Human Immunodeficiency VirusPhase 1NCT00798265
A Phase I Study of Quadrivalent Human Papilloma Virus (HPV) (Types 6, 11, 16, 18) Recombinant Vaccine in HIV-Infected and HIV-Negative Pre-Adolescents, Adolescents, and Young Adults
A Phase 1 study testing Gardasil and Survey in people with Human Immunodeficiency Virus and Human Papillomavirus- 6, 11, 16, 18, run by National Cancer Institute (NCI) at 1 site in United States.
Trial summary
Background: Human papilloma virus (HPV) is a common sexually transmitted disease. There are more than 100 different HPV types, and both males and females can get HPV infection. Most people do not have any symptoms when they become infected and are able to get rid of the infection on their own. Read more about this study
- Who is it for?
- Ages 12 to 26 years
- Conditions the study is for
- Human Immunodeficiency Virus, Human Papillomavirus- 6, 11, 16, 18, Adolescent
- What is being tested?
- Gardasil and Survey
- Type of treatment
- Vaccines, Injection or infusion, Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 26 participants
- Where
- 1 siteUnited States
- Study dates
- 29 Jun 2009to 4 Feb 2013
- Phase
- Phase 1
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
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 12 to 26 years
- All sexes
- No healthy volunteers
- Child, Adult
Who may be able to join
- 2.1.1.1 Age 12 to 26 years
- 2.1.1.2 Females and males
- 2.1.1.3 Human immunodeficiency virus (HIV)-positive
- 2.1.1.4 Cluster of differentiation 4 (CD4) cell count and Human immunodeficiency virus type 1 (HIV-1) ribonucleic acid (RNA) level parameters
- CD4 cell count greater than or equal to 350 cells/mm(3)
- HIV-1 RNA level by reverse transcription-polymerase chain reaction (RT PCR) less than or equal to 20,000 copies/ml
Show all 26Show fewer
- 2.1.1.5 On stable highly active antiretroviral therapy (HAART) regimen for greater than or equal to 6 months with CD4 and viral load parameters as outlined in 2.1.1.4
- 2.1.1.6 Patients greater than or equal to 18 years willing to provide informed consent or parent/guardian willing to provide informed consent for minor children less than 18 years of age.
- 2.1.1.7 Informed assent for patients 12-17 years of age (Optional at the discretion of the Principal Investigator and Parent/Guardian based on maturity level of minor)
- 2.1.1.8 Willing to use acceptable forms of contraception, if applicable, or abstinence to prevent pregnancy.
- 2.1.2.1 Age 12 to 26 years
- 2.1.2.2 Females and males
- 2.1.2.3 HIV-positive
- 2.1.2.4 CD4 cell count and HIV-1 RNA level parameters
- CD4 cell count greater than or equal to 500 cells/mm(3)
- HIV-1 RNA level by RT PCR less than or equal to 20,000 copies/ml.
- 2.1.2.5 Not receiving antiretroviral treatment with CD4 and viral load parameters as outlined in 2.1.2.4.
- 2.1.2.6 Patients greater than or equal to 18 years willing to provide informed consent or parent/guardian willing to provide informed consent for minor children less than 18 years of age.
- 2.1.2.7 Informed assent for patients 12-17 years of age (Optional at the discretion of the Principal Investigator and Parent/Guardian based on maturity level of minor)
- 2.1.2.8 Willing to use acceptable forms of contraception, if applicable, or abstinence to prevent pregnancy.
- 2.1.3.1 Age 12 to 26 years
- 2.1.3.2 Females and males
- 2.1.3.3 HIV-negative
- 2.1.3.4 Patients greater than or equal to 18 years willing to provide informed consent or parent/guardian willing to provide informed consent for minor children less than 18 years of age.
- 2.1.3.5 Informed assent for patients 12-17 years of age (Optional at the discretion of the Principal Investigator and Parent/Guardian based on maturity level of minor)
- 2.1.3.6 Willing to use acceptable forms of contraception, if applicable, or abstinence to prevent pregnancy.
Who cannot join
- 2.1.1.9 Any of the following hematologic abnormalities
- Hemoglobin less than 10.0 g/dL
- Neutrophil count less than 1500/mm(3)
- Platelet count less than 75,000/mm(3)
- Prothrombin time (PT) or partial thromboplastin time (PTT) greater than or equal to 1.5 times upper limits of normal (ULN) (with the exception of patients with known clotting disorders or known lupus anticoagulant).
- 2.1.1.10 Any of the following hepatic abnormalities
Show all 54Show fewer
- Alanine transaminase (ALT)/ serum glutamate-pyruvate transaminase (SGPT) and/or Aspartate aminotransferase (AST)/Serum glutamic oxaloacetic transaminase (SGOT) greater than 2.5 times ULN
- Total bilirubin greater than 1.5 times ULN unless attributable to protease inhibitor therapy.
- 2.1.1.11 Positive tests (antibody and/or antigen) for hepatitis B and hepatitis C viruses, unless the result is consistent with prior vaccination or prior infection with full recovery.
- 2.1.1.12 Acute infection requiring therapy at time of enrollment. Participants may be eligible for study after being on stable and appropriate anti-infective therapy.
- 2.1.1.13 Chemotherapy for active cancer.
- 2.1.1.14 Documented history of non-adherence to antiretroviral treatment regimen within 12 months of study entry.
- 2.1.1.15 Pregnancy or breastfeeding.
- 2.1.1.16 Use of immunosuppressive or immunomodulating agents within 8 weeks of study enrollment. Note: patients receiving oral corticosteroids for management of asthma or contact hypersensitivity for less than or equal to 14 days in duration will be allowed to enroll as long as it has been greater than or equal to 30 days since oral corticosteroid administration.
- 2.1.1.17 Known immediate hypersensitivity to yeast or any of the vaccine components.
- 2.1.1.18 Use of investigational agents within 4 weeks prior to study enrollment.
- 2.1.1.19 Active external genital warts requiring treatment or cervical intraepithelial neoplasia (CIN)2/3
- 2.1.1.20 Any clinically significant diseases (other than HIV infection) or findings during study screening that, in the opinion of the Principal Investigator or Lead Associate Investigator, may interfere with the study.
- Cohort 2 Inclusion and Exclusion Eligibility Criteria:
- 2.1.2.9 Any of the following hematologic abnormalities:
- Hemoglobin less than 10.0 g/dL
- Neutrophil count less than 1500/mm(3)
- Platelet count less than 75,000/mm(3)
- PT or PTT greater than or equal to 1.5 times ULN (with the exception of patients with known clotting disorders or known lupus anticoagulant).
- 2.1.2.10 Any of the following hepatic abnormalities
- ALT/SGPT and/or AST/SGOT greater than 2.5 times ULN
- Total bilirubin greater than 1.5 times ULN unless attributable to protease inhibitor therapy.
- 2.1.2.11 Positive tests (antibody and/or antigen) for hepatitis B and hepatitis C viruses, unless the result is consistent with prior vaccination or prior infection with full recovery.
- 2.1.2.12 Acute infection requiring therapy at time of enrollment. Participants may be eligible for study after being on stable and appropriate anti-infective therapy.
- 2.1.2.13 Chemotherapy for active cancer.
- 2.1.2.14 Pregnancy or breastfeeding.
- 2.1.2.15 Use of immunosuppressive or immunomodulating agents within 8 weeks prior to study enrollment. Note: patients receiving oral corticosteroids for management of asthma or contact hypersensitivity for less than or equal to 14 days in duration will be allowed to enroll as long as it has been greater than or equal to 30 days since oral corticosteroid administration.
- 2.1.2.16 Known immediate hypersensitivity to yeast or any of the vaccine components.
- 2.1.2.17 Use of investigational agents within 4 weeks prior to study enrollment.
- 2.1.2.18 Active external genital warts requiring treatment or CIN2/3
- 2.1.2.19 Any clinically significant diseases (other than HIV infection) or findings during study screening that, in the opinion of the Principal Investigator or Lead Associate Investigator may interfere with the study.
- Cohort 3 Inclusion and Exclusion Eligibility Criteria:
- 2.1.3.7 Any of the following hematologic abnormalities:
- Hemoglobin less than 10.0 g/dL
- Neutrophil count less than 1500/mm(3)
- Platelet count less than 75,000/mm(3)
- PT or PTT greater than or equal to 1.5 times ULN (with the exception of patients with known clotting disorders or known lupus anticoagulant).
- 2.1.3.8 Any of the following hepatic abnormalities
- ALT/SGPT and/or AST/SGOT greater than 2.5 times ULN
- Total Bilirubin greater than 1.5 times ULN unless attributable to protease inhibitor therapy.
- 2.1.3.9 Positive tests (antibody and/or antigen) for HIV, hepatitis B and hepatitis C viruses, unless the result is consistent with prior vaccination or prior infection with full recovery.
- 2.1.3.10 Acute infection requiring therapy at time of enrollment. Participants may be eligible for study after being on stable and appropriate anti-infective therapy.
- 2.1.3.11 Chemotherapy for active cancer.
- 2.1.3.12 Pregnancy or breastfeeding
- 2.1.3.13 Use of immunosuppressive or immunomodulating agents within 8 weeks prior to study enrollment. Note: patients receiving oral corticosteroids for management of asthma or contact hypersensitivity for less than or equal to 14 days in duration will be allowed to enroll as long as it has been greater than or equal to 30 days since oral corticosteroid administration.
- 2.1.3.14 Known immediate hypersensitivity to yeast or any of the vaccine components.
- 2.1.3.15 Use of investigational agents within 4 weeks prior to study enrollment.
- 2.1.3.16 Active external genital warts requiring treatment or carcinoma in-situ 2/3 (CIN2/3)
- 2.1.3.17 Any clinically significant diseases or findings during study screening that, in the opinion of the Principal Investigator or Lead Associate Investigator may interfere with the study.
Trial locations and contacts
1 site in 1 country.
United States1 site
National Institutes of Health Clinical Center, 9000 Rockville Pike
Bethesda, Maryland, 20892
About this study
Official title: A Phase I Study of Quadrivalent Human Papilloma Virus (HPV) (Types 6, 11, 16, 18) Recombinant Vaccine in HIV-Infected and HIV-Negative Pre-Adolescents, Adolescents and Young Adults
Background:
- Human papilloma virus (HPV) is a common sexually transmitted disease. There are more than 100 different HPV types, and both males and females can get HPV infection. Most people do not have any symptoms when they become infected and are able to get rid of the infection on their own. However, they can still become re-infected with the same or a different HPV type, and in some people HPV infection persists.
- Persistent HPV infection is associated with the development of precancerous lesions and cancer. HPV types are classified as either high risk or low risk based on whether their persistence will lead to cancer.
