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HIV InfectionsPhase 49-VPH-MVIHNCT04270773

Immunogenicity and Safety of a 9-valent Human Papillomavirus Vaccine in HIV-positive Women

A Phase 4 study testing Human Papillomavirus 9-valent Vaccine, Recombinant in people with HIV Infections and HPV Infection, run by University Hospital Virgen de las Nieves at 1 site in Spain.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

In adult HIV-positive patients, data on the safety and immunogenicity of the quadrivalent HPV (qHPV) vaccine have been reported with excellent results (13 14); also, the results of a clinical trial of qHPV vaccine conducted in seropositive patients older than 36 years (WLHIV and MSM) have been published. Read more about this study

Who is it for?
Ages 18 years and older, women only
Conditions the study is for
HIV Infections, HPV Infection
What is being tested?
Human Papillomavirus 9-valent Vaccine, Recombinant
Type of treatment
Vaccines
Could I receive a placebo?
No, everyone receives an active treatment
How many people
158 participants
Where
1 siteSpain
Study dates
12 Feb 2020to 30 Dec 2024
Phase
Phase 4
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 years and older
  • Women only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • HIV-positive women patients of ≥18 years of age who, at the time of study inclusion were not infected simultaneously by the 16, 18 genotypes of HPV in vagina and/or anus.

Who cannot join

  • WLHIV patients who had simultaneous anal infection with the 16, 18, 31, 33, 45, 52 y 58 genotypes. - WLHIV diagnosed in V0 of ASCC or anal HSIL.
  • Active opportunist infection at the time of recruitment into the study.
  • Cd4 count < 200 cel/µL.
  • History of allergy to aluminium and/or yeast extract excipient.

Trial locations and contacts

1 site in 1 country.

Spain1 site
  • Hospital Universitario Virgen de Las Nieves

    Granada, Andalusia, 18008

Other trials in Spain

About this study

Official title: Immunogenicity and Safety of a 9-valent Human Papillomavirus Vaccine in HIV-positive Women.

In adult HIV-positive patients, data on the safety and immunogenicity of the quadrivalent HPV (qHPV) vaccine have been reported with excellent results (13 14); also, the results of a clinical trial of qHPV vaccine conducted in seropositive patients older than 36 years (WLHIV and MSM) have been published.

Even now, there is not a trial about immunogenicity and safety of a 9-valent human papillomavirus vaccine in HIV-positive women; for this reason, the investigators plan to conduct this clinical trial.

HYPOTHESYS: The administration of Nonavalent HPV vaccine (HPV-9) in adult women living with HIV will produce antibodies against nine genotypes of HPV, thus preventing the acquisition of new infections by those genotypes. Besides, this will prevent the cervical and anal dysplasia in these women.

Read the detailed description

This is a phase IV (post-authorization study), open, single-arm trial of 9-valent human papillomavirus (9-HPV) vaccine in HIV-positive women. The recruitment and follow-up period will be 6 and 30 months, respectively.

At the initial clinical visit (V0), the conditions and objectives of the study were explained. The details were summarised in a document, which was presented to the patient who then signed the informed consent form. 2 mucosa samples were taken from the anal canal for the detection and genotyping of the HPV and for anal cytology; and high resolution anoscopy will be carried out. The patients will send to gynaecologist for exploration. Finally, full blood haemogram and blood chemistry analysis were measured, together with cluster of differentiation 4 (CD4), cluster of differentiation 8 (CD8) lymphocytes counts, HIV viral load (VL) and antibodies against 9 genotypes of the 9-HPV vaccine. 9-HPV vaccine will be administered at day 1 (V1), month 2 (V2) and month 6 (V3). Flow of subjects through the study in graphic 1.

Settings and locations: The patients who enrolled were HIV-positive women that were attending the Infectious Diseases Service of the "University Hospital Virgen de las Nieves", Granada (Spain), "Hospitalary Complex Ciudad de Jaén" (Spain) and "University hospital San Cecilio", Granada (Spain).

The purposes of the study were explained to the potential participants who then underwent screening, and enrolled if they met the inclusion criteria for the trial. They were asked to sign the fully informed consent form. The study will be conducted in compliance with ethical and moral principles stated in the Declaration of Helsinki as well as the current Spanish Laws on Biomedical Research(LEY 14/2007, de 3 de julio). Data were coded to ensure anonymity.

SAMPLE SIZE CONSIDERATIONS:

Currently, the rate of infections in unvaccinated women in the participating centers is 46.4% (12). The efficacy rate of the tetravalent vaccine in the prevention of cervical cancer is close to 100% and in the appearance of external anal lesions in men, around 85% (21). Considering that in our study population, the effectiveness is at least 75%, to achieve an accuracy of 5% in the estimation of a proportion through a normal 95% asymptotic confidence interval, assuming that the proportion is 11, 6% (25% of 46.4%), it will be necessary to include 158 women in the study. To this sample size will be added 10% in anticipation of possible losses in the follow-up or dropouts.

DATA COLLECTION:

All data were collected and coded to ensure anonymity according to the current legal requirements in Spain and European Union (EU) (GDPR Regulation (EU) 2016/679). At the initial clinical visit (V0), the conditions and objectives of the study were explained to subjects. The details were summarised in a document, which was presented to the patient who then signed the informed consent form.

Being tested
Human Papillomavirus 9-valent Vaccine, Recombinant
Medical subject headings
HIV Infections, Papillomavirus Infections

What participants receive

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

  • Human Papillomavirus 9-valent Vaccine, RecombinantBiological

    Vaccine administrated

Study groups in NCT04270773
Study groupRoleWhat they receive
Only armOtherSingle arm, Receiving treatment
Receives: Biological: Human Papillomavirus 9-valent Vaccine, Recombinant

What is being measured

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

  1. Antibodies against the 9 genotypes of the qHPV vaccine

    immunogenicity of a 9-valent human papillomavirus vaccine in HIV-positive women older than ≥18 years

    Measured: 30 months

  2. Incidence of Treatment-Emergent Adverse Events of a 9-valent human papillomavirus vaccine in HIV-positive women older than ≥18 years

    Number of Participants With Any Adverse Event (AE)

    Measured: Through study completion, up to 30 months

Secondary outcomes (3)
  1. new HPV genotypes

    acquisition rate of HPV genotypes of anal and cervical mucosa.

    Measured: Determined at 12th, 24th, 30th month

  2. Data analysis of risk factors in subject who acquire HPV genotypes from data recorded at follow-up visits via survey.

    The survey asks about HPV risk factors.

    Measured: 30 months

  3. progression to dysplastic lesions

    rate of progression to dysplastic lesions (LSIL, high grade squamous intraepithelial lesion (HSIL) and Cancer) anal and cervical after vaccination.

    Measured: Determined at 12th, 24th, 30th month

Timeline

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

  1. First posted17 Feb 2020
  2. Study start12 Feb 2020
  3. Primary completion30 Sep 2024 (estimated)
  4. Study completion30 Dec 2024 (estimated)

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 4
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Model description
This is a phase IV (post-authorization study), open, single-arm trial
Masking
None (open label)
Enrolment
158 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04270773
Sponsor's protocol ID
9-VPH-MVIH
Acronym
9-VPH-MVIH
Status last verified
Jul 2024
First submitted
13 Jan 2020
Last updated
10 Jul 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Palefsky JM. Human papillomavirus-associated anal and cervical cancers in HIV-infected individuals: incidence and prevention in the antiretroviral therapy era. Curr Opin HIV AIDS. 2017 Jan;12(1):26-30. doi: 10.1097/COH.0000000000000336.

    PubMed 27828801
  • Stier EA, Sebring MC, Mendez AE, Ba FS, Trimble DD, Chiao EY. Prevalence of anal human papillomavirus infection and anal HPV-related disorders in women: a systematic review. Am J Obstet Gynecol. 2015 Sep;213(3):278-309. doi: 10.1016/j.ajog.2015.03.034. Epub 2015 Mar 19.

    PubMed 25797230
  • Jemal A, Simard EP, Dorell C, Noone AM, Markowitz LE, Kohler B, Eheman C, Saraiya M, Bandi P, Saslow D, Cronin KA, Watson M, Schiffman M, Henley SJ, Schymura MJ, Anderson RN, Yankey D, Edwards BK. Annual Report to the Nation on the Status of Cancer, 1975-2009, featuring the burden and trends in human papillomavirus(HPV)-associated cancers and HPV vaccination coverage levels. J Natl Cancer Inst. 2013 Feb 6;105(3):175-201. doi: 10.1093/jnci/djs491. Epub 2013 Jan 7.

    PubMed 23297039
  • Firnhaber C, Westreich D, Schulze D, Williams S, Siminya M, Michelow P, Levin S, Faesen M, Smith JS. Highly active antiretroviral therapy and cervical dysplasia in HIV-positive women in South Africa. J Int AIDS Soc. 2012 Jun 7;15(2):17382. doi: 10.7448/IAS.15.2.17382.

    PubMed 22713259
  • Piketty C, Selinger-Leneman H, Grabar S, Duvivier C, Bonmarchand M, Abramowitz L, Costagliola D, Mary-Krause M; FHDH-ANRS CO 4. Marked increase in the incidence of invasive anal cancer among HIV-infected patients despite treatment with combination antiretroviral therapy. AIDS. 2008 Jun 19;22(10):1203-11. doi: 10.1097/QAD.0b013e3283023f78.

    PubMed 18525266
  • Franceschi S, Lise M, Clifford GM, Rickenbach M, Levi F, Maspoli M, Bouchardy C, Dehler S, Jundt G, Ess S, Bordoni A, Konzelmann I, Frick H, Dal Maso L, Elzi L, Furrer H, Calmy A, Cavassini M, Ledergerber B, Keiser O; Swiss HIV Cohort Study. Changing patterns of cancer incidence in the early- and late-HAART periods: the Swiss HIV Cohort Study. Br J Cancer. 2010 Jul 27;103(3):416-22. doi: 10.1038/sj.bjc.6605756. Epub 2010 Jun 29.

    PubMed 20588274
  • Hidalgo-Tenorio C, de Jesus SE, Esquivias J, Pasquau J. High prevalence and incidence of HPV-related anal cancer precursor lesions in HIV-positive women in the late HAART era. Enferm Infecc Microbiol Clin (Engl Ed). 2018 Nov;36(9):555-562. doi: 10.1016/j.eimc.2017.10.014. Epub 2017 Dec 6. English, Spanish.

    PubMed 29208455
  • Hidalgo-Tenorio C, Rivero-Rodriguez M, Gil-Anguita C, Esquivias J, Lopez-Castro R, Ramirez-Taboada J, de Hierro ML, Lopez-Ruiz MA, Martinez RJ, Llano JP. The role of polymerase chain reaction of high-risk human papilloma virus in the screening of high-grade squamous intraepithelial lesions in the anal mucosa of human immunodeficiency virus-positive males having sex with males. PLoS One. 2015 Apr 7;10(4):e0123590. doi: 10.1371/journal.pone.0123590. eCollection 2015.

    PubMed 25849412
  • Park IU, Palefsky JM. Evaluation and Management of Anal Intraepithelial Neoplasia in HIV-Negative and HIV-Positive Men Who Have Sex with Men. Curr Infect Dis Rep. 2010 Mar;12(2):126-33. doi: 10.1007/s11908-010-0090-7. Epub 2010 Feb 24.

    PubMed 20461117
  • Wilkin T, Lee JY, Lensing SY, Stier EA, Goldstone SE, Berry JM, Jay N, Aboulafia D, Cohn DL, Einstein MH, Saah A, Mitsuyasu RT, Palefsky JM. Safety and immunogenicity of the quadrivalent human papillomavirus vaccine in HIV-1-infected men. J Infect Dis. 2010 Oct 15;202(8):1246-53. doi: 10.1086/656320.

    PubMed 20812850
  • Wilkin TJ, Chen H, Cespedes MS, Leon-Cruz JT, Godfrey C, Chiao EY, Bastow B, Webster-Cyriaque J, Feng Q, Dragavon J, Coombs RW, Presti RM, Saah A, Cranston RD. A Randomized, Placebo-Controlled Trial of the Quadrivalent Human Papillomavirus Vaccine in Human Immunodeficiency Virus-Infected Adults Aged 27 Years or Older: AIDS Clinical Trials Group Protocol A5298. Clin Infect Dis. 2018 Oct 15;67(9):1339-1346. doi: 10.1093/cid/ciy274.

    PubMed 29659751
  • Hidalgo-Tenorio C, Ramirez-Taboada J, Gil-Anguita C, Esquivias J, Omar-Mohamed-Balgahata M, SamPedro A, Lopez-Ruz M, Pasquau J. Safety and immunogenicity of the quadrivalent human papillomavirus (qHPV) vaccine in HIV-positive Spanish men who have sex with men (MSM). AIDS Res Ther. 2017 Jul 18;14(1):34. doi: 10.1186/s12981-017-0160-0.

    PubMed 28720147

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Human Papillomavirus 9-valent Vaccine, Recombinant in people with HIV Infections and HPV Infection, run by University Hospital Virgen de las Nieves at 1 site in Spain.

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 1 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: status not confirmed, as of the sponsor's last update on 10 Jul 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 Spain. 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 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

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

Are results available for this study?

Results are not available in the source record.

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?

Antibodies against the 9 genotypes of the qHPV vaccine (time frame: 30 months). 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 NCT04270773, which also lists 12 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 10 Jul 2024.

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