AzTrials
AzTrials

HIV InfectionsPhase 2NCT00183261

Immune Response to a Therapeutic HIV Vaccine Followed by Treatment Interruption in Patients With Acute or Recent HIV Infection

A Phase 2 study testing MRKAd5 HIV-1 gag/pol/nef in people with HIV Infections, run by National Institute of Allergy and Infectious Diseases (NIAID) at 23 sites in 3 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

The purpose of this study is to determine whether the HIV vaccine MRKAd5 HIV-1 gag/pol/nef followed by treatment interruption can increase immune system function in adults with acute or recent HIV infection who have started taking anti-HIV drugs. Read more about this study

Who is it for?
Ages 18 to 55 years
Conditions the study is for
HIV Infections
What is being tested?
MRKAd5 HIV-1 gag/pol/nef
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
25 participants
Where
23 sitesin 3 countries
Study dates
Mar 2006to Oct 2010
Phase
Phase 2
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 55 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • Initiated HAART within 30 days of an acute or recent HIV-1 infection diagnosis. More information on this criterion can be found in the protocol.
  • Initiated HAART within 30 days of documented acute or recent HIV-1 infection without interruption for more than 7 days
  • Sustained viral suppression, defined as a viral load of 500 copies/mL or less 12 months prior to baseline with an undetectable HIV-1 RNA viral load between 60 to 7 days prior to baseline
  • CD4 count of 450 cells/mm3 or more OR 35% or more between 60 to 14 days prior to baseline
  • Ad5 neutralizing antibody titer of 200 or less at screening
  • Willing to follow all study procedures and schedules
Show all 10Show fewer
  • Willing to interrupt HAART for at least 24 weeks following completion of the vaccination stage
  • Negative for hepatitis B surface antigen (HBsAg) at screening
  • Willing to use acceptable forms of contraception
  • Infected with HIV-1 subtype B, if this information is available

Who cannot join

  • Virologic relapse, defined as 2 consecutive measurements of viral load of 500 copies/mL or more at least 7 days apart within 12 months of baseline visit
  • Received more than 7 days of continuous HAART other than that received within 16 days of acute or recent HIV-1 infection. Participants who received HAART as part of post-exposure prophylaxis (PEP) more than 6 months prior to the start of initial HAART may be eligible, provided that they did not acquire HIV-1 infection from the event that required PEP.
  • History of anaphylaxis or allergy to vaccine components, including Tris buffer, magnesium chloride, and polysorbate 80 (Tween)
  • History of clinically significant heart, lung, kidney, liver, pancreatic, gastrointestinal, or neurological disease that, in the opinion of the study investigator, may interfere with the study
  • Contraindication to intramuscular (IM) injection, such as anticoagulant therapy or thrombocytopenia
  • Receipt of any immune globulin or blood products within 3 months prior to baseline
Show all 16Show fewer
  • Receipt of any live vaccine within 30 days prior to baseline or any inactivated vaccine within 14 days prior to baseline
  • Previous receipt of any HIV vaccine. Participants that were documented to have received only placebo are not excluded.
  • History of any AIDS-defining illness. If a participant's sole AIDS-defining illness is Kaposi's sarcoma limited to the skin and is not anticipated to require systemic chemotherapy, that participant is not excluded.
  • Currently receiving drugs or biologics not approved by the Food and Drug Administration (FDA) other than investigational HIV medications
  • Current or past participation in other studies that might alter the participant's response to the study vaccination
  • Use of any immunomodulatory agents, including but not limited to interleukin-2 (IL-2), granulocyte/macrophage-colony stimulating factor (GM-CSF), and systemic corticosteroids, within 30 days prior to baseline
  • Active alcohol or substance use that, in the investigator's opinion, may interfere with the study
  • Any other criteria or condition that, in the investigator's opinion, may interfere with the study
  • Unwilling or unable to contribute to the planned peripheral blood mononuclear cell (PBMC) blood collection
  • Pregnancy or breastfeeding

Trial locations and contacts

23 sites in 3 countries.

