A Phase I Study to Evaluate the Safety and Immunogenicity of Recombinant HIV-1 Envelope Antigen in Children Born to HIV-Infected Mothers - Full Text View

Sponsor:	National Institute of Allergy and Infectious Diseases (NIAID)
Collaborators:	Genentech Biocine
Information provided by:	National Institute of Allergy and Infectious Diseases (NIAID)
ClinicalTrials.gov Identifier:	NCT00000774

Purpose

PRIMARY: To determine the safety of envelope recombinant proteins rgp120/HIV-1MN (Genentech) and rgp120/HIV-1SF2 (Chiron/Biocine) in infants who are of indeterminate HIV status born to HIV-infected women. To evaluate changes in viral load in infants proven to be infected and absolute CD4 counts in all immunized infants.

SECONDARY: To evaluate the immunogenicity of these envelope recombinant proteins in infants of indeterminate HIV status born to HIV-infected women.

Only 30-50 percent of HIV-infected infants have detectable virus at birth. Successful early sensitization to HIV envelope epitopes may help prevent infection or, alternatively, may enhance HIV-specific immune function to alter HIV replication and disease progression.

Condition	Intervention	Phase
HIV Infections HIV Seronegativity	Biological: rgp120/HIV-1MN Biological: rgp120/HIV-1 SF-2 Biological: Placebo version of rgp120/HIV-1MN Biological: Placebo version of rgp120/HIV-1SF2	Phase I

Study Type:	Interventional
Study Design:	Treatment, Randomized, Double Blind (Subject, Investigator), Parallel Assignment, Safety/Efficacy Study
Official Title:	A Phase I Study to Evaluate the Safety and Immunogenicity of Recombinant HIV-1 Envelope Antigen in Children Born to HIV-Infected Mothers

Resource links provided by NLM:

MedlinePlus related topics: AIDS

U.S. FDA Resources

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

Primary Outcome Measures:

Development of adverse clinical, laboratory, or immunological responses to any of the recombinant vaccines [ Time Frame: Throughout study ] [ Designated as safety issue: Yes ]
Changes in viral load in infants found to be HIV infected [ Time Frame: Throughout study ] [ Designated as safety issue: No ]
Changes in the slope of absolute CD4 counts in all immunized children [ Time Frame: Throughout study ] [ Designated as safety issue: No ]

Secondary Outcome Measures:

Changes in immune response to the vaccine candidates [ Time Frame: Throughout study ] [ Designated as safety issue: No ]

Enrollment:	156
Study Start Date:	November 1999
Primary Completion Date:	June 2005 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
1: Experimental Patients who will receive rgp120/HIV-1MN	Biological: rgp120/HIV-1MN Administered at weeks 0, 4, 8, 12, and 20. Individual group assignment will determine specific dosage and schedule.
2: Experimental Patients who will receive rgp120/HIV-1SF2	Biological: rgp120/HIV-1 SF-2 Administered at weeks 0, 4, 8, 12, and 20. Individual group assignment will determine specific dosage and schedule.
3: Placebo Comparator Patients who will receive the placebo counterpart of 120/HIV-1MN	Biological: Placebo version of rgp120/HIV-1MN Administered at weeks 0, 4, 8, 12, and 20. Individual group assignment will determine specific dosage and schedule.
4: Placebo Comparator Patients who will receive the placebo counterpart of rgp120/HIV-1SF2	Biological: Placebo version of rgp120/HIV-1SF2 Administered at weeks 0, 4, 8, 12, and 20. Individual group assignment will determine specific dosage and schedule.

Detailed Description:

Only 30-50 percent of HIV-infected infants have detectable virus at birth. Successful early sensitization to HIV envelope epitopes may help prevent infection or, alternatively, may enhance HIV-specific immune function to alter HIV replication and disease progression.

Newborns are randomized to one of three different doses of either rgp120/HIV-1MN or rgp120/HIV-1SF2 or their matching placebos. At each dose level, 12 patients receive vaccine and three patients receive placebo. Immunizations are performed at 0, 4, 12, and 20 weeks, and patients are followed until 2 years of age. Three of four patients treated at a given dose level must have received two immunizations without evidence of grade 3 or 4 clinical or laboratory toxicity before dose escalation occurs. Twelve additional patients are treated with the optimal dose of each vaccine at weeks 0, 2, 8, and 20 (An accelerated schedule PER AMENDMENT 3/20/96. Changed from - 0, 4, 8, and 20) accompanied by three additional placebo patients per vaccine. PER AMENDMENT 3/20/96: The optimal dose of rgp120/HIV-1MN is 100 mcg and will be given to the 12 patients and the placebo will be given to 3. The optimal dose of rgp120/HIV-1SF2 is 5 mcg and will be given to the 12 patients and the placebo will be given to 3.

