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| ID | Type | Description | Link |
|---|---|---|---|
| EDCTP_MSI.2009.10800.001 | Other Grant/Funding Number | EDCTP_MSI.2009.10800.001 |
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| Name | Class |
|---|---|
| Ministry of the Interior and Health, Denmark | OTHER_GOV |
| European and Developing Countries Clinical Trials Partnership (EDCTP) | OTHER_GOV |
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Treatment: Immunization with peptide-mix and adjuvant. The vaccine should induce cellular immunity against HIV-1.
Target group: Untreated healthy individuals with chronic HIV-1 infection.
Purpose: The primary purpose is to evaluate tolerability and safety of the vaccine.
The secondary purpose is to evaluate the clinical effect of the vaccination treatment as measured by induction of immunity, lowering of viral load, induction of escape mutations in the virus and improvement in the patient CD4 lymphocyte blood counts.
The third purpose is to evaluate the feasibility of conducting a therapeutic HIV immunization study in a poorly-resourced African setting.
Design: The experiment is designed as a blinded, placebo-controlled phase 1 clinical trial in HIV-1 infected individuals in West Africa.
Numbers of individuals: Phase I: 20 fully evaluable HIV-1-infected patients should enter the study (15 vaccine treated and 5 placebo(saline) treated controls).
The HIV infection does not leave lifelong immunity, but leads to break down of the immune system, opportunistic infections and death. The immunity obtained by the infection itself can only partially contain the HIV infection. The purpose with a targeted therapeutic vaccination is therefore in addition to the existing immunity to induce a broader, more powerful and more rationally or better directed immunity than the one induced by the "natural" HIV-1 infection. This would potentially lower the viral load in the blood making it more difficult to spread the virus to others and prolong the time to AIDS disease and medical treatment. There is a need for new rational vaccination possibilities, able to prevent (HIV) disease, postpone the need for antiretroviral medical treatment, prolong the life, and limit spread of HIV-1 in the population. The present protocol seak to introduce such a new immune treatment principle for HIV-1 infected individuals. In this study, individuals with chronic HIV-1 infection will be vaccinated with selected synthetic HIV immune-peptides representing new discovered conserved target´s on the virus. The vaccine should induce new immunity against several epitope targets on their HIV, whereby the HIV infection may be controlled for a longer time by the immune system. The purpose of the study is primarily to evaluate the safety and tolerability of the vaccine and secondary to evaluate the immunological and antiviral response in the vaccinated individuals.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| AFO-18 | Experimental | 18 peptides representing CD8 and CD4 epitopes mainly on HIV-1 in an adjuvants (CAF01) |
|
| Saline | Placebo Comparator | Saline |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| AFO-18 | Biological | 18 peptides representing CD8 and CD4 epitopes mainly on HIV-1 in an adjuvants (CAF01) |
|
| Measure | Description | Time Frame |
|---|---|---|
| Tolerability and Safety of the Treatment. | We report here the numbers of participants with vaccine related adverse events degree 3 or 4. Our goal for safety and tolerability was: "Fewer than or 3 patients of the 15 vaccine treated show treatment related (reaction 3) side-effects of degree 3 or 4". | up to 6 months after end of treatment |
| Measure | Description | Time Frame |
|---|---|---|
| Induction of New T-cell Immune Response by the Vaccine | induction of new T-cell immune response against one or more of the vaccine epitopes using Interferon gamma Enzyme Linked Immuno spot assay (IFNg-ELISPOT assay)measuring Spot forming Unis per 1 million periferal blood mononuclear cells (SFU/1 mio PBMCs) above treshold (> 50 sfu/mio PBMC). | up to 6 months after last immunisation |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Anders Fomsgaard, DMSc | Statens Serum Institut | Study Director |
| Zacarias Jose da Silva, PhD | Bandim Health Project, Bissau, Guinea-Bissau | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hospital Nacional Simao Mendes | Bissau | Guinea-Bissau | Guinea-Bissau | |||
| Hospital Nacional Simao Mendes |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 23634822 | Result | Roman VR, Jensen KJ, Jensen SS, Leo-Hansen C, Jespersen S, da Silva Te D, Rodrigues CM, Janitzek CM, Vinner L, Katzenstein TL, Andersen P, Kromann I, Andreasen LV, Karlsson I, Fomsgaard A. Therapeutic vaccination using cationic liposome-adjuvanted HIV type 1 peptides representing HLA-supertype-restricted subdominant T cell epitopes: safety, immunogenicity, and feasibility in Guinea-Bissau. AIDS Res Hum Retroviruses. 2013 Nov;29(11):1504-12. doi: 10.1089/AID.2013.0076. Epub 2013 Jun 21. |