23 sites in 3 countries

United States13 sites
  • Fenway Community Health Ctr. CRS

    Boston, Massachusetts, 02115

  • Unc Aids Crs

    Chapel Hill, North Carolina, 27514

  • UNC, Chapel Hill AIEDRP

    Chapel Hill, North Carolina, 27599

  • Univ. of Colorado Health Sciences Ctr. AIEDRP

    Denver, Colorado, 80220

  • Duke Univ. Med. Ctr. Adult CRS

    Durham, North Carolina, 27710

  • Dumc Aiedrp

    Durham, North Carolina

  • Beth Israel Med. Ctr., ACTU

    New York, New York, 10003

  • Aaron Diamond AIDS Research Ctr. AIEDRP

    New York, New York, 10016

  • The Miriam Hosp. ACTG CRS

    Providence, Rhode Island, 02906

  • Ucsd Aiedrp

    San Diego, California, 92103

  • Ucsf Aiedrp

    San Francisco, California, 94110

  • Washington U CRS

    St Louis, Missouri, 63110

  • LA Biomedical Research Institute at Harbor-UCLA AIEDRP

    Torrance, California

Other trials in United States

Australia9 sites
  • Holdsworth House Medical Practice CRS

    Darlinghurst, New South Wales, 2010

  • St. Vincent's Hospital CRS

    Darlinghurst, New South Wales, 2010

  • Taylor Square Private Clinic CRS

    Darlinghurst, New South Wales, 2010

  • AIDS Research Initiative, Darlinghurst CRS

    Darlinghurst, New South Wales

  • 407 Doctors (Australia) AIEDRP

    Sydney, 2010

  • AIDS Research Initiative (Australia) AIEDRP

    Sydney, 2010

  • St. Vincent's Hosp. (Australia) AIEDRP

    Sydney, 2010

  • Taylor Square Private Clinic (Australia) AIEDRP

    Sydney, 2010

  • Holdsworth House Gen. Practice (Australia) AIEDRP

    Sydney

Other trials in Australia

American Samoa1 site
  • 407 Doctors CRS

    Surry Hills, New South Wales, 2010

About this study

Official title: A Randomized Phase II Study of Therapeutic Immunization and Treatment Interruption Among Subjects Who Began Potent Antiretroviral Therapy Within 30 Days of Diagnosis of Acute or Recent HIV Infection

The purpose of this study is to determine whether the HIV vaccine MRKAd5 HIV-1 gag/pol/nef followed by treatment interruption can increase immune system function in adults with acute or recent HIV infection who have started taking anti-HIV drugs.

Read the detailed description

While the advent of highly active antiretroviral therapy (HAART) has contributed to the increasing control of HIV infection and viral replication, ultimate control of HIV infection will require the development of effective HIV-specific immunity in HIV infected individuals. Therapeutic vaccination within the earliest weeks following acute or recent HIV infection may increase the immune system's response to HIV. This study will determine whether MRKAd5 HIV-1 gag/pol/nef vaccine followed by treatment interruption can maintain viral suppression in patients with acute or recent HIV infection.

The interventional part of the study will last 102 weeks. Participants will be randomly assigned to receive either MRKAd5 HIV-1 gag/pol/nef or placebo vaccine at baseline and Weeks 4 and 26. Participants must remain on HAART from study entry until Week 38. Participants whose HIV viral load rebounds two times or more above 500 copies/ml by Weeks 39 to 41 will not enter Step 2 of the study. Participants whose viral load drops to 500 copies/ml or less by Weeks 39 to 41 will enter Step 2, where they will discontinue HAART for 24 weeks. Participants in Step 2 will have plasma HIV viral loads measured every 2 weeks for the first 4 weeks and weekly for the next 3 weeks. Study participants will continue in Step 2 until they experience virologic and immunologic failure or they need to restart HAART for another reason; they will then enter Step 3, where they will reinitiate HAART. Step 3 participants will continue on HAART until Week 102. A long-term safety follow-up period will occur from Weeks 103 to 240.

Timing of the study visits will be determined by which steps a participant enters. A physical exam and blood and urine collection will occur at most study visits throughout the study until Week 102. Follow-up phone calls to study participants will occur every 6 months from Week 102 until Week 240 to collect long-term safety data, including clinical status, CD4 count, and medication history. During the long-term safety follow-up, participants will also have study visits every 6 months. Visits will include medical and medication history.

Conditions
HIV Infections
Being tested
MRKAd5 HIV-1 gag/pol/nef, MRKAd5 HIV-1 gag/pol/nef placebo
Keywords
Treatment Interruption, HIV Therapeutic Vaccine, Acute Infection, Acute Retroviral Syndrome
Medical subject headings
HIV Infections, Acute Retroviral Syndrome

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • MRKAd5 HIV-1 gag/pol/nefBiological

    1.5 x 1010 Ad vg/mL, 1.0 mL administered intramuscularly

  • MRKAd5 HIV-1 gag/pol/nef placeboBiological

    1.0 mL administered intramuscularly

Study groups in NCT00183261
Study groupRoleWhat they receive
1ExperimentalParticipants will receive the MRKAd5 HIV-1 gag/pol/nef vaccine at study entry and on Weeks 4 and 26
Receives: Biological: MRKAd5 HIV-1 gag/pol/nef
2Placebo comparatorParticipants will receive the MRKAd5 HIV-1 gag/pol/nef vaccine placebo at study entry and on Weeks 4 and 26
Receives: Biological: MRKAd5 HIV-1 gag/pol/nef placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Average of log10 HIV-1 RNA viral load