- Patients who have suppressed immune systems are at a higher risk for HPV-related complications. They are more likely to contract multiple HPV types and have more persistent infection that can lead to precancerous lesions or cancer, which are then difficult to treat and often recur.
- A recently approved vaccine for HPV induces immunity to HPV 6, 11, 16, and 18. It was shown to be highly effective in preventing infection with these HPV types, and is approved for use in females 9 to 26 years of age. However, much less is known about the vaccines ability to induce immunity in males or individuals with suppressed immune systems.
Read more
Objectives:
- To investigate whether the HPV vaccine is safe to give and able to induce immunity in both female and male adolescents and young adults with HIV infection compared to healthy, human immunodeficiency virus (HIV)-negative persons of the same age.
Eligibility:
- Males and females, 12 to 26 years of age, divided into three groups: (1) Healthy and HIV-negative, (2) HIV-positive and on antiretroviral therapy, and (3) HIV-positive and not on antiretroviral therapy.
Design:
- Before beginning vaccination, participants will have a complete physical examination and blood drawn for routine blood tests, special tests of the immune system, antibody tests, and an HIV test.
- HPV vaccine will be given by injection into the muscle at 0, 2, and 6 months, according to the standard vaccination schedule.
- Patients with HIV infection will be monitored for a week following the first injection to test the level of HIV in the blood 3 days and 5 days after the first injection.
- Participants will also be asked to fill out a 10- to 15-minute Web-based survey about awareness, health behaviors, and personal choices related to risk factors for HIV, HPV, and other sexually transmitted diseases. Participants are not required to fill out the survey to receive the vaccine.
- The total duration of the study is 4 years. During the first year of the study, participants will return for six additional 1-day visits at months 1, 2, 3, 6, 7, and 12. Participants will return for 1-day visits every 6 months for the remaining 3 years.
Read the detailed description
Background:
Human papilloma virus (HPV) is one of the most common sexually transmitted diseases and a significant cause of cutaneous genital warts and anogenital cancer.
Infection with high-risk, oncogenic HPV types, most commonly types 16 and 18, is associated with low and high-grade cervical cellular abnormalities that are precursors to invasive cervical cancer, as well as vulvar and anal cancer, while HPV types 6 and 11 are associated with genital warts.
Persistence of HPV infection is more common in individuals with or at risk for chronic immunosuppression and HIV-infected individuals have a higher prevalence of HPV infection and HPV-associated anogenital disease compared to age-matched human immunodeficiency virus (HIV)-negative controls.
Study Objectives:
To assess the safety and immunogenicity of quadrivalent human papillomavirus (types 6, 11, 16, 18) recombinant vaccine in HIV-infected preadolescents, adolescents and young adults 12-26 years of age.
To determine whether there are differences in HPV vaccine immunogenicity between HIV-infected and HIV negative age-matched controls.
To determine whether there are differences in HPV vaccine immunogenicity between HIV-infected patients receiving highly active antiretroviral therapy (HAART) and those not receiving HAART with similar cluster of differentiation 4 (CD4) and viral load parameters at entry.
To determine whether HPV vaccination alters human immunodeficiency virus type 1 (HIV-1) ribonucleic acid (RNA) levels.
To investigate the impact of CD4 count and HIV-1 RNA levels on HPV vaccine immunogenicity.
To characterize HPV deoxyribonucleic acid (DNA) positivity in the study cohort populations through oral/buccal and anogenital sampling at baseline.
To characterize HPV and HIV knowledge and risk and sexual behaviors in the study cohort populations.
Eligibility:
Individual Cohorts
Cohort 1: HIV-positive, CD4 cell count greater than or equal to 350 cells/mm^3, HIV-1 RNA level by reverse transcription (RT) polymerase chain reaction (PCR) less than or equal to 20,000 copies/ml, on stable HAART regimen for greater than or equal to 6 months.
Cohort 2: HIV-infected, CD4 cell count greater than or equal to 500 cells/mm^3, HIV-1 RNA level by RT PCR less than or equal to 20,000 copies/ml, on no antiretroviral treatment.
Cohort 3: healthy, HIV-negative controls All Cohorts
Females and males age 12 to 26 years
Patients must have a hemoglobin greater than or equal to 10.0 gm/dL, neutrophil count (ANC) greater than or equal to 1500/mm^3, platelet count greater than or equal to 75,000/mm^3 and prothrombin time (PT) or partial thromboplastin time (PTT) less than or equal to 1.5x upper limit of normal (ULN) (with the exception of patients with known clotting disorders or lupus anticoagulant); serum glutamic-pyruvic transaminase (SGPT)/Serum glutamic oxaloacetic transaminase (SGOT) < 2/5x ULN, total bilirubin less than or equal to 1.5x ULN unless attributable to protease inhibitor therapy.
Patients must test negative for hepatitis B virus and hepatitis C virus, unless the result is consistent with prior vaccination or prior infection with full recovery.
No use of investigational agents within 4 weeks of study enrollment or use of immunosuppressive or immunomodulating agents within 8 weeks of study entry.
Study Design:
This is a non-randomized, prospective, phase I study of quadrivalent human papillomavirus (types 6, 11, 16, 18) recombinant vaccine.
The study includes 3 cohorts of pre-adolescents, adolescents and young adults 12-26 years of age as outlined under Eligibility Criteria. Each cohort will enroll 35 patients.
