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Pneumococcal InfectionEarly Phase 1NCT02558751

Pneumonia Vaccine in Aging HIV Positive Individuals

A Early Phase 1 study testing 23-valent pneumococcal polysaccharide vaccine and 13-valent pneumococcal conjugate vaccine in people with Pneumococcal Infection, run by University of Toledo Health Science Campus at 1 site in United States.

Completed

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

Official record
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Trial summary

The investigators hypothesized that vaccination with either the 23-valent pneumococcal polysaccharide vaccine (PPV23) alone or the 13-valent pneumococcal conjugate vaccine (PCV 13) followed by PPV23 results in similar antibody levels/functional activity and induce a similar pneumococcal polysaccharide (PPS)-specific B… Read more about this study

Who is it for?
Ages 50 to 65 yearsHealthy volunteers can take part
Conditions the study is for
Pneumococcal Infection
What is being tested?
23-valent pneumococcal polysaccharide vaccine and 13-valent pneumococcal conjugate vaccine
Type of treatment
Vaccines
Could I receive a placebo?
No, everyone receives an active treatment
How many people
51 participants
Where
1 siteUnited States
Study dates
Jul 2013to Jun 2015
Phase
Early Phase 1
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 50 to 65 years
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • HIV negative:
  • never immunized with PCV13
  • HIV positive:
  • need for pneumococcal vaccination per standard of care

Who cannot join

  • steroid use
  • other immunosuppressive agents;
  • pregnancy
  • incapable of completing consent form

Trial locations and contacts

1 site in 1 country.

United States1 site
  • The University of Toledo-Health Science Campus

    Toledo, Ohio, 43614

Other trials in United States

About this study

Official title: Immune Response to Pneumococcal Vaccination in Aging HIV Positive Individuals

The investigators hypothesized that vaccination with either the 23-valent pneumococcal polysaccharide vaccine (PPV23) alone or the 13-valent pneumococcal conjugate vaccine (PCV 13) followed by PPV23 results in similar antibody levels/functional activity and induce a similar pneumococcal polysaccharide (PPS)-specific B cell response in HIV-positive individuals >50 years of age and HIV-negative persons>50 years of age. The investigators immunized the study group HIV+ persons>50 and controls (HIV negative >50 years) with PCV13 followed by PPV23 and HIV+>50 with PPV23 alone. The investigators examined immune responses to PPS23F and PPS14 on a quantitative and qualitative level using ELISA and opsonophagocytic assays (OPA).

To test the hypothesis that the levels of antigen specific B cells identified with PPS were comparable between the PPV23 and PCV13 vaccine recipients. Pre- and post-immunization peripheral blood samples were obtained. Extensive B cell phenotype analysis using fluorescent antibodies was used to characterize PPS-labeled B cells. Specific phenotypes were correlated with antibody levels and OPA and compared to historic populations immunized with PPV.

Read the detailed description

All potential study candidates were asked to fill out a questionnaire concerning their medical history and medications. This survey determined eligibility. If eligible, as part of the experimental protocol the HIV positive participants agreed to be randomized to PPV23 alone versus PCV13 followed 8 weeks later by PPV23 immunization and 3 to 5 blood draws around the time of immunization. The HIV negative control population agreed to immunization with PCV13 followed 8 weeks later by PPV23, not standard of care for this population, and 5 blood draws around the time of immunization. The investigators compared the effect of single dose pneumococcal polysaccharide vaccination versus PCV13 followed by PPV23 vaccination in HIV positive adults. Prior to 2012, the standard of care of HIV positive adults included vaccination with PPV23. In 2012, these recommendations changed and it was recommended that all HIV positive adults be vaccinated with PCV13 followed at least 8 weeks later by PPV23. The benefit of this vaccination protocol over PPV23 alone in HIV positive adults >50 years of age however had not been studied. As part of this study, all HIV positive adults>50 years of age and a CD4 count>200 who were due for pneumococcal vaccination as standard of care, were asked to participate in the study. Those who agreed and were eligible to participate were randomly assigned to receive PCV13 followed at least 8 weeks later with PPV23 or received a single vaccination with PPV23. As standard of care, all individuals who were due for their pneumococcal vaccine and were not eligible for the study received PCV13 followed by PPV23.

