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CompletedNCT03408262Ad4HIVUpdated Oct 16, 2024Results posted

Clinical Trial of HIV Vaccine Combinations in Healthy Men and Women

A Phase 1 interventional study of Ad4-EnvCN54 and MVA-CN54 in Human Immunodeficiency Virus, sponsored by Imperial College London. Completed at 1 site in United Kingdom. Open to participants aged 18 Years to 50 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2024-10-16.

Sponsored by Imperial College London · Phase 1, Interventional, and Prevention

Phase
Phase 1
Study type
Interventional
Enrollment
68
Allocation
Randomized
Ages
18 Years to 50 Years
Sex
All
01

Study summary

A Phase I Single-Blind randomised trial investigating immunisation strategies using Ad4-EnvCN54, MVA-CN54 and CN54gp140/MPLA combinations in order to maximise antibody responses to Human Immunodeficiency Virus

Read the detailed description

This is a randomised two-part Phase I study which will explore the impact of different boosting options (MVA-CN54 and recombinant CN54gp140 protein) for oral Adenovirus serotype 4 vector prime expressing HIV-1 CN54 envelope (Ad4-EnvCN54) designed to optimize systemic and mucosal antibody responses.

Part 1 is exploratory and designed to select conditions capable of promoting enhanced systemic and mucosal B cell responses in a limited number of participants.

Part 2 is dependent upon Part 1 and is designed to study groups selected on performance in part 1 in an expanded number of subjects. Data from both stages will be combined for safety and immunological analyses.

02

Conditions studied

03

Who can participate

Ages eligible
18 Years to 50 Years
Sexes eligible
All
Accepts healthy volunteers
Yes

Inclusion criteria

  1. Men and women aged between 18 and 50 years on the day of screening
  2. BMI between 18-30
  3. Seronegative for Adenovirus 4 serum neutralising antibodies
  4. Available for follow-up for the duration of the study
  5. Willing and able to give written informed consent
  6. At low risk of HIV infection and willing to remain so for the duration of the study defined as:

    • no history of injecting drug use in the previous ten years
    • no gonorrhoea or syphilis in the last six months
    • no high risk partner (e.g. injecting drug use, HIV positive partner) either currently or within the past six months
    • no unprotected anal or vaginal intercourse in the last six months, outside a relationship with a regular partner known to be HIV negative
  7. Willing to undergo HIV testing
  8. Willing to undergo a STI screen for chlamydia, gonorrhoea and syphilis
  9. Must agree to require male sexual partner to use condoms, from at least 14 days before the first vaccination until at least 4 months after the last
  10. If heterosexually active female capable of becoming pregnant, must (in addition to requiring male partner to use condoms) agree to use hormonal contraception, or to complete abstinence, from at least 30 days before the first vaccination until at least 4 months after the last. [Note: Acceptable hormonal contraception is combined (estrogen and progestogen containing) or progestogen-only hormonal contraception associated with inhibition of ovulation. Complete abstinence can be used, when in line with the preferred and usual lifestyle of the subject. Periodic abstinence (calendar, symptothermal, post-ovulation methods), withdrawal (coitus interruptus), spermicides only, lactational amenorrhoea method, and IUD/IUS are not acceptable methods of contraception.]
  11. If sexually active male, must agree to use condoms from the day of first vaccination until at least 4 months after the last. [Note: Additional use of an effective method of contraception is recommended for any non-pregnant female partner over the same period.]
  12. Agree to abstain from donating blood, eggs or sperm from the day of first vaccination until at least 3 months after the end of their participation in the trial
  13. Registered with a GP for at least the past month
  14. Entered and clearance obtained from The Overvolunteering Prevention System (TOPS) database

Exclusion criteria

Exclusion Criteria:

  1. Are pregnant or breast feeding, or living with anyone under the age of 5 years old or over 75 years old
  2. Have close contact with an immunocompromised individual thought to be at clinical risk from Adenovirus infection
  3. Clinically relevant abnormality on history or examination including:

    1. Liver disease with inadequate hepatic function
    2. Any skin condition which may interfere with the trial assessment of the injection sites
    3. Haematological, metabolic, gastrointestinal or cardio-pulmonary disorders
    4. Uncontrolled infection; autoimmune disease, immunodeficiency
  4. Known hypersensitivity to any component of the vaccine formulations used in this trial, or have severe or multiple allergies to drugs or pharmaceutical agents
  5. History of severe local or general reaction to vaccination defined as

