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Safety and Tolerability of and Immune Response to LC002, an Experimental Therapeutic Vaccine, in Adults Receiving Anti-HIV Treatment
This study is ongoing, but not recruiting participants.
Sponsored by: National Institute of Allergy and Infectious Diseases (NIAID)
Information provided by: National Institute of Allergy and Infectious Diseases (NIAID)
ClinicalTrials.gov Identifier: NCT00270205
  Purpose

LC002 is an experimental therapeutic vaccine that was designed to boost the immune response of people infected with HIV. The purpose of this study is to determine the safety and tolerability of and immune response to LC002 in HIV-infected adults who are currently receiving anti-HIV treatment.


Condition Intervention Phase
HIV Infections
Biological: LC002 standard vaccination
Biological: LC002 high-dose vaccination
Biological: LC002 placebo vaccination
Phase I
Phase II

MedlinePlus related topics: AIDS
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Randomized, Double Blind (Subject, Caregiver), Placebo Control, Parallel Assignment, Safety/Efficacy Study
Official Title: A Phase I/II, Randomized, Double-Blind Study to Evaluate the Safety, Tolerability, and Immunogenicity of LC002, a DermaVir Vaccine, HIV-1-Infected Subjects Currently Under Treatment With Highly Active Antiretroviral Therapy (HAART)

Further study details as provided by National Institute of Allergy and Infectious Diseases (NIAID):

Primary Outcome Measures:
  • Occurrence of at least one Grade 3 or higher adverse event, including signs/symptoms, lab toxicities, and/or clinical events possibly or definitely related to study treatment [ Time Frame: Through Day 28 ] [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • CD4+ T-cell count/ml in PBMCs [ Time Frame: Throughout study ] [ Designated as safety issue: No ]
  • CD8+ T-cell count/ml in PBMCs [ Time Frame: Throughout study ] [ Designated as safety issue: No ]
  • T-cell count and percent of HIV-1-specific CD4+ and CD8+ T-cell subsets, based on flow cytometry with CFSE staining to detect antigen-specific lymphocyte proliferation responding to whole HIV-1 antigen, p24 protein, and various HIV-1 peptide antigens [ Time Frame: Throughout study ] [ Designated as safety issue: No ]
  • T-cell count and percent of HIV-1-specific CD4+ and CD8+ T-cell subsets, based on flow cytometry to detect antigen-specific IFN-gamma- and IL-2-producing cells responding to whole Zn-finger inactivated virus stimulation and various HIV-1 peptide antigens [ Time Frame: Throughout study ] [ Designated as safety issue: No ]
  • Magnitude of HIV-specific immune response, as determined by summing the number of spot-forming cells/10^5 PBMCs observed in each ELISPOT assay for IFN-gamma production for whole HIV-1 antigen, p24 protein, and HIV-1 peptide antigen pools [ Time Frame: Throughout study ] [ Designated as safety issue: No ]
  • Breadth of HIV-1-specific immune response, as determined by the number of overlapping HIV-1 peptides for which the ELISPOT assay for IFN-gamma production is observed to have five or more spot-forming cells/ 10^5 PBMCs [ Time Frame: Throughout study ] [ Designated as safety issue: No ]
  • Lymphocyte proliferation stimulation Index (SI) in response to whole HIV-1 antigen, p24 antigen, and pooled HIV-1 peptide antigens [ Time Frame: Throughout study ] [ Designated as safety issue: No ]
  • Anti-dsDNA antibody response [ Time Frame: Throughout study ] [ Designated as safety issue: No ]