    Measured: At Weeks 58 and 63

  2. Frequency of Grade 3 or 4 systemic adverse events, the occurrence of a severe or life-threatening injection site adverse event, or death

    Measured: Throughout study

Secondary outcomes (13)
  1. Distribution of plasma HIV RNA viral load

    Measured: At Weeks 63 and 87

  2. Proportion of patients with controlled viremia and their respective distribution of plasma HIV RNA viral load

    Measured: At Weeks 63 and 87

  3. Mean viral burden, defined as time-averaged area under the log10 HIV-1 RNA viral load curve

    Measured: At Weeks 63 and 87

  4. HIV DNA levels

    Measured: At Weeks 30, 38, 63, and 87

  5. HIV-1 DNA levels

    Measured: At Weeks 30, 38, 46, 50, 63, and 87

  6. Magnitude and absolute change in CD4 and CD8 counts

    Measured: At Weeks 63 and 87

  7. Percent and absolute change in the number of HIV-1- specific CD8 cells, as measured by interferon (IFN)-gamma Elispot assay and intracellular cytokine staining

    Measured: Through Week 30

  8. Percent and absolute change in the cytokine secretion patterns and the proliferative capacity of HIV-1- specific CD4 and CD8 cells, as measured by multiparameter flow cytometry

    Measured: Through Week 30

  9. Breadth and magnitude of HIV-1- specific CD4 and CD8 cell responses

    Measured: Throughout study

  10. Time to reach the specified virologic or immunologic criteria for reinitiating antiretroviral therapy after treatment interruption

    Measured: Throughout study

  11. Frequency of Grade 3 or 4 systemic adverse events or the occurrence of a severe or life-threatening injection site adverse event, or HIV-related events, AIDS-defining infections, and death from time of vaccination

    Measured: Throughout study

  12. Cell-associated infectivity in latently infected cells

    Measured: At Week 63

  13. Cell-associated infectivity at Week 63 and immunologic responses

    Measured: At Weeks 63 and 87

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted16 Sep 2005 (estimated)
  2. Study startMar 2006
  3. Primary completionAug 2007
  4. Study completionOct 2010

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Care provider
Enrolment
25 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00183261
Sponsor's protocol ID
AIN504/A5218
Other IDs
10025, AIN504/ACTG A5218, AIN504-A5218
Status last verified
Oct 2021
First submitted
13 Sep 2005
Last updated
1 Nov 2021
Results posted
No

Publications

  • Markowitz M, Jin X, Hurley A, Simon V, Ramratnam B, Louie M, Deschenes GR, Ramanathan M Jr, Barsoum S, Vanderhoeven J, He T, Chung C, Murray J, Perelson AS, Zhang L, Ho DD. Discontinuation of antiretroviral therapy commenced early during the course of human immunodeficiency virus type 1 infection, with or without adjunctive vaccination. J Infect Dis. 2002 Sep 1;186(5):634-43. doi: 10.1086/342559. Epub 2002 Aug 9.

    PubMed 12195350
  • Moss RB, Brandt C, Giermakowska WK, Savary JR, Theofan G, Zanetti M, Carlo DJ, Wallace MR. HIV-specific immunity during structured antiviral drug treatment interruption. Vaccine. 2003 Mar 7;21(11-12):1066-71. doi: 10.1016/s0264-410x(02)00610-2.

    PubMed 12559781
  • Papasavvas E, Ortiz GM, Gross R, Sun J, Moore EC, Heymann JJ, Moonis M, Sandberg JK, Drohan LA, Gallagher B, Shull J, Nixon DF, Kostman JR, Montaner LJ. Enhancement of human immunodeficiency virus type 1-specific CD4 and CD8 T cell responses in chronically infected persons after temporary treatment interruption. J Infect Dis. 2000 Sep;182(3):766-75. doi: 10.1086/315748. Epub 2000 Aug 17.

    PubMed 10950770
  • Rosenberg ES, Altfeld M, Poon SH, Phillips MN, Wilkes BM, Eldridge RL, Robbins GK, D'Aquila RT, Goulder PJ, Walker BD. Immune control of HIV-1 after early treatment of acute infection. Nature. 2000 Sep 28;407(6803):523-6. doi: 10.1038/35035103.

    PubMed 11029005

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing MRKAd5 HIV-1 gag/pol/nef in people with HIV Infections, run by National Institute of Allergy and Infectious Diseases (NIAID) at 23 sites in 3 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 10 inclusion and 16 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 1 Nov 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 23 sites in United States, Australia, American Samoa. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Average of log10 HIV-1 RNA viral load (time frame: At Weeks 58 and 63). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00183261, which also lists 4 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 1 Nov 2021.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in