, and IgM binding antibodies, measured using BAMA
Time frame: Through Week 48
Gene expression profiles
Measured by RNA-seq in whole blood
Time frame: Entry and Weeks 1, 4, and 10
Differential leukocyte count and immunophenotype
Measured in cryopreserved ex vivo whole blood (DLC-ICE) by flow cytometry
Time frame: Entry and Weeks 1, 4, and 10
Measurement of soluble proinflammatory mediators
Based on serum measurement
Time frame: Entry and Weeks 1, 4, and 10
Acceptability of the study products
Based on scores derived from questionnaire responses
Time frame: Week 24