All study subjects will receive three doses of HPV vaccine at 0, 2 and 6 months administered IM.
Study participants will be monitored at months 0, 1, 2, 3, 6, 7, and 12 (+/- 2 weeks for each visit, and every 6 months (+/- 30 days) thereafter for 48 months total.
- Conditions
- Human Immunodeficiency Virus, Human Papillomavirus- 6, 11, 16, 18, Adolescent, Papillomavirus Vaccines
- Being tested
- Gardasil, Survey
- Keywords
- HPV Vaccination, HPV Immunogenicity, HIV Infection, HIV Negative, Adolescents and Young Adults, Healthy Volunteer, HV, Adolescent
- Medical subject headings
- Acquired Immunodeficiency Syndrome, HIV Infections
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
GardasilBiological
Also called Human Papillomavirus 9-valent Vaccine, Recombinant
.5 mL dose injected intramuscular (IM) at 0, 2 and 6 months
SurveyBehavioural
Administration of online risk behavior and knowledge survey done at week 0.
| Study group | Role | What they receive |
|---|---|---|
| Cohort 1 - 0.5 mL dose injected intramuscular (IM) | Experimental | 0.5 mL dose injected intramuscular (IM) at 0, 2 and 6 months (+/- 2 weeks) and knowledge survey at week 0 Receives: Biological: Gardasil; Behavioral: Survey |
| Cohort 2 - 0.5 mL dose injected intramuscular (IM) | Experimental | 0.5 mL dose injected intramuscular (IM) at 0, 2 and 6 months (+/- 2 weeks) and knowledge survey at week 0 Receives: Biological: Gardasil; Behavioral: Survey |
| Cohort 3 - 0.5 mL dose injected intramuscular (IM) | Active comparator | 0.5 mL dose injected intramuscular (IM) at 0, 2 and 6 months (+/- 2 weeks) and knowledge survey at week 0 Receives: Biological: Gardasil; Behavioral: Survey |
What is being measured
The primary outcome is the main question the study is designed to answer.
Immunogenicity of the Quadrivalent Human Papillomavirus (Types 6, 11, 16, 18) Recombinant Vaccine in Human Immunodeficiency Virus (HIV)-Infected Preadolescents, Adolescents and Young Adults 12-26 Years of Age
Immunogenicity was measured by the vaccine-induced antibody response collectively for preadolescents, adolescents and young adults an reported per cohort for participants with HIV and without HIV. Participants' serum was used to check the level of human papillomavirus (HPV) neutralization antibody. Neutralizing antibody is an antibody that can bind to the infectious organism such as viruses and stop the spread of the disease. The antibody level was compared between the participants with HIV and without HIV.
Measured: Up to 36 months
Secondary outcomes (14)
Human Papilloma Virus (HPV) Vaccine Immunogenicity Between Human Immunodeficiency Virus (HIV)-Infected Participants Receiving Highly Active Antiretroviral Therapy (HAART) & Those Not Receiving HAART With Similar T-lymphocytes (CD4) & Viral Load Parameters
Match per the HIV level at study entry to compare between cohort 1 and 2.
Measured: At study entry
Number of Participants With Log Change in Human Immunodeficiency Virus Type 1 (HIV-1) Ribonucleic Acid (RNA) Levels After Human Papilloma Virus (HPV) Vaccination
Within each cohort, the number of participants with a change in log^10 HIV-1 RNA levels will be determined between day 1 and day 7 and will be evaluated to see if the values at the two time points are not statistically different from one another. HIV-1 RNA levels below the lower limits of detection (50 copies/ml) will be expressed as 1.69 log^10 on a logarithmic scale equivalent to 49 copies/ml. There is at least 95% power to detect a change from day 1 to day 7 with an effect size of 1 standard deviation (SD) and a 0.025 two-sided alpha level test (0.05/2 cohorts) after allowing for a Bonferroni adjustment.
Measured: Baseline, and months 1, 3, 7 and 12
Fold Change in Anti-Human Papilloma Virus (HPV) Titer and T-lymphocytes (CD4) Count (Only at Baseline)
Fold change in anti-HPV titer with baseline T-lymphocytes (CD4) count. Fold change is a measure of the antibody titer after vaccination divided by the baseline titer.
Measured: Months 7, 12, 24 and 36
T-lymphocytes (CD4) Count (Only at Baseline)
Baseline T-lymphocytes (CD4) count.
Measured: Baseline
Number of Participants With Human Papilloma Virus (HPV) Deoxyribonucleic Acid (DNA) Positivity by Oral/Buccal Swabs at Baseline in the Study Cohort Populations
Human papillomavirus (HPV) deoxyribonucleic acid (DNA) positivity by oral/buccal swabs was performed by swabbing the oral/buccal mucosa and
Measured: Baseline
Number of Participants With Human Papillomavirus (HPV) Deoxyribonucleic Acid (DNA) Positivity by Anogenital Swabs
HPV DNA positivity by anogenital swabs was performed by Papanicolaou test (PAP) test. PAPs were not conducted when the participant stated that she was not sexually active.