Estimated Enrollment: 24
Study Start Date: February 2006
Estimated Primary Completion Date: November 2008 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
A: Experimental
Participants will receive three low-dose vaccinations of LC002. Vaccinations will be given over two skin sites on the left and right upper back. Participants will receive vaccinations at Weeks 1, 7, and 13.
Biological: LC002 standard vaccination
0.1 mg DNA/subject, 0.8 mL total administered subcutaneously
B: Experimental
Participants will receive three vaccinations of LC002 placebo. Vaccinations will be given over two skin sites on the left and right upper back. Participants will receive vaccinations at Weeks 1, 7, and 13.
Biological: LC002 placebo vaccination
Placebo vaccination administered subcutaneously
C: Experimental
Participants will receive three high-dose vaccinations of LC002. Vaccinations will be given over four skin sites on the left and right upper back and left and right upper ventral thigh. Participents will receive vaccinations at Weeks 1, 7, and 13.
Biological: LC002 high-dose vaccination
0.4 mg DNA/subject, 3.2 mL total administered subcutaneously
D: Experimental
Participants will receive three high-dose vaccinations of LC002 placebo. Vaccinations will be given over four skin sites on the left and right upper back and left and right upper ventral thigh. Participants will receive vaccinations at Weeks 1, 7, and 13.
Biological: LC002 placebo vaccination
Placebo vaccination administered subcutaneously
E: Experimental
Participants will receive six high-dose vaccinations of LC002. Vaccinations will be given over four skin sites on the left and right upper back and left and right upper ventral thigh. Participants will receive vaccinations at study entry and Weeks 1, 6, 7, 12, and 13.
Biological: LC002 high-dose vaccination
0.4 mg DNA/subject, 3.2 mL total administered subcutaneously
F: Experimental
Participants will receive six high-dose vaccinations of LC002 placebo. Vaccinations will be given over four skin sites on the left and right upper back and left and right upper ventral thigh. Participants will receive vaccinations at study entry and Weeks 1, 6, 7, 12, and 13.
Biological: LC002 placebo vaccination
Placebo vaccination administered subcutaneously

Detailed Description:

The use of highly active antiretroviral therapy (HAART) has dramatically improved the rates of survival, morbidity, and mortality among HIV-infected people throughout the world. However, the costs, long-term toxicity, and problems with adherence associated with HAART regimens make such treatment plans less than optimal for individuals seeking treatment for HIV infection. Also, because viral reservoirs cannot be eradicated, HIV-infected patients must usually be on HAART indefinitely in order to keep their infection under control. While the mechanism is still unclear, the immune system weakens as HIV disease progresses. A therapeutic HIV vaccine given to HIV infected people may help to promote better immune responses. LC002 is a novel HIV therapeutic vaccine containing a DNA plasmid that codes for most of HIV-1's proteins. LC002 is a unique vaccine in that it is given through topical administration; this allows for Langerhans cells (immune cells located under the surface of the skin) to pick up the vaccine and deliver it to the lymph nodes, causing an immune reaction. This study will evaluate the safety, tolerability, and immunogenicity of LC002 in HIV-infected adults currently receiving HAART.

There are three cohorts in this study; cohorts will enroll sequentially. Patients in a given cohort will be randomly assigned to receive either LC002 or placebo.

  • In Cohort 1, patients will receive three low-dose vaccinations of LC002 (Arm A) or 3 vaccinations of placebo (Arm B). Vaccinations will be given over two skin sites on the left and right upper back. Patients will receive vaccinations at Weeks 1, 7, and 13.
  • In Cohort 2, patients will receive three high-dose vaccinations of LC002 (Arm C) or three vaccinations of placebo (Arm D). Vaccinations will be given over four skin sites on the left and right upper back and left and right upper ventral thigh. Patients will receive vaccinations at Weeks 1, 7, and 13.
  • In Cohort 3, patients will receive six high-dose vaccinations of LC002 (Arm E) or six vaccinations of placebo (Arm F). Vaccinations will be given over four skin sites on the left and right upper back and left and right upper ventral thigh. Patients will receive vaccinations at study entry and Weeks 1, 6, 7, 12, and 13.

Prior to receiving the vaccine, the chosen vaccine administration site on the back or thigh will be disinfected and exfoliated. A skin patch will be applied to the site, and the vaccine solution will be placed on the skin underneath the patch with a needleless syringe. Patients will be allowed to remove the skin patch 3 hours post vaccination. For the first and second vaccinations, patients will be required to remain at the clinic for 3 hours post-vaccination so study staff can assess for side effects. If no side effects occur after the first two vaccinations, patients need only stay at the clinic for 30 minutes after receiving later vaccinations.

At the start of the study, patients will be asked to keep a diary and record daily any side effects or skin irritation they may have experienced following vaccination. Patients will need to bring their diaries with them to their next clinic visit. Two days after vaccination, patients will be called at home and asked about any side effects they may have experienced. Patients who experience side effects may be asked to return to the clinic for examination. There will be 13 study visits; they will occur at study entry and Weeks 1, 3, 6, 7, 9, 12, 13, 15, 17, 24, 37, and 61. Study visits will include medication history, a physical exam, and collection of diaries. Blood and urine collection will occur at selected visits. HAART will not be provided by this study.