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medical clinic
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| ID | Title | Description |
|---|---|---|
| FG000 | AFO-18 | 18 peptides representing 15 CD8 and 3 CD4 epitopes on HIV-1 plus 1 CD4 T helper epitope unrelated to HIV in an adjuvant (CAF01). Total 4.5 mg peptide (250 micro gram of each peptide) in CAF01 adjuvant. Total volume of 1.25 ml was injected i.m. (in m. deltoideus) at weeks 0, 2, 4, 8 |
| FG001 | Saline | Placebo was Sterile saline injection, 1.25 ml i.m. (in m. deltoideus) at each vaccination weeks 0, 2, 4, 8 |
| Title | Milestones | Reasons Not Completed | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
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| ID | Title | Description |
|---|---|---|
| BG000 | AFO-18 | 18 peptides representing CD8 and CD4 epitopes mainly on HIV-1 in an adjuvants (CAF01) |
| BG001 | Saline | Saline injection |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Tolerability and Safety of the Treatment. | We report here the numbers of participants with vaccine related adverse events degree 3 or 4. Our goal for safety and tolerability was: "Fewer than or 3 patients of the 15 vaccine treated show treatment related (reaction 3) side-effects of degree 3 or 4". | Analyzed: number of participants started minus individuals lost to follow up or participants that withdraw. Thus we include the two individuals where the physician stopped his/her participation because of SAE not related to the vaccine or to the placebo. Reported: numbers of participants with vaccina related SAE | Posted | Number | participants | up to 6 months after end of treatment |
|
6 months
One participant in the vaccinee group of 18 individuals had a SAE (serious infection) not related to the vaccine. One participant in the saline placebo group of 5 individuals experienced a SAE (increase in liver enzymes) not related to the placebo saline.
None others experienced any AE was noted.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | AFO-18 | 18 peptides representing CD8 and CD4 epitopes mainly on HIV-1 in an adjuvants (CAF01) |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Died of pneumonia | Infections and infestations | CTCAE (3.0) | Non-systematic Assessment | One participant died of severe gastroenteritis and pneumonia unrelated to the vaccine |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr Anders Fomsgaard | Statens Serum Institut | +45-32683460 | afo@ssi.dk |
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| ID | Term |
|---|---|
| D000163 | Acquired Immunodeficiency Syndrome |
| ID | Term |
|---|---|
| D015658 | HIV Infections |
| D000086982 | Blood-Borne Infections |
| D003141 | Communicable Diseases |
| D007239 | Infections |
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| ID | Term |
|---|---|
| D012965 | Sodium Chloride |
| ID | Term |
|---|---|
| D002712 | Chlorides |
| D006851 | Hydrochloric Acid |
| D017606 | Chlorine Compounds |
| D007287 | Inorganic Chemicals |
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| Saline | Drug | 1.2 ml saline intramuscularly |
|
|
| Lowering of HIV-1 RNA Viral-load in HIV-1 Immune Responders More Than 1 Log | changes (lowering) in Plasma HIV-1 RNA viral-load (measured by Quantitative RT-PCR kit, ROCHE) of more than 1 log | up to 6 months post immunization |
| Increase in Blood CD4 T-cell Counts | Analyzed: Participants (minus drop-outs and withdrawn) with measured blood CD4 T-cell counts (cells/microliter). Reported: Numbers of participants obtaining an increase in measured blood CD4 T-cell counts post vaccination of >100 CD4 Tcell per microliter | up to 6 months post vaccination |
| Bissau |
| Guinea-Bissau |
| Withdrawal by Subject |
|
| BG002 | Total | Total of all reporting groups |
| Participants |
|
| Age Continuous | Mean | Standard Deviation | years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
| Placebo |
participants receiving saline |
|
|
| Secondary | Induction of New T-cell Immune Response by the Vaccine | induction of new T-cell immune response against one or more of the vaccine epitopes using Interferon gamma Enzyme Linked Immuno spot assay (IFNg-ELISPOT assay)measuring Spot forming Unis per 1 million periferal blood mononuclear cells (SFU/1 mio PBMCs) above treshold (> 50 sfu/mio PBMC). | Analyzed: Participants minus drop-outs and withdrawn participants. Reported: numbers of participants with a new induced ELISPOT Y-cell immune response to the vaccine peptide epitopes | Posted | Number | ELