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Pivotal Phase 2b/3 ALVAC/Bivalent gp120/MF59 HIV Vaccine Prevention Safety and Efficacy Study in South Africa (HVTN702)

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ClinicalTrials.gov Identifier: NCT02968849
Recruitment Status : Active, not recruiting
First Posted : November 21, 2016
Last Update Posted : August 5, 2019
Sponsor:
Collaborators:
Sanofi
GlaxoSmithKline
Bill and Melinda Gates Foundation
Information provided by (Responsible Party):
National Institute of Allergy and Infectious Diseases (NIAID)

Brief Summary:
This study will evaluate the preventive vaccine efficacy, safety, and tolerability of ALVAC-HIV (vCP2438) + Bivalent Subtype C gp120/MF59 in HIV-seronegative South African adults over 24 months and potentially up to 36 months from enrollment.

Condition or disease Intervention/treatment Phase
HIV Infections Biological: ALVAC-HIV (vCP2438) Biological: Bivalent Subtype C gp120/MF59 Biological: Placebo Phase 2 Phase 3

Detailed Description:

This study will evaluate the preventive vaccine efficacy, safety, and tolerability of the ALVAC-HIV vaccine + Bivalent Subtype C gp120 protein adjuvanted with MF59 in HIV-seronegative South African adults over 24 months from enrollment.

Participants will be randomized to receive ALVAC-HIV (vCP2438), or placebo, by intramuscular injection at weeks 0 and 4; they will receive ALVAC-HIV (vCP2438) + Bivalent Subtype C gp120/MF59, or placebo, by IM injection at weeks 12, 24, and 52.

In addition to the vaccination visits, participants will attend study visits at weeks 26, 39, 54, 65, 78, 91, 104, 117, 130, 142, and 156. All study visits, including vaccination visits, will include HIV risk reduction counseling, a physical exam, and an interview/questionnaire. and pregnancy testing for participants capable of becoming pregnant. Select study visits will include a medical history review, physical exam, blood collection, urine collection, HIV testing, and pregnancy testing for participants capable of becoming pregnant.


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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 5407 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Prevention
Official Title: A Pivotal Phase 2b/3 Multisite, Randomized, Double-blind, Placebo-controlled Clinical Trial to Evaluate the Safety and Efficacy of ALVAC-HIV (vCP2438) and Bivalent Subtype C gp120/MF59 in Preventing HIV-1 Infection in Adults in South Africa
Actual Study Start Date : October 26, 2016
Estimated Primary Completion Date : July 2022
Estimated Study Completion Date : July 2022

Resource links provided by the National Library of Medicine

MedlinePlus related topics: HIV/AIDS

Arm Intervention/treatment
Active Comparator: ALVAC-HIV + subtype C gp120/MF59
2700 participants will receive an IM injection of ALVAC-HIV (vCP2438) at months 0 and 1, and an IM injection of ALVAC-HIV (vCP2438) + Bivalent Subtype C gp120/MF59 at months 3, 6, and 12.
Biological: ALVAC-HIV (vCP2438)
Expresses the gene products ZM96 gp120 (clade C strain) linked to the sequences encoding the HIV-1 transmembrane anchor (TM) sequence of gp41 (28 amino acids clade B LAI strain) and gag and pro (clade B LAI strain). It is formulated as a lyophilized vaccine for injection at a dose > 10^6 cell culture infectious dose 50% (CCIDv50) and < 1 × 10^8 CCIDv50 (nominal dose of 10^7 CCIDv50) and is reconstituted with 1 mL of sterile sodium chloride solution (NaCl 0.4%) delivered IM

Biological: Bivalent Subtype C gp120/MF59
Subtype C TV1.C gp120 Env and 1086.C gp120 Env proteins, each at a dose of 100 mcg, mixed with MF59 adjuvant (an oil-in-water emulsion) and delivered IM

Placebo Comparator: Placebo
2700 participants will receive Sodium Chloride for injection, 0.9% at months 0, 1, 3, 6, and 12.
Biological: Placebo
Sodium Chloride for injection, 0.9% delivered IM




Primary Outcome Measures :
  1. Preventive vaccine efficacy (VE) of ALVAC-HIV (vCP2438) + Bivalent Subtype C gp120/MF59 for the prevention of HIV infection [ Time Frame: 24 months after Day 0 vaccination of last participant enrolled ]
    HIV-1 infection diagnosed after enrollment (concurrent with first vaccination) through 24 months after enrollment

  2. Incidence of treatment-emergent reactogenicity [ Time Frame: through 3 days after vaccination ]
    Local and systemic reactogenicity signs and symptoms

  3. Incidence of treatment-emergent adverse events [ Time Frame: through 30 days after vaccination ]
    Adverse events by body system, severity, and assessed relationship to study products

  4. Incidence of treatment-emergent severe adverse events [ Time Frame: 36 months ]
    Severe adverse events occuring at any time in the study

  5. Incidence of new chronic medical conditions [ Time Frame: 36 months ]
    At any time in the study, new onset or exacerbation of medical condition requiring 2 or more visits to a medical provider during a period of at least 30 days