Measured: Up to 36 months
Number of Participants Who Completed The Youth Risk Behavior Surveillance System (YRBSS)
Here are the number of participants who properly completed (i.e., answered correctly) the YRBSS. The human papilloma virus (HPV) \& human immunodeficiency virus (HIV) knowledge and risk and sexual behaviors was assessed by a middle school or high school version of web-based Youth Risk Behavior Survey developed by Centers for Disease Control and Prevention (CDC). The Youth Risk Behavior Surveillance System (YRBSS) developed by the CDC was used to monitor six categories of priority health risk behaviors among middle school and high school youth: behaviors that contribute to unintentional injuries and violence; tobacco use; alcohol and other drug use; sexual behaviors that contribute to unintended pregnancy and sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV) infections; unhealthy dietary behaviors; and physical inactivity and determine the number of participants who answered correctly on the assessment tool (i.e., YRBSS).
Measured: Baseline
Number of Participants With Serum for Human Papilloma Virus (HPV) Antibody Titers Performed by Merck (Competitive Luminex Assay)
Participants collection Tube: 10ml red top tube (RTT) send via courier to National Cancer Institute (NCI) FCRF for processing, aliquoting and cryopreservation by Baselar lab. Batched specimens to be sent to Merck for HPV antibody titers.
Measured: 0, 1, 2, 3, 6, 7, 12, 18, 24, 30, 36, 42, and 48 hours
Functional Human Papilloma Virus (HPV) Antibody Neutralization Assays
Month 7 anti-HPV Ab titer was correlated with Neutralization Assay (PBNA) antibody titers and analyzed by the secreted alkaline phosphatase (SEAP)/enzyme-linked immunosorbent assay (ELISA) R.
Measured: At 7 months
Cryopreserved Peripheral Blood Mononuclear Cells (PBMCs) for Human Papilloma Virus (HPV) & Human Immunodeficiency Virus (HIV) Lymphocyte Proliferation Assays, Cytokine Induction Assay, Luminex Multi-cytokine Profiling of PBMCs
Participants collection tube: 6 tubes sodium heparin 10ml green top tube (GTT) (60ml total) send via courier to National Cancer Institute (NCI) FCRF for processing, aliquoting and cryopreservation by Baselar lab according to protocol provided by the investigator. Note: HIV lymphocyte proliferation assays will only be performed in HIV-infected subjects
Measured: 0, 1, 3, 7, 12, 24, 36, and 48 hours
Extended Fluorescence Activated Cell Sorting (FACS)/Quantitative Lymphocyte Subpopulation Studies
Extended FACS/Quantitative lymphocyte subpopulation studies human immunodeficiency virus (HIV)-infected subjects only (Cohorts 1 and 2) using a 10ml sodium heparin green top tube (GTT).
Measured: 0, 1, 3, 7, 12, 18, 24, 30, 36, 42, and 48 hours
Quantitative Measurement of Human Immunodeficiency Virus (HIV)-Related Chemokines Macrophage Inflammatory Proteins (MIP)-1 Alpha (α), MIP-1 Beta (β) and Regulated Upon Activation, Normal T Cell Expressed and Presumably Secreted (RANTES)
Collection tube: 10ml red top tube (RTT) send via courier to National Cancer Institute (NCI) FCRF for processing, aliquoting and cryopreservation by Baselar lab.
Measured: 0, 1, 2, 3, 6, 7, 12, 18, 24, 30, 36, 42, and 48 hours
Cryopreserved Whole Blood for Human Papilloma Virus (HPV) Deoxyribonucleic Acid (DNA) Testing
Three collection tube: 6ml purple top ethylenediamine tetraacetic acid (EDTA) tubes (18ml total)
Measured: 0, 7, 12, 24, 36, and 48 Months
Research Assays Immunologic Responses for Human Immunodeficiency Virus (HIV) Infected Subjects Only
Two collection tubes: 10ml sodium heparin green top tube (GTT) (20ml total) from HIV infected subjects only (Cohorts 1 and 2).
Measured: Month 0 only
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted26 Nov 2008 (estimated)
- Study start29 Jun 2009
- Primary completion22 Sep 2012
- Study completion4 Feb 2013
Why it stopped: Study closed due to low accrual.
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (3)Papers the sponsor has linked to this study.
- Other trials for Human Immunodeficiency VirusStudies of the same condition, open and under way.
- More trials run by National Cancer Institute (NCI)The sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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 1
- Primary purpose
- Prevention
- Allocation
- Non-randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 26 participants (actual)
Sponsor and investigators
- Lead sponsor
- National Cancer Institute (NCI)
- Sponsor type
- US National Institutes of Health
- Responsible party
- Principal investigator, Hoyoung M. Maeng, M.D., National Cancer Institute (NCI)
- Investigators
- Hoyoung M Maeng, M.D., Principal investigator, National Cancer Institute (NCI)
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00798265
- Sponsor's protocol ID
- 090024
- Other IDs
- 09-C-0024
- Status last verified
- Nov 2024
- First submitted
- 25 Nov 2008
- Last updated
- 20 Nov 2024
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- Yes: All individual participant data (IPD) recorded in the medical record will be shared with intramural investigators upon request.
Publications
Koutsky LA, Galloway DA, Holmes KK. Epidemiology of genital human papillomavirus infection. Epidemiol Rev. 1988;10:122-63. doi: 10.1093/oxfordjournals.epirev.a036020.
PubMed 2852116Munoz N, Bosch FX, de Sanjose S, Herrero R, Castellsague X, Shah KV, Snijders PJ, Meijer CJ; International Agency for Research on Cancer Multicenter Cervical Cancer Study Group. Epidemiologic classification of human papillomavirus types associated with cervical cancer. N Engl J Med. 2003 Feb 6;348(6):518-27. doi: 10.1056/NEJMoa021641.
