This study will test a new ribonucleic acid (RNA)-based vaccine called BNT168 in adults living both with and without human immunodeficiency virus (HIV), to see how safe it is, how well it triggers the body's immune response and how it affects the amount of virus in the body.
Currently, this study consists of one part (Part A) which will be a Phase I, randomized, placebo-controlled, double-blind, first-in-human (FIH), dose escalation with an initial proof-of-principle component. Depending on the safety and immunogenicity data generated in this study, the Phase II part of this study and/or some of the cohorts may not be initiated or may be terminated earlier by sponsor decision. In this study: * Three cohorts of people living without HIV (PLWOH) will be randomized in a 5:1 ratio to receive BNT168 or placebo. Participants in these cohorts will receive 3 injections. BNT168 will be evaluated for safety, reactogenicity, and vaccine-induced immunogenicity in this population. * Two cohorts of people living with HIV (PLWH), will be randomized in a 2:1 ratio to receive BNT168 or placebo. Participants in these cohorts will receive 4 injections. BNT168 will be evaluated in PLWH on combination antiretroviral therapy (cART) for safety, reactogenicity, and vaccine-induced immunogenicity in this population. An initial proof-of-principle assessment will be conducted in PLWH who undergo analytical treatment interruption (ATI) to evaluate viral kinetics after investigational medicinal product (IMP) administration. After the ATI period, cART will be restarted as per protocol. For PLWOH, there will be an \~1-month screening period, \~2-month treatment period and an \~6-month follow-up period. The planned study duration per participant is \~9 months. For PLWH, there will be an \~1-month screening period, \~6-month treatment period and an \~6-month follow-up period. The planned study duration per participant is maximum \~13 months.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
126
Intramuscular injection to be applied in the deltoid muscle, using the same non-dominant arm for all IMP injections
Isotonic sodium chloride (NaCl) solution (0.9%). Intramuscular injection to be applied in the deltoid muscle, using the same non-dominant arm for all IMP injections
Occurrence of at least one adverse event
In PLWOH and PLWH. By cohort and pooled placebo.
Time frame: From dosing through 28 days after each IMP dose
Occurrence of at least one serious adverse event
In PLWOH and PLWH. By cohort and pooled placebo.
Time frame: From Dose 1 through the end of study (up to 12 months)
Occurrence of at least one adverse event of special interest
In PLWOH and PLWH. By cohort and pooled placebo.
Time frame: From Dose 1 through the end of study (up to 12 months)
Occurrence of at least one solicited local reaction (pain, erythema/redness, swelling) at the IMP injection site
In PLWOH and PLWH. By cohort and pooled placebo. From dosing through 7 days after each IMP dose.
Time frame: Up to 7 days after each IMP dose
Occurrence of at least one solicited systemic event (vomiting, diarrhea, headache, fatigue/tiredness, myalgia/muscle pain, fever)
In PLWOH and PLWH. By cohort and pooled placebo. From dosing through 7 days after each IMP dose.
Time frame: Up to 7 days after each IMP dose
Occurrence of cytokine positive cluster of differentiation (CD) 4+ T cells
In PLWOH and PLWH. By cohort and pooled placebo. For PLWOH, at 7 days post-Dose 2, and 7 days post-Dose 3. For PLWH, at 7 days post-Dose 2, 7 days post-Dose 3 and/or 7 days post-Dose 4. As assessed by multi-parameter intracellular cytokine staining (ICS) following stimulation with IMP-specific peptide pools.
Time frame: Up to 7 days post-Dose 2, 3 and/or 4
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Occurrence of cytokine positive CD8+ T cells
In PLWOH and PLWH. By cohort and pooled placebo. For PLWOH, at 7 days post-Dose 2 and 7 days post-Dose 3. For PLWH, at 7 days post-Dose 2, 7 days post-Dose 3 and/or 7 days post-Dose 4. As assessed by multi-parameter ICS following stimulation with IMP-specific peptide pools.
Time frame: Up to 7 days post-Dose 2, 3 and/or 4
Occurrence of proliferating CD8+ T cell responses (measured by carboxifluorescein diacetate succinimidyl ester)
In PLWOH and PLWH. By cohort and pooled placebo. For PLWOH, at 28 days post-Dose 2 and 28 days post-Dose 3. For PLWH, at 28 days post-Dose 2, 28 days post-Dose 3 and 28 days post-Dose 4. As assessed by flow cytometry following stimulation with IMP-specific peptide pools.
Time frame: At 28 days post-Dose 2, 3 and/or 4
Magnitude of CD4+ T cell counts from ATI start through cART restart
In PLWH. By cohort and pooled placebo.
Time frame: Up to 168 days post ATI start
Change in CD4+ T cell count from ATI start to cART restart and end of study
In PLWH. By cohort and pooled placebo.
Time frame: Up to 168 days post ATI start
Occurrence of absolute CD4+ T cell count <350 cells/µL from ATI start through cART restart
In PLWH. By cohort and pooled placebo.
Time frame: Up to 168 days post ATI start
Occurrence of at least one adverse event from the start of ATI to cART restart
In PLWH. By cohort and pooled placebo.
Time frame: Up to 168 days post ATI start
Occurrence of at least one serious adverse event from the start of ATI to cART restart
In PLWH. By cohort and pooled placebo.
Time frame: Up to 168 days post ATI start
Occurrence of any acquired immunodeficiency syndrome (AIDS)-defining illness or opportunistic infection from the start of ATI to cART restart
In PLWH. By cohort and pooled placebo. AIDS-defining illnesses and opportunistic infections as listed in the protocol.
Time frame: Up to 168 days post ATI start
Time from ATI start to loss of virologic control (HIV-1 plasma viral load >200 copies [cps]/mL, confirmed by the next measurement)
In PLWH. By cohort and pooled placebo.
Time frame: Up to 168 days post ATI start
Time from ATI start to meeting cART restart criteria
In PLWH. By cohort and pooled placebo.
Time frame: Up to 168 days post ATI start