    • Local: extensive, indurated redness and swelling involving most of the antero-lateral thigh or the arm, not resolving within 72 hours
    • General: fever ≥39.5oC within 48 hours; anaphylaxis; bronchospasm; laryngeal oedema; collapse; convulsions or encephalopathy within 72 hours
  6. Receipt of live attenuated vaccine within 60 days or other vaccine within 30 days of enrolment
  7. Receipt of an experimental vaccines containing HIV antigens, Ad4 and MVA-C products at any time in the past
  8. Receipt of blood products or immunoglobin within 4 months of screening, or drugs that suppress the immune system, such as steroids (including inhaled steroids, excluding topical steroids unless applied to the upper arm), in the preceding 3 months
  9. Participating in another trial of a medicinal product, completed less than 30 days prior to enrolment
  10. HIV 1 or 2 positive or indeterminate on screening
  11. Positive for antibodies to hepatitis B surface antigen, hepatitis C antibody or serology indicating active syphilis requiring treatment
  12. Clinically significant positive reaction in antinuclear antibody screen or clinically significant immunoglobulin (IgA, IgG or IgM) values
  13. Grade 1 or above clinically significant routine laboratory parameters
  14. Unable to read and/or speak English to a fluency level adequate for the full comprehension of procedures required in participation and consent
  15. Women with a history of toxic shock syndrome
  16. Women using an intrauterine device for contraception (as incompatible with softcup sampling)
  17. Any other significant disease, disorder or finding which may significantly increase the risk to the volunteer because of participation in the study, affect the ability of the volunteer to participate in the study or impair interpretation of the study data
  18. Unlikely to comply with protocol
04

Study design

Phase
Phase 1
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Participant)
Enrollment
68 participants (actual)

Study arms

  • Active comparator
    Group A

    Month 0: oral placebo Month 3: oral placebo + I.M. CN54gp140/MPLA + I.M. placebo Month 6: oral placebo + I.M. CN54gp140/MPLA + I.M. placebo

    Biological: CN54gp140/MPLA

  • Experimental
    Group B

    Month 0: Ad4-EnvCN54 Month 3: oral placebo + I.M. CN54gp140/MPLA + I.M. placebo Month 6: oral placebo + I.M. CN54gp140/MPLA + I.M. placebo

    Biological: Ad4-EnvCN54 · Biological: CN54gp140/MPLA

  • Experimental
    Group C

    Month 0: Ad4-EnvCN54 Month 3: Ad4-EnvCN54 + I.M. CN54gp140/MPLA + I.M. placebo Month 6: oral placebo + I.M. CN54gp140/MPLA + I.M. placebo

    Biological: Ad4-EnvCN54 · Biological: CN54gp140/MPLA

  • Experimental
    Group D

    Month 0: Ad4-EnvCN54 Month 3: Ad4-EnvCN54 + I.M. CN54gp140/MPLA + I.M. placebo Month 6: Ad4-EnvCN54 + I.M. CN54gp140/MPLA + I.M. placebo

    Biological: Ad4-EnvCN54 · Biological: CN54gp140/MPLA

  • Active comparator
    Group E

    Month 0: oral placebo Month 3: oral placebo + I.M. CN54gp140/MPLA + I.M. MVA-CN54 Month 6: oral placebo + I.M. CN54gp140/MPLA + I.M. MVA-CN54

    Biological: MVA-CN54 · Biological: CN54gp140/MPLA

  • Experimental
    Group F

    Month 0: Ad4-EnvCN54 Month 3: oral placebo + I.M. CN54gp140/MPLA + I.M. MVA-CN54 Month 6: oral placebo + I.M. CN54gp140/MPLA + I.M. MVA-CN54

    Biological: Ad4-EnvCN54 · Biological: MVA-CN54 · Biological: CN54gp140/MPLA

  • Experimental
    Group G

    Month 0: Ad4-EnvCN54 Month 3: Ad4-EnvCN54 + I.M. CN54gp140/MPLA + I.M. MVA-CN54 Month 6: oral placebo + I.M. CN54gp140/MPLA + I.M. MVA-CN54

    Biological: Ad4-EnvCN54 · Biological: MVA-CN54 · Biological: CN54gp140/MPLA

  • Experimental
    Group H

    Month 0: Ad4-EnvCN54 Month 3: Ad4-EnvCN54 + I.M. CN54gp140/MPLA + I.M. MVA-CN54 Month 6: Ad4-EnvCN54 + I.M. CN54gp140/MPLA + I.M. MVA-CN54

    Biological: Ad4-EnvCN54 · Biological: MVA-CN54 · Biological: CN54gp140/MPLA

Interventions

  • BiologicalAd4-EnvCN54

    Live, replication-competent adenovirus 4 vector, engineered to express the envelope glycoprotein of HIV-1 isolate 97CN54