PubMed 12571259Koshiol JE, Laurent SA, Pimenta JM. Rate and predictors of new genital warts claims and genital warts-related healthcare utilization among privately insured patients in the United States. Sex Transm Dis. 2004 Dec;31(12):748-52. doi: 10.1097/01.olq.0000145851.76025.ad.
PubMed 15608590
Study at a glance
From the registry record, last updated by the sponsor on 20 Nov 2024. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase I Study of Quadrivalent Human Papilloma Virus (HPV) (Types 6, 11, 16, 18) Recombinant Vaccine in HIV-Infected and HIV-Negative Pre-Adolescents, Adolescents and Young Adults
- ClinicalTrials.gov ID
- NCT00798265
- Acronym / sponsor ID
- 090024
- Conditions
- Human Immunodeficiency Virus, Human Papillomavirus- 6, 11, 16, 18, Adolescent, Papillomavirus Vaccines
- Keywords
- HPV Vaccination, HPV Immunogenicity, HIV Infection, HIV Negative, Adolescents and Young Adults, Healthy Volunteer, HV, Adolescent
- Phase
- Phase 1
- Study type
- Interventional
- Recruitment status
- TerminatedReason stopped: Study closed due to low accrual.
- Enrolment
- 26 participants (actual)
- Lead sponsor
- National Cancer Institute (NCI)US National Institutes of Health
- Study start
- 29 Jun 2009 (actual)
- Primary completion
- 22 Sep 2012 (actual)
- Study completion
- 4 Feb 2013 (actual)
- First posted
- 26 Nov 2008 (estimated)
- Results
- Posted 20 Nov 2024
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Background:
- Human papilloma virus (HPV) is a common sexually transmitted disease. There are more than 100 different HPV types, and both males and females can get HPV infection. Most people do not have any symptoms when they become infected and are able to get rid of the infection on their own. However, they can still become re-infected with the same or a different HPV type, and in some people HPV infection persists.
- Persistent HPV infection is associated with the development of precancerous lesions and cancer. HPV types are classified as either high risk or low risk based on whether their persistence will lead to cancer.
- Patients who have suppressed immune systems are at a higher risk for HPV-related complications. They are more likely to contract multiple HPV types and have more persistent infection that can lead to precancerous lesions or cancer, which are then difficult to treat and often recur.
- A recently approved vaccine for HPV induces immunity to HPV 6, 11, 16, and 18. It was shown to be highly effective in preventing infection with these HPV types, and is approved for use in females 9 to 26 years of age. However, much less is known about the vaccines ability to induce immunity in males or individuals with suppressed immune systems.
Objectives:
- To investigate whether the HPV vaccine is safe to give and able to induce immunity in both female and male adolescents and young adults with HIV infection compared to healthy, human immunodeficiency virus (HIV)-negative persons of the same age.
Eligibility:
- Males and females, 12 to 26 years of age, divided into three groups: (1) Healthy and HIV-negative, (2) HIV-positive and on antiretroviral therapy, and (3) HIV-positive and not on antiretroviral therapy.
Design:
- Before beginning vaccination, participants will have a complete physical examination and blood drawn for routine blood tests, special tests of the immune system, antibody tests, and an HIV test.
- HPV vaccine will be given by injection into the muscle at 0, 2, and 6 months, according to the standard vaccination schedule.
- Patients with HIV infection will be monitored for a week following the first injection to test the level of HIV in the blood 3 days and 5 days after the first injection.
- Participants will also be asked to fill out a 10- to 15-minute Web-based survey about awareness, health behaviors, and personal choices related to risk factors for HIV, HPV, and other sexually transmitted diseases. Participants are not required to fill out the survey to receive the vaccine.
- The total duration of the study is 4 years. During the first year of the study, participants will return for six additional 1-day visits at months 1, 2, 3, 6, 7, and 12. Participants will return for 1-day visits every 6 months for the remaining 3 years.
Detailed description
Background:
Human papilloma virus (HPV) is one of the most common sexually transmitted diseases and a significant cause of cutaneous genital warts and anogenital cancer.
Infection with high-risk, oncogenic HPV types, most commonly types 16 and 18, is associated with low and high-grade cervical cellular abnormalities that are precursors to invasive cervical cancer, as well as vulvar and anal cancer, while HPV types 6 and 11 are associated with genital warts.
Persistence of HPV infection is more common in individuals with or at risk for chronic immunosuppression and HIV-infected individuals have a higher prevalence of HPV infection and HPV-associated anogenital disease compared to age-matched human immunodeficiency virus (HIV)-negative controls.
Study Objectives:
To assess the safety and immunogenicity of quadrivalent human papillomavirus (types 6, 11, 16, 18) recombinant vaccine in HIV-infected preadolescents, adolescents and young adults 12-26 years of age.
To determine whether there are differences in HPV vaccine immunogenicity between HIV-infected and HIV negative age-matched controls.
To determine whether there are differences in HPV vaccine immunogenicity between HIV-infected patients receiving highly active antiretroviral therapy (HAART) and those not receiving HAART with similar cluster of differentiation 4 (CD4) and viral load parameters at entry.
To determine whether HPV vaccination alters human immunodeficiency virus type 1 (HIV-1) ribonucleic acid (RNA) levels.
To investigate the impact of CD4 count and HIV-1 RNA levels on HPV vaccine immunogenicity.