Secondary Outcome Measures :
  1. Durability of vaccine efficacy [ Time Frame: 36 months ]
    HIV-1 infection diagnosed up to 36 months after enrollment; will be measured only if vaccine efficacy at 24 months >0%

  2. Vaccine efficacy from Month 6.5 (Week 26) through 24 months post enrollment [ Time Frame: 24 months after Day 0 vaccination of last participant enrolled ]
    HIV-1 infection diagnosed after Month 6.5 through 24 months post enrollment for all participants

  3. Immunogenicity of the vaccine regimen [ Time Frame: 26 weeks ]
    Vaccine-specific antibody and T cell responses

  4. Immunogenicity and immune response biomarkers as correlates of risk of subsequent HIV acquisition [ Time Frame: 26 weeks ]
    Vaccine-specific antibody and T cell responses correlated with vaccine efficacy

  5. Vaccine efficacy by various demographic characteristics [ Time Frame: 24 months for all participants, up to 36 months if vaccine efficacy >0% at 24 months ]
    Diagnosed HIV-1 infection, by demographic characteristics

  6. If significant positive evidence of vaccine efficacy, if and how vaccine efficacy depends on genotypic characteristics of HIV such as signature mutations [ Time Frame: 24 months ]
    Genotypic characteristics of viral sequences from HIV-1-infected participants at HIV-1 diagnosis, such as signature site mutations

  7. Comparison of genomic sequences of viral isolates from HIV-1-infected vaccine and placebo recipients, and assessment by sieve analysis methods of whether there is evidence of vaccine-induced immune pressure on the viral sequences [ Time Frame: 24 months ]
    Viral sequences from HIV-1-infected participants at HIV-1 diagnosis



Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.


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Ages Eligible for Study:   18 Years to 35 Years   (Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria

  • Age of 18 to 35 years
  • Sexually active, defined as having had sexual intercourse at least twice in the past 30 days prior to screening, and is considered by the site staff to be at risk for HIV infection.
  • Access to a participating HVTN CRS and willingness to be followed for the planned duration of the study
  • Ability and willingness to provide informed consent
  • Assessment of understanding: volunteer demonstrates understanding of this study prior to first vaccination with verbal demonstration of understanding of all questions.
  • Agrees not to enroll in another study of an investigational research agent until the participant is unblinded or their study participation ends, whichever occurs last
  • Good general health as shown by medical history, physical exam, and screening laboratory tests
  • Willingness to receive HIV test results
  • Willingness to discuss HIV infection risks and willing to receive HIV risk reduction counseling.
  • Alanine aminotransferase (ALT) < 2.5 times the institutional upper limit of normal
  • Negative HIV-1 and -2 blood test within 30 days prior to enrollment: Sites may use locally available assays that have been approved by HVTN Laboratory Operations.
  • Volunteers who were born female: negative serum or urine beta human chorionic gonadotropin (β-HCG) pregnancy test performed prior to vaccination on the day of initial vaccination. Persons who are NOT of reproductive potential due to having undergone total hysterectomy or bilateral oophorectomy (verified by medical records), are not required to undergo pregnancy testing.
  • Reproductive status: A volunteer who was born female must:

    • Agree to consistently use effective contraception (Appendix B and Appendix C) for sexual activity that could lead to pregnancy from at least 21 days prior to enrollment through 3 months after the last vaccination. Effective contraception is defined as using 2 methods of birth control. These include 1 of the following methods:

      • Condoms (male or female)
      • Diaphragm or cervical cap

PLUS 1 of the following methods:

  • Intrauterine device (IUD),
  • Hormonal contraception (in accordance with applicable national contraception guidelines), or
  • Successful vasectomy in the male partner (considered successful if a volunteer reports that a male partner has [1] documentation of azoospermia by microscopy, or [2] a vasectomy more than 2 years ago with no resultant pregnancy despite sexual activity postvasectomy), or
  • Any other contraceptive method approved by the protocol safety review team;

    • Or not be of reproductive potential, such as having been diagnosed with premature menopause (with no menses for 1 year) or having undergone hysterectomy, bilateral oophorectomy, or tubal ligation.

      • Volunteers who were born female must also agree not to seek pregnancy through alternative methods, such as artificial insemination or in vitro fertilization until 3 months after the last vaccination

Exclusion Criteria

  • Blood products received within 90 days before first vaccination
  • Investigational research agents received within 30 days before first vaccination
  • Intent to participate in another study of an investigational research agent or any other study that requires non-HVTN HIV antibody testing during the planned duration of the study
  • Pregnant or breastfeeding
  • HIV vaccine(s) received in a prior HIV vaccine trial. For volunteers who have received control/placebo in an HIV vaccine trial, the HVTN 702 PSRT will determine eligibility on a case-by-case basis.
  • Non-HIV experimental vaccine(s) received within the last 5 years in a prior vaccine trial. Exceptions may be made for vaccines that have subsequently undergone licensure. For volunteers who have received control/placebo in an experimental vaccine trial, the protocol safety review team will determine eligibility on a case-by-case basis. For volunteers who have received an experimental vaccine(s) greater than 5 years ago, eligibility for enrollment will be determined by the protocol safety review team on a case-by-case basis.
  • Live attenuated vaccines other than influenza vaccine received within 30 days before first vaccination or scheduled within 14 days after injection (eg, measles, mumps, and rubella [MMR]; oral polio vaccine [OPV]; varicella; yellow fever)
  • Influenza vaccine or any vaccines that are not live attenuated vaccines and were received within 14 days prior to first vaccination (eg, tetanus, pneumococcal, Hepatitis A or B)
  • Immunosuppressive medications received within 168 days before first vaccination. (Not exclusionary: [1] corticosteroid nasal spray; [2] inhaled corticosteroids; [3] topical corticosteroids for mild, uncomplicated dermatitis; or [4] a single course of oral/parenteral corticosteroids at doses < 2 mg/kg/day and length of therapy < 11 days with completion at least 30 days prior to enrollment.)
  • Serious adverse reactions to vaccines or to vaccine components such as eggs, egg products, or neomycin including history of anaphylaxis and related symptoms such as hives, respiratory difficulty, angioedema, and/or abdominal pain. (Not excluded from participation: a volunteer who had a non-anaphylactic adverse reaction to pertussis vaccine as a child.)
  • Immunoglobulin received within 60 days before first vaccination
  • Immunodeficiency
  • Clinically significant medical condition, physical examination findings, clinically significant abnormal laboratory results, or past medical history with clinically significant implications for current health. A clinically significant condition or process includes but is not limited to:

    • A process that would affect the immune response,
    • A process that would require medication that affects the immune response,
    • Any contraindication to repeated injections or blood draws,
    • A condition that requires active medical intervention or monitoring to avert grave danger to the volunteer's health or well-being during the study period,
    • A condition or process for which signs or symptoms could be confused with reactions to vaccine, or
    • Any condition specifically listed among the exclusion criteria below.
  • Any medical, psychiatric, occupational, or other condition that, in the judgment of the investigator, would interfere with, or serve as a contraindication to, protocol adherence, assessment of safety or reactogenicity, or a volunteer's ability to give informed consent
  • Psychiatric condition that precludes compliance with the protocol. Specifically excluded are persons with psychoses within the past 3 years, ongoing risk for suicide, or history of suicide attempt or gesture within the past 3 years.
  • Active tuberculosis (TB) disease
  • Uncontrolled hypertension: systolic blood pressure (SBP) ≥ 160 mm Hg or diastolic blood pressure (DBP) ≥ 100 mm Hg
  • Bleeding disorder (diagnosed by a doctor) contraindicating IM injection and/or blood draws, based on investigator's judgment
  • Malignancy (Not excluded from participation: Volunteer who has had malignancy excised surgically and who, in the investigator's estimation, has a reasonable assurance of sustained cure or who is unlikely to experience recurrence of malignancy during the period of the study)
  • History of hereditary angioedema, acquired angioedema, or idiopathic angioedema

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02968849


Locations
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South Africa
Walter Sisulu University HIV Vaccine Research Unit CRS
Mthatha, Eastern Cape, South Africa, 5099
Kliptown Soweto CRS
Johannesburg, Gauteng, South Africa, 1409
Aurum Tembisa CRS
Johannesburg, Gauteng, South Africa, 1632
Soweto HVTN CRS
Johannesburg, Gauteng, South Africa, 1862
MeCRU CRS
Pretoria, Gauteng, South Africa, 0204
Setshaba Research Centre CRS
Soshanguve, Gauteng, South Africa, 0152
eThekwini CRS
Durban, Kwa Zulu Natal, South Africa, 4013
Isipingo CRS
Isipingo, Kwa Zulu Natal, South Africa, 4110
Qhakaza Mbokodo Research Clinic CRS
Ladysmith, Kwa Zulu Natal, South Africa, 3370
Verulam CRS
Verulam, Kwa Zulu Natal, South Africa
Aurum Institute Klerksdorp CRS
Klerksdorp, North West Province, South Africa, 2571
Rustenburg CRS
Rustenburg, North West Province, South Africa, 0300
Emavundleni CRS
Cape Town, Western Cape, South Africa, 7750
Khayelitsha CRS
Cape Town, Western Cape, South Africa, 7784
Sponsors and Collaborators
National Institute of Allergy and Infectious Diseases (NIAID)
Sanofi
GlaxoSmithKline
Bill and Melinda Gates Foundation
Investigators
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Study Chair: Glenda Gray, MD Perinatal HIV Research Unit (PHRU), Chris Hani Baragwanath Hospital

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Responsible Party: National Institute of Allergy and Infectious Diseases (NIAID)
ClinicalTrials.gov Identifier: NCT02968849     History of Changes
Other Study ID Numbers: HVTN 702
First Posted: November 21, 2016    Key Record Dates
Last Update Posted: August 5, 2019
Last Verified: August 2019
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No
Keywords provided by National Institute of Allergy and Infectious Diseases (NIAID):
HIV
Additional relevant MeSH terms:
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Infection
MF59 oil emulsion
Adjuvants, Immunologic
Immunologic Factors
Physiological Effects of Drugs