The HIV positive volunteers (n=37) agreed to (experimental part of the protocol):

  1. Be randomized to either vaccination with PCV13 followed by PPV23 OR PPV23 alone.
  2. Donate blood specimens at 3-5 different times: PPV23 group:day 0, day of vaccination: 2 mL, at day 7, 40 mL and at day 28-42 a one time sample of 2 mL PCV13/PPV23 group: day 0, day of vaccination with PCV13: 2 mL, at day 7, 40 mL and at day 56, day of PPPV23, 2 mL, day 63 a 40 mL sample and finally at day 90 a one time sample of 2 mL.
  3. Have blood samples subjected to antibody analysis (concentration and functional activity) and PPS-specific B cell phenotype and tumor necrosis factor receptors (TNFR) .

The HIV negative controls in the study (n=14) who agree to participate were vaccinated with the PCV13 followed by PPV23.This is NOT a vaccine regime recommended for healthy adults but is NOT contraindicated.

Thus as part of the experimental procedure for these individuals they will:

  1. Receive the FDA approved PCV13 and PPV23
  2. Blood samples were obtained at day 0, day of vaccination with PCV13: 2 mL, at day 7, 40 mL and at day 56, day of PPPV23, 2 mL, day 63 a 40 mL sample and finally at day 90 a one time sample of 2 mL.
  3. Blood samples were analyzed for antibody concentration, functional activity and PPS-specific B cell phenotype and TNFR.

In summary,the investigators studied 3 populations, all were between 50-65 years of age:

Group 1: HIV positive CD4>200 vaccinated with PPV23 Group 2: HIV positive CD4> 200 vaccinated with PCV13 followed 8 weeks later by PPV23 Group 3: HIV negative vaccinated with PCV13/PPV23.

Being tested
23-valent pneumococcal polysaccharide vaccine, 13-valent pneumococcal conjugate vaccine
Keywords
pneumococcal conjugate vaccine, aging HIV
Medical subject headings
Pneumococcal Infections

What participants receive

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

  • 23-valent pneumococcal polysaccharide vaccineBiological

    Also called PPV23 or Pneumovax

    One standard adult dose of the 23-valent pneumococcal polysaccharide vaccine

  • 13-valent pneumococcal conjugate vaccineBiological

    Also called PCV13 or Prevnar 13

    One dose of the 13-valent pneumococcal conjugate vaccine, PCV13, followed 8 weeks later by one dose of the 23-valent pneumococcal polysaccharide vaccine, PPV23.

Study groups in NCT02558751
Study groupRoleWhat they receive
HIV positive PPV23Active comparatorHIV-positive individuals 50-65 years of age immunized with one dose of the 23-valent pneumococcal polysaccharide vaccine, PPV23
Receives: Biological: 23-valent pneumococcal polysaccharide vaccine
HIV positive PCV13/PPV23Active comparatorHIV-positive individual 50-65 years of age, Intervention: one dose of 13-valent pneumococcal conjugate vaccine,PCV13, followed 8 weeks later with one dose of 23-valent pneumococcal polysaccharide vaccine, PPV23
Receives: Biological: 23-valent pneumococcal polysaccharide vaccine; Biological: 13-valent pneumococcal conjugate vaccine
HIV negative PCV13/PPV23Active comparatorHIV-negative individual 50-65 years of age, Intervention: one dose of 13-valent pneumococcal conjugate vaccine,PCV13, followed 8 weeks later with one dose of 23-valent pneumococcal polysaccharide vaccine, PPV23
Receives: Biological: 23-valent pneumococcal polysaccharide vaccine; Biological: 13-valent pneumococcal conjugate vaccine

What is being measured

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

  1. Antibody response measured by ELISA (ug/ml)

    Measured: Change in ug/ml from day 0 to day 30

  2. Opsonophagocytic antibody activity measured by opsonophagocytic assay (OPA titer)

    Measured: Change in OPA titer from day 0 to day 30

  3. Antibody response measured by ELISA (ug/ml)

    Measured: Change in ug/ml from day 0 to day 90

  4. Opsonophagocytic antibody activity measured by opsonophagocytic assay (OPA titer)

    Measured: Change in OPA titer from day 0 to day 90

Secondary outcomes (17)
  1. B cell phenotype of PPS-specific B cells expressing CD27+IgM+: flowcytometry (%)

    Measured: Change from day 0 to day 7 in %

  2. Serum C-reactive protein (ng/ml)

    Measured: day 0

  3. Flow cytometry : percentage cells expressing BAFF-R on surface (%)

    Measured: Change from day 0 to day 7

  4. Flow cytometry : percentage cells expressing BAFF-R on surface (%)

    Measured: Change from day 56 to day 63

  5. B cell phenotype of PPS-specific B cells expressing CD27IgM: flowcytometry (%)

    Measured: Change from day 56 to day 63 (%)