To characterize HPV deoxyribonucleic acid (DNA) positivity in the study cohort populations through oral/buccal and anogenital sampling at baseline.
To characterize HPV and HIV knowledge and risk and sexual behaviors in the study cohort populations.
Eligibility:
Individual Cohorts
Cohort 1: HIV-positive, CD4 cell count greater than or equal to 350 cells/mm^3, HIV-1 RNA level by reverse transcription (RT) polymerase chain reaction (PCR) less than or equal to 20,000 copies/ml, on stable HAART regimen for greater than or equal to 6 months.
Cohort 2: HIV-infected, CD4 cell count greater than or equal to 500 cells/mm^3, HIV-1 RNA level by RT PCR less than or equal to 20,000 copies/ml, on no antiretroviral treatment.
Cohort 3: healthy, HIV-negative controls All Cohorts
Females and males age 12 to 26 years
Patients must have a hemoglobin greater than or equal to 10.0 gm/dL, neutrophil count (ANC) greater than or equal to 1500/mm^3, platelet count greater than or equal to 75,000/mm^3 and prothrombin time (PT) or partial thromboplastin time (PTT) less than or equal to 1.5x upper limit of normal (ULN) (with the exception of patients with known clotting disorders or lupus anticoagulant); serum glutamic-pyruvic transaminase (SGPT)/Serum glutamic oxaloacetic transaminase (SGOT) < 2/5x ULN, total bilirubin less than or equal to 1.5x ULN unless attributable to protease inhibitor therapy.
Patients must test negative for hepatitis B virus and hepatitis C virus, unless the result is consistent with prior vaccination or prior infection with full recovery.
No use of investigational agents within 4 weeks of study enrollment or use of immunosuppressive or immunomodulating agents within 8 weeks of study entry.
Study Design:
This is a non-randomized, prospective, phase I study of quadrivalent human papillomavirus (types 6, 11, 16, 18) recombinant vaccine.
The study includes 3 cohorts of pre-adolescents, adolescents and young adults 12-26 years of age as outlined under Eligibility Criteria. Each cohort will enroll 35 patients.
All study subjects will receive three doses of HPV vaccine at 0, 2 and 6 months administered IM.
Study participants will be monitored at months 0, 1, 2, 3, 6, 7, and 12 (+/- 2 weeks for each visit, and every 6 months (+/- 30 days) thereafter for 48 months total.
Study design
- Primary purpose
- Prevention
- Allocation
- Non-randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Cohort 1 - 0.5 mL dose injected intramuscular (IM) | Experimental | Biological: Gardasil, Behavioral: Survey0.5 mL dose injected intramuscular (IM) at 0, 2 and 6 months (+/- 2 weeks) and knowledge survey at week 0 |
| Cohort 2 - 0.5 mL dose injected intramuscular (IM) | Experimental | Biological: Gardasil, Behavioral: Survey0.5 mL dose injected intramuscular (IM) at 0, 2 and 6 months (+/- 2 weeks) and knowledge survey at week 0 |
| Cohort 3 - 0.5 mL dose injected intramuscular (IM) | Active comparator | Biological: Gardasil, Behavioral: Survey0.5 mL dose injected intramuscular (IM) at 0, 2 and 6 months (+/- 2 weeks) and knowledge survey at week 0 |
Who may qualify
- Ages
- 12 to 26 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child, Adult
Key inclusion criteria (26 listed)
- 2.1.1.1 Age 12 to 26 years
- 2.1.1.2 Females and males
- 2.1.1.3 Human immunodeficiency virus (HIV)-positive
- 2.1.1.4 Cluster of differentiation 4 (CD4) cell count and Human immunodeficiency virus type 1 (HIV-1) ribonucleic acid (RNA) level parameters
- CD4 cell count greater than or equal to 350 cells/mm(3)
Key exclusion criteria (54 listed)
- 2.1.1.9 Any of the following hematologic abnormalities
- Hemoglobin less than 10.0 g/dL
- Neutrophil count less than 1500/mm(3)
- Platelet count less than 75,000/mm(3)
- Prothrombin time (PT) or partial thromboplastin time (PTT) greater than or equal to 1.5 times upper limits of normal (ULN) (with the exception of patients with known clotting disorders or known lupus anticoagulant).
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| GardasilAlso: Human Papillomavirus 9-valent Vaccine, Recombinant.5 mL dose injected intramuscular (IM) at 0, 2 and 6 months | Biological | Cohort 1 - 0.5 mL dose injected intramuscular (IM), Cohort 2 - 0.5 mL dose injected intramuscular (IM), Cohort 3 - 0.5 mL dose injected intramuscular (IM) |
| SurveyAdministration of online risk behavior and knowledge survey done at week 0. | Behavioural | Cohort 1 - 0.5 mL dose injected intramuscular (IM), Cohort 2 - 0.5 mL dose injected intramuscular (IM), Cohort 3 - 0.5 mL dose injected intramuscular (IM) |
Primary outcome
Immunogenicity of the Quadrivalent Human Papillomavirus (Types 6, 11, 16, 18) Recombinant Vaccine in Human Immunodeficiency Virus (HIV)-Infected Preadolescents, Adolescents and Young Adults 12-26 Years of Age
Time frame: Up to 36 months
Immunogenicity was measured by the vaccine-induced antibody response collectively for preadolescents, adolescents and young adults an reported per cohort for participants with HIV and without HIV. Participants' serum was used to check the level of human papillomavirus (HPV) neutralization antibody. Neutralizing antibody is an antibody that can bind to the infectious organism such as viruses and stop the spread of the disease. The antibody level was compared between the participants with HIV and without HIV.