  Eligibility

Ages Eligible for Study:   18 Years to 50 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • HIV-1-infected
  • On a stable HAART regimen without changes or interruptions for more than 4 consecutive days for at least 12 weeks prior to study entry. Patients must be currently taking regimens containing drugs of at least two different classes.
  • Two readings of HIV-1 viral load of less than 50 copies/ml within 30 days prior to study entry. More information on this criterion can be found in the protocol.
  • CD4 count greater than 350 cells/mm3 within 12 weeks prior to study entry
  • Lowest CD4 count greater than 250 cells/mm3 at any time prior to study entry
  • Willing to use acceptable forms of contraception

Exclusion Criteria:

  • HIV-1 viral load greater than 500 copies/ml within the 24 weeks prior to study entry
  • History of or current active skin disease (e.g., atopic dermatitis, psoriasis) or any chronic autoimmune disease (e.g., Graves' disease). Participants with minor, localized skin conditions that, in the opinion of the investigator, do not represent a safety concern are not excluded.
  • Treatment with topical corticosteroids at proposed vaccination sites (Cohort 1: left and right upper back; Cohorts 2 and 3: left and right upper back and left and right upper ventral thigh) within 2 weeks of study entry
  • Excessive exposure to the sun (e.g., sunbathing, tanning bed) within 2 weeks prior to study entry
  • Laser hair removal within 2 weeks prior to study entry
  • Use of local skin treatments (e.g., topical/chemical hair removal, ointments, possible irritants) to targeted vaccination sites within 7 days prior to study entry
  • History of diabetes or bleeding disorders
  • Previous CDC Category C event. More information on this criterion can be found in the protocol.
  • Use of immunomodulating therapy, including cyclosporine, IgG-containing products, interleukins, interferons, or systemic glucocorticosteroids (including those inhaled) within 6 months prior to study entry
  • Exposure to an experimental HIV vaccine within 6 months prior to study entry
  • Any vaccine within 30 days prior to study entry
  • Investigational products within 12 weeks prior to study entry
  • Allergy or sensitivity to study vaccine products, adhesives, or polyester
  • Current drug or alcohol use or dependence that may interfere with the study
  • Serious illness requiring systemic treatment or hospitalization. Participants who complete therapy or are clinically stable on therapy for at least 14 days prior to study entry are not excluded.
  • Positive hepatitis B surface antigen or positive anti-hepatitis C antibody at screening
  • History of treatment with HAART during primary infection
  • History of lymph node irradiation
  • Pregnant or breastfeeding
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00270205

Locations
United States, California
University of California, Davis Medical Center
Sacramento, California, United States, 95814
United States, Illinois
Rush-Presbyterian/St. Lukes (Chicago)
Chicago, Illinois, United States, 60612-3806
United States, Ohio
MetroHealth Medical Center
Cleveland, Ohio, United States, 44109-1998
Case Western Reserve University
Cleveland, Ohio, United States, 44106-5083
United States, Pennsylvania
University of Pittsburgh
Pittsburgh, Pennsylvania, United States, 15213-2582
Sponsors and Collaborators
Investigators
Study Chair: Richard Pollard, MD Division of Infectious Diseases, University of California, Davis Medical Center
  More Information

Haga clic aquí para ver información sobre este ensayo clínico en español.  This link exits the ClinicalTrials.gov site

Publications:
Responsible Party: DAIDS ( Rona Siskind )
Study ID Numbers: ACTG A5176
Study First Received: December 21, 2005
Last Updated: November 6, 2008
ClinicalTrials.gov Identifier: NCT00270205  
Health Authority: United States: Food and Drug Administration

Keywords provided by National Institute of Allergy and Infectious Diseases (NIAID):
Treatment Experienced
HIV Therapeutic Vaccine

Study placed in the following topic categories:
Virus Diseases
Sexually Transmitted Diseases, Viral
HIV Infections
Sexually Transmitted Diseases
Acquired Immunodeficiency Syndrome
Retroviridae Infections
Immunologic Deficiency Syndromes

Additional relevant MeSH terms:
RNA Virus Infections
Slow Virus Diseases
Immune System Diseases
Lentivirus Infections
Infection

ClinicalTrials.gov processed this record on January 16, 2009