The purpose of this study is to evaluate the safety, tolerability, and efficacy of combination broadly neutralizing antibodies (bNAbs), to induce HIV-1 control during analytic treatment interruption (ATI).
This study is an open-label, two-arm, multi-step phase I study evaluating a combination of two broadly neutralizing antibodies (bNAbs), VRC07-523LS and PGT121.414.LS, in people living with HIV (PWH) who started antiretroviral therapy (ART) during acute/early infection. Participants will receive PGT121.414.LS and VRC07-523LS prior to undergoing an analytical treatment interruption (ATI). Participants will restart ART and continue follow-up after ATI to confirm viral suppression. Participants will be screened for eligibility and have a pre-entry visit. After determination of eligibility, participants will be enrolled sequentially into Arm A (n=20) and then Arm B (n=20). The study consists of three steps including an analytic treatment interruption. Arm A: * Step 1: Participants remain on ART and will receive an infusion of VRC07-523LS and PGT121.414.LS at study entry. * Step 2: Participants will interrupt their ART and receive a second infusion of VRC07-523LS 12 weeks after the initial infusion. Participants will be monitored closely for indications to resume ART. * Step 3: Upon meeting ART restart criteria in Step 2; participants will resume ART and be followed for up to 24 weeks. Arm B: * Step 1: Participants remain on ART and will receive an infusion of VRC07-523LS and PGT121.414.LS at study entry and a second infusion of VRC07-523LS 12 weeks later. * Step 2: Participants will interrupt their ART. Participants will be monitored closely for indications to resume ART. * Step 3: Upon meeting ART restart criteria in Step 2; participants will resume ART and be followed for up to 24 weeks. Participation in both arms will last up to 98 weeks.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
40
Administered by Intravenous (IV) infusion at Week 0 and 12 weeks later
Administered by IV infusion at Week 0
Alabama CRS
Birmingham, Alabama, United States
UCSD Antiviral Research Center CRS
San Diego, California, United States
University of Colorado Hospital CRS
Aurora, Colorado, United States
The Ponce de Leon Center CRS
Atlanta, Georgia, United States
Northwestern University CRS
Chicago, Illinois, United States
Massachusetts General Hospital CRS (MGH CRS)
Boston, Massachusetts, United States
Chapel Hill CRS
Chapel Hill, North Carolina, United States
Ohio State University CRS
Columbus, Ohio, United States
Penn Therapeutics CRS
Philadelphia, Pennsylvania, United States
Houston Advancing Research Team CRS
Houston, Texas, United States
...and 3 more locations
Number of participants experiencing a Grade ≥3 Adverse Event (AE) or Serious Adverse Events (SAE) that are related to VRC07-523LS or PGT121.414.LS
Time frame: Baseline through 36 weeks after the last dose of study treatment received
Proportion of study participants experiencing viral suppression, defined as HIV-1 RNA <200 copies/mL and remaining off ART
Time frame: At 62 weeks after Step 1 entry
Change from Step 1 entry in cell-associated HIV-1 RNA/DNA ratio in total CD4+ cells
To be measured focusing on unspliced and single spliced env mRNA and corresponding total and env DNA.
Time frame: Study entry through 72 weeks
Change from Step 1 entry in low-level viremia measured by single copy assay (SCA)
Time frame: Study entry through 72 weeks
Change from Step 1 entry in levels of intact proviral DNA in CD4+ T-cells
Time frame: Study entry through 72 weeks
Change from Step 1 entry in levels of inducible infectious virus on CD4+ T-cells
Time frame: Study entry through 72 weeks
Average number of weeks from ATI until meeting the virologic criteria for ART restart
Time frame: Week 2 through Week 72
Proportion of participants with HIV-1 RNA<1000 copies/mL
Time frame: At 62 weeks
Serum concentrations of VRC07-523LS and PGT121.414.LS at the time meeting the virologic criteria for ART restart
Time frame: At week 72
Area Under the Curve (AUC) of VRC07-523LS and PGT121.414.LS
Time frame: Week 0 through End of Study, an average of 98 weeks
IC50 for neutralization sensitivity of the HIV-1 envelope population to VRC07-523LS and PGT121.414.LS
Time frame: Week 0 through Week 72
Proportion of participants who develop antibodies to VRC07-523LS and PGT121.414.LS
Time frame: Week 0 through End of Study, an average of 98 weeks
CD4+ T-cells counts
Time frame: Week 0 through End of Study, an average of 98 weeks
HIV-1-specific T-cell count measured by Intracellular Cytokine Staining
Time frame: Week 0 through Week 72
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