  • BiologicalMVA-CN54

    Live, non-replicating modified vaccinia Ankara vector, engineered to express the envelope glycoprotein of HIV-1 isolate 97CN54

  • BiologicalCN54gp140/MPLA

    Recombinant glycoprotein of HIV-1 isolate 97CN54, with liposomal monophosphoryl lipid A adjuvant

    Also known as: CN54-M

05

What researchers measure

Primary outcomes

  1. Number of Participants With Mucosal Binding IgG Antibodies to HIV CN54gp140 Antigen

    Number of participants with mucosal (semen, nasal, vaginal or rectal) binding IgG antibodies to HIV CN54gp140 antigen, as determined by ELISA

    Time frame: At two weeks after the final immunisation

  2. Number of Participants With Severe or Greater (Grades 3-4) Adverse Reactions During the Study

    Number of Participants With Severe or Greater (Grades 3-4) Adverse Reactions up to twenty-four weeks after the final immunisation

    Time frame: Up to twenty-four weeks after the final immunisation

  3. Median Concentration of CN54-gp140 Specific IgG Binding Antibodies

    Median concentration of CN54-gp140 specific IgG binding antibodies, as measured by ELISA. Concentration is in ng/mL

    Time frame: At two weeks after the final immunisation

Secondary outcomes

  1. Number of Participants With Detectable Serum Binding Antibodies to HIV CN54gp140 Antigen

    Number of participants with detectable serum binding antibodies to HIV CN54gp140 antigen, as measured by IgG binding ELISA

    Time frame: At two weeks post-final immunisation

06

Results

Posted Oct 16, 2024

Participant flow

Participant flow — Overall Study
MilestoneGroup AGroup BGroup CGroup DGroup EGroup FGroup GGroup H
Started1566136697
Completed1166126666
Not completed40010031

Outcome measures

PrimaryNumber of Participants With Mucosal Binding IgG Antibodies to HIV CN54gp140 Antigen

Number of participants with mucosal (semen, nasal, vaginal or rectal) binding IgG antibodies to HIV CN54gp140 antigen, as determined by ELISA

Time frame:
At two weeks after the final immunisation
Reported as:
Count of participants · Participants
Number of Participants With Mucosal Binding IgG Antibodies to HIV CN54gp140 Antigen
ParticipantsGroup AGroup BGroup CGroup DGroup EGroup FGroup GGroup H
Number of Participants With Mucosal Binding IgG Antibodies to HIV CN54gp140 Antigen03160121
PrimaryNumber of Participants With Severe or Greater (Grades 3-4) Adverse Reactions During the Study

Number of Participants With Severe or Greater (Grades 3-4) Adverse Reactions up to twenty-four weeks after the final immunisation

Time frame:
Up to twenty-four weeks after the final immunisation
Reported as:
Count of participants · Participants
Number of Participants With Severe or Greater (Grades 3-4) Adverse Reactions During the Study
ParticipantsGroup AGroup BGroup CGroup DGroup EGroup FGroup GGroup H
Number of Participants With Severe or Greater (Grades 3-4) Adverse Reactions During the Study10100103
PrimaryMedian Concentration of CN54-gp140 Specific IgG Binding Antibodies

Median concentration of CN54-gp140 specific IgG binding antibodies, as measured by ELISA. Concentration is in ng/mL

Time frame:
At two weeks after the final immunisation
Reported as:
Median · ng/mL
Median Concentration of CN54-gp140 Specific IgG Binding Antibodies
ng/mLGroup AGroup BGroup CGroup DGroup EGroup FGroup GGroup H
Median Concentration of CN54-gp140 Specific IgG Binding Antibodies464 (23 to 1521)14141 (3971 to 18348)8992 (3798 to 79435)11367 (398 to 26149)6280 (1102 to 15044)9639 (3250 to 14282)20512 (10583 to 36552)9041 (4735 to 21023)
SecondaryNumber of Participants With Detectable Serum Binding Antibodies to HIV CN54gp140 Antigen

Number of participants with detectable serum binding antibodies to HIV CN54gp140 antigen, as measured by IgG binding ELISA

Time frame:
At two weeks post-final immunisation
Reported as:
Count of participants · Participants
Number of Participants With Detectable Serum Binding Antibodies to HIV CN54gp140 Antigen
ParticipantsGroup AGroup BGroup CGroup DGroup EGroup FGroup GGroup H
Number of Participants With Detectable Serum Binding Antibodies to HIV CN54gp140 Antigen765116666