  6. Serum IL-6 level (pg/ml)

    Measured: Day 0

  7. Serum sCD27 (U/ml)

    Measured: Day 0

  8. Serum sCD30 (U/ml)

    Measured: Day 0

  9. Serum BAFF concentration (pg/ml)

    Measured: Day 0

  10. Serum TACI concentration (pg/ml)

    Measured: Day 0

  11. Serum BCMA concentration (pg/ml)

    Measured: Day 0

  12. Flow cytometry : percentage cells expressing CD40 on surface (%)

    Measured: Change from day 0 to day 7 (%)

  13. Flow cytometry : percentage cells expressing CD40 on surface (%)

    Measured: Change from day 56 to day 63 (%)

  14. Flow cytometry : percentage cells expressing CD21 on surface (%)

    Measured: Change from day 0 to day 7 (%)

  15. Flow cytometry : percentage cells expressing CD21 on surface (%)

    Measured: Change from day 56 to day 63 (%)

  16. Flow cytometry : percentage cells expressing TACI on surface (%)

    Measured: Change from day 0 to day 7 (%)

  17. Flow cytometry : percentage cells expressing TACI on surface (%)

    Measured: Change from day 56 to day 63 (%)

Timeline

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

  1. First posted24 Sep 2015 (estimated)
  2. Study startJul 2013
  3. Primary completionJun 2015
  4. Study completionJun 2015

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
Early Phase 1
Primary purpose
Prevention
Allocation
Non-randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
51 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02558751
Sponsor's protocol ID
R01AG045973
Other IDs
R01AG045973
Status last verified
Sep 2015
First submitted
16 Sep 2015
Last updated
24 Sep 2015
Results posted
No
Data monitoring committee
No

Publications

  • Ballet JJ, Sulcebe G, Couderc LJ, Danon F, Rabian C, Lathrop M, Clauvel JP, Seligmann M. Impaired anti-pneumococcal antibody response in patients with AIDS-related persistent generalized lymphadenopathy. Clin Exp Immunol. 1987 Jun;68(3):479-87.

    PubMed 3652522
  • Janoff EN, Douglas JM Jr, Gabriel M, Blaser MJ, Davidson AJ, Cohn DL, Judson FN. Class-specific antibody response to pneumococcal capsular polysaccharides in men infected with human immunodeficiency virus type 1. J Infect Dis. 1988 Nov;158(5):983-90. doi: 10.1093/infdis/158.5.983.

    PubMed 3183430
  • Klein RS, Selwyn PA, Maude D, Pollard C, Freeman K, Schiffman G. Response to pneumococcal vaccine among asymptomatic heterosexual partners of persons with AIDS and intravenous drug users infected with human immunodeficiency virus. J Infect Dis. 1989 Nov;160(5):826-31. doi: 10.1093/infdis/160.5.826.

    PubMed 2572650
  • Kroon FP, van Dissel JT, Ravensbergen E, Nibbering PH, van Furth R. Enhanced antibody response to pneumococcal polysaccharide vaccine after prior immunization with conjugate pneumococcal vaccine in HIV-infected adults. Vaccine. 2000 Nov 22;19(7-8):886-94. doi: 10.1016/s0264-410x(00)00232-2.

    PubMed 11115712
  • Rodriguez-Barradas MC, Musher DM, Lahart C, Lacke C, Groover J, Watson D, Baughn R, Cate T, Crofoot G. Antibody to capsular polysaccharides of Streptococcus pneumoniae after vaccination of human immunodeficiency virus-infected subjects with 23-valent pneumococcal vaccine. J Infect Dis. 1992 Mar;165(3):553-6. doi: 10.1093/infdis/165.3.553.

    PubMed 1347058

Questions about this trial

What is this clinical trial studying?

A Early Phase 1 study testing 23-valent pneumococcal polysaccharide vaccine and 13-valent pneumococcal conjugate vaccine in people with Pneumococcal Infection, run by University of Toledo Health Science Campus 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 4 inclusion and 4 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 24 Sep 2015. 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?

Early Phase 1 (sometimes called Phase 0) studies give a very small amount of a treatment to a few people, mainly to see how the body handles it.

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?

Antibody response measured by ELISA (ug/ml) (time frame: Change in ug/ml from day 0 to day 30). The study lists 4 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 NCT02558751, which also lists 5 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 24 Sep 2015.

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