PER 2/3/95 AMENDMENT: After the initial patients are enrolled, 18 additional newborns will be randomized to one of the three dose levels of rgp120/HIV-1MN (with no placebos). PER AMENDMENT 6/5/95: Another group of 18 newborns will be randomized to one of three treatments representing 3 different doses of the Chiron/Biocine vaccine (with no placebos).

Eligibility

Ages Eligible for Study:	up to 3 Days
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	Yes

Criteria

Inclusion Criteria

Concurrent Medication:

Allowed:

Antiretroviral therapy.
Coenrollment in a therapeutic protocol if begun at least 30 days following the week 20 immunization.
Routine immunizations if given more than 1 week before or after study vaccine.

Patients must be:

> 37 weeks gestation and < 72 hours of age born to HIV-infected women.
NOT born to women who received either passive or active immunotherapy during pregnancy.
NOT breast-fed.
NOT born to women who are hepatitis B surface antigen positive.
Receiving AZT at study entry (except infants enrolled in ACTG 076).

NOTE:

Parent or guardian must provide informed consent and be willing to comply with study requirements.

Exclusion Criteria

Co-existing Condition:

Patients with the following symptoms or conditions are excluded:

Documented or suspected serious bacterial infection, metabolic illness, or other immediate life-threatening conditions.

Concurrent Medication:

Excluded:

Passive or active HIV-specific immunotherapy other than the study candidate vaccines.
Investigational medications.

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00000774

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Locations

United States, California
UCSF / Moffitt Hosp - Pediatric
San Francisco, California, United States, 941430105
UCSD Med Ctr / Pediatrics / Clinical Sciences
La Jolla, California, United States, 920930672
San Francisco Gen Hosp
San Francisco, California, United States, 94110
Harbor - UCLA Med Ctr / UCLA School of Medicine
Los Angeles, California, United States, 905022004
UCLA Med Ctr / Pediatric
Los Angeles, California, United States, 900951752
Long Beach Memorial (Pediatric)
Long Beach, California, United States, 90801
United States, Colorado
Children's Hosp of Denver
Denver, Colorado, United States, 802181088
United States, Connecticut
Yale Univ Med School
New Haven, Connecticut, United States, 06504
United States, Florida
Univ of Miami (Pediatric)
Miami, Florida, United States, 33161
Univ of Florida Health Science Ctr / Pediatrics
Jacksonville, Florida, United States, 32209
United States, Illinois
Chicago Children's Memorial Hosp
Chicago, Illinois, United States, 606143394
Cook County Hosp
Chicago, Illinois, United States, 60612
Univ of Chicago Children's Hosp
Chicago, Illinois, United States, 606371470
United States, Louisiana
Tulane Univ / Charity Hosp of New Orleans
New Orleans, Louisiana, United States, 701122699
United States, Maryland
Johns Hopkins Hosp - Pediatric
Baltimore, Maryland, United States, 212874933
United States, Massachusetts
Univ of Massachusetts Med School
Worcester, Massachusetts, United States, 016550001
Boston City Hosp / Pediatrics
Boston, Massachusetts, United States, 02118
Brigham and Women's Hosp
Boston, Massachusetts, United States, 02115
Baystate Med Ctr of Springfield
Springfield, Massachusetts, United States, 01199
Children's Hosp of Boston
Boston, Massachusetts, United States, 021155724
United States, New Jersey
Univ of Medicine & Dentistry of New Jersey / Univ Hosp
Newark, New Jersey, United States, 071032714
Children's Hosp of New Jersey / UMDNJ - New Jersey Med Schl
Newark, New Jersey, United States, 071072198
Saint Joseph's Hosp and Med Ctr/UMDNJ - New Jersey Med Schl
Newark, New Jersey, United States, 07103
United States, New York
Univ of Rochester Medical Center
Rochester, New York, United States, 14642
Bellevue Hosp / New York Univ Med Ctr
New York, New York, United States, 10016
Bronx Lebanon Hosp Ctr
Bronx, New York, United States, 10457
Columbia Presbyterian Med Ctr
New York, New York, United States, 10032
Mount Sinai Med Ctr / Pediatrics
New York, New York, United States, 10029
SUNY Health Sciences Ctr at Syracuse / Pediatrics
Syracuse, New York, United States, 13210
Mount Sinai Med Ctr
New York, New York, United States, 10029
Incarnation Children's Ctr / Columbia Presbyterian Med Ctr
New York, New York, United States, 10032
State Univ of New York at Stony Brook
Stony Brook, New York, United States, 117948111
Children's Hosp Pact Prog / Children's Hosp of Buffalo
Buffalo, New York, United States, 14222
Beth Israel Med Ctr / Pediatrics
New York, New York, United States, 10003
United States, North Carolina
Duke Univ Med Ctr
Durham, North Carolina, United States, 277103499
United States, Pennsylvania
Children's Hosp of Philadelphia
Philadelphia, Pennsylvania, United States, 191044318
Hosp of the Univ of Pennsylvania
Philadelphia, Pennsylvania, United States, 19104
United States, Texas
Texas Children's Hosp / Baylor Univ
Houston, Texas, United States, 77030
United States, Washington
Children's Hospital & Medical Center / Seattle ACTU
Seattle, Washington, United States, 981050371
Puerto Rico
San Juan City Hosp
San Juan, Puerto Rico, 009367344

Sponsors and Collaborators

National Institute of Allergy and Infectious Diseases (NIAID)

Genentech

Biocine

Investigators

Study Chair:	Borkowsky W	NYU MEDICAL CENTER
Study Chair:	Wara DW	UCSF Moffit Hospital

More Information

Publications:

Rogers MF, Mofenson LM, Moseley RR. Reducing the risk of perinatal HIV transmission through zidovudine therapy: treatment recommendations and implications. J Am Med Womens Assoc. 1995 May-Aug;50(3-4):78-82, 93. Review.

Cunningham CK, Wara DW, Kang M, Fenton T, Hawkins E, McNamara J, Mofenson L, Duliege AM, Francis D, McFarland EJ, Borkowsky W. Safety of 2 recombinant human immunodeficiency virus type 1 (HIV-1) envelope vaccines in neonates born to HIV-1-infected women. Clin Infect Dis. 2001 Mar 1;32(5):801-7.

Cunningham CK, Wara DW, Fenton T, Kang M, Hawkins E, McNamara J, Mofenson L, Duliege AM, Francis D, McFarland E, Borkowsky W. Safety of recombinant HIV-1 envelope vaccines in neonates born to HIV-1 infected women. Conf Retroviruses Opportunistic Infect. 1998 Feb 1-5;5th:93 (abstract no 81)

Borkowsky W, Wara D, Fenton T, McNamara J, Kang M, Mofenson L, McFarland E, Cunningham C, Duliege AM, Francis D, Bryson Y, Burchett S, Spector SA, Frenkel LM, Starr S, Van Dyke R, Jimenez E. Lymphoproliferative responses to recombinant HIV-1 envelope antigens in neonates and infants receiving gp120 vaccines. AIDS Clinical Trial Group 230 Collaborators. J Infect Dis. 2000 Mar;181(3):890-6.

Responsible Party:	DAIDS ( Rona Siskind )
Study ID Numbers:	ACTG 230
Study First Received:	November 2, 1999
Last Updated:	September 26, 2008
ClinicalTrials.gov Identifier:	NCT00000774 History of Changes
Health Authority:	United States: Federal Government; United States: Food and Drug Administration

Keywords provided by National Institute of Allergy and Infectious Diseases (NIAID):

Vaccines, Synthetic
Virus Replication
HIV Envelope Protein gp120

AIDS Vaccines
HIV Preventive Vaccine
HIV Therapeutic Vaccine

Additional relevant MeSH terms:

Virus Diseases
Sexually Transmitted Diseases, Viral
RNA Virus Infections
Slow Virus Diseases
Immune System Diseases
HIV Infections

Sexually Transmitted Diseases
Acquired Immunodeficiency Syndrome
Lentivirus Infections
Infection
Retroviridae Infections
Immunologic Deficiency Syndromes

ClinicalTrials.gov processed this record on November 27, 2009