Adverse events

Collected over 12 months. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Group A0/12 (0%)1/12 (8.3%)6/12 (50%)
Group B0/6 (0%)0/6 (0%)3/6 (50%)
Group C0/6 (0%)1/6 (16.7%)2/6 (33.3%)
Group D0/12 (0%)0/12 (0%)9/12 (75%)
Group E0/6 (0%)0/6 (0%)3/6 (50%)
Group F0/6 (0%)1/6 (16.7%)3/6 (50%)
Group G0/6 (0%)0/6 (0%)3/6 (50%)
Group H0/6 (0%)3/6 (50%)5/6 (83.3%)
Most frequent serious events
Most frequent serious events
EventGroup AGroup BGroup CGroup DGroup EGroup FGroup GGroup H
UTI on Kidney stonesRenal and urinary disorders0/120/60/60/120/60/60/61/6
PalpitationsCardiac disorders0/120/60/60/120/60/60/61/6
Blood loss anaemiaBlood and lymphatic system disorders0/120/60/60/120/60/60/61/6
Haematemesis secondary to Mallory WeissGastrointestinal disorders0/120/60/60/120/60/60/61/6
ConcussionGeneral disorders0/120/60/60/120/60/60/61/6
Cellulitis on handSkin and subcutaneous tissue disorders0/120/61/60/120/60/60/60/6
DiverticulitisGastrointestinal disorders0/120/60/60/120/61/60/60/6
Depressive Disorder Triggering OverdosePsychiatric disorders1/120/60/60/120/60/60/60/6
Most frequent other events
Showing 10 of 44
Most frequent other events
EventGroup AGroup BGroup CGroup DGroup EGroup FGroup GGroup H
Rhinorrhoea/nasopharyngitis/rhinitis/cold/upper respiratory tract infectionRespiratory, thoracic and mediastinal disorders4/122/62/64/121/61/63/61/6
VomitingGastrointestinal disorders0/120/60/60/120/60/60/62/6
MyalgiaGeneral disorders0/121/60/60/120/60/60/60/6
Tenderness left armProduct Issues0/121/60/60/120/60/60/60/6
CoughRespiratory, thoracic and mediastinal disorders0/121/60/60/120/60/60/60/6
Anal haemorrhageGastrointestinal disorders0/120/61/60/120/60/60/60/6
DizzinessGeneral disorders0/120/61/60/120/61/60/61/6
HeadacheGeneral disorders0/121/61/61/121/60/61/60/6
Right wrist synovialcyst surgical removalSurgical and medical procedures0/120/61/60/120/60/60/60/6
PyrexiaGeneral disorders0/120/61/60/120/60/60/60/6

Baseline characteristics

Healthy male or female adults, 18 to 50 years of age, at low risk for HIV infection.

Age, Categorical
Age, Categorical(Participants)Group AGroup BGroup CGroup DGroup EGroup FGroup GGroup HTotal
<=18 years000000000
Between 18 and 65 years156613669768
>=65 years000000000
Sex: Female, Male
Sex: Female, Male(Participants)Group AGroup BGroup CGroup DGroup EGroup FGroup GGroup HTotal
Female7236224329
Male8437445439
Race/Ethnicity, Customized
Race/Ethnicity, Customized(Participants)Group AGroup BGroup CGroup DGroup EGroup FGroup GGroup HTotal
White British7333254128
White Irish000000000
Any other white background5003402317
Indian110101004
Pakistani000100001
Bangladeshi000000000
Any other Asian background010200126
Mixed White and Black Caribbean000100001
Mixed White and Black African100000001
Mixed White and Asian000000000
Any other Mixed background000100012
Black Caribbean101000103
Black African012000104
Any other Black background000100001
Region of Enrollment
Region of Enrollment(participants)Group AGroup BGroup CGroup DGroup EGroup FGroup GGroup HTotal
United Kingdom156613669768
Number of participants with CN54-gp140 IgG antibodies at time of vaccination
Number of participants with CN54-gp140 IgG antibodies at time of vaccination(Participants)Group AGroup BGroup CGroup DGroup EGroup FGroup GGroup HTotal
Count of participants000000000
07

Study locations

1 site
  • NIHR Imperial Clinical Research Facility
    London, W12 0HS, United Kingdom
08

References and documents

Study documents

  • Study protocol · Nov 1, 2019
  • Statistical analysis plan · Jul 20, 2021

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: No

09

Registry details

Key details

Study ID
NCT03408262
Lead sponsor
Imperial College London
Responsible party
Sponsor
First posted
Jan 23, 2018
Start date
Oct 6, 2017
Primary completion
Feb 10, 2020
Completion
Feb 10, 2020
Results posted
Oct 16, 2024
Last update
Oct 16, 2024

Study contacts

David Lewis, MD
principal investigator · Imperial College London

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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