14 secondary outcomes
Human Papilloma Virus (HPV) Vaccine Immunogenicity Between Human Immunodeficiency Virus (HIV)-Infected Participants Receiving Highly Active Antiretroviral Therapy (HAART) & Those Not Receiving HAART With Similar T-lymphocytes (CD4) & Viral Load Parameters
Time frame: At study entry
Number of Participants With Log Change in Human Immunodeficiency Virus Type 1 (HIV-1) Ribonucleic Acid (RNA) Levels After Human Papilloma Virus (HPV) Vaccination
Time frame: Baseline, and months 1, 3, 7 and 12
Fold Change in Anti-Human Papilloma Virus (HPV) Titer and T-lymphocytes (CD4) Count (Only at Baseline)
Time frame: Months 7, 12, 24 and 36
T-lymphocytes (CD4) Count (Only at Baseline)
Time frame: Baseline
Number of Participants With Human Papilloma Virus (HPV) Deoxyribonucleic Acid (DNA) Positivity by Oral/Buccal Swabs at Baseline in the Study Cohort Populations
Time frame: Baseline
Number of Participants With Human Papillomavirus (HPV) Deoxyribonucleic Acid (DNA) Positivity by Anogenital Swabs
Time frame: Up to 36 months
Number of Participants Who Completed The Youth Risk Behavior Surveillance System (YRBSS)
Time frame: Baseline
Number of Participants With Serum for Human Papilloma Virus (HPV) Antibody Titers Performed by Merck (Competitive Luminex Assay)
Time frame: 0, 1, 2, 3, 6, 7, 12, 18, 24, 30, 36, 42, and 48 hours
Functional Human Papilloma Virus (HPV) Antibody Neutralization Assays
Time frame: At 7 months
Cryopreserved Peripheral Blood Mononuclear Cells (PBMCs) for Human Papilloma Virus (HPV) & Human Immunodeficiency Virus (HIV) Lymphocyte Proliferation Assays, Cytokine Induction Assay, Luminex Multi-cytokine Profiling of PBMCs
Time frame: 0, 1, 3, 7, 12, 24, 36, and 48 hours
Extended Fluorescence Activated Cell Sorting (FACS)/Quantitative Lymphocyte Subpopulation Studies
Time frame: 0, 1, 3, 7, 12, 18, 24, 30, 36, 42, and 48 hours
Quantitative Measurement of Human Immunodeficiency Virus (HIV)-Related Chemokines Macrophage Inflammatory Proteins (MIP)-1 Alpha (α), MIP-1 Beta (β) and Regulated Upon Activation, Normal T Cell Expressed and Presumably Secreted (RANTES)
Time frame: 0, 1, 2, 3, 6, 7, 12, 18, 24, 30, 36, 42, and 48 hours
Cryopreserved Whole Blood for Human Papilloma Virus (HPV) Deoxyribonucleic Acid (DNA) Testing
Time frame: 0, 7, 12, 24, 36, and 48 Months
Research Assays Immunologic Responses for Human Immunodeficiency Virus (HIV) Infected Subjects Only
Time frame: Month 0 only
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 20 Nov 2024.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Background: PubMed 2852116Koutsky LA, Galloway DA, Holmes KK. Epidemiology of genital human papillomavirus infection. Epidemiol Rev. 1988;10:122-63. doi: 10.1093/oxfordjournals.epirev.a036020.
- Background: PubMed 12571259Munoz N, Bosch FX, de Sanjose S, Herrero R, Castellsague X, Shah KV, Snijders PJ, Meijer CJ; International Agency for Research on Cancer Multicenter Cervical Cancer Study Group. Epidemiologic classification of human papillomavirus types associated with cervical cancer. N Engl J Med. 2003 Feb 6;348(6):518-27. doi: 10.1056/NEJMoa021641.
- Background: PubMed 15608590Koshiol JE, Laurent SA, Pimenta JM. Rate and predictors of new genital warts claims and genital warts-related healthcare utilization among privately insured patients in the United States. Sex Transm Dis. 2004 Dec;31(12):748-52. doi: 10.1097/01.olq.0000145851.76025.ad.
- NIH Clinical Center Detailed Web PageLink provided by the sponsor.
- Individual participant dataSharing planned: Yes. All individual participant data (IPD) recorded in the medical record will be shared with intramural investigators upon request.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Hoyoung M Maeng, M.D. principal investigator
National Cancer Institute (NCI)
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 1 study testing Gardasil and Survey in people with Human Immunodeficiency Virus and Human Papillomavirus- 6, 11, 16, 18, run by National Cancer Institute (NCI) at 1 site in United States.
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 26 inclusion and 54 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: stopped early, as of the sponsor's last update on 20 Nov 2024. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. 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. 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 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 20 Nov 2024). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
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?
Immunogenicity of the Quadrivalent Human Papillomavirus (Types 6, 11, 16, 18) Recombinant Vaccine in Human Immunodeficiency Virus (HIV)-Infected Preadolescents, Adolescents and Young Adults 12-26 Years of Age (time frame: Up to 36 months). 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 NCT00798265, which also lists 3 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 20 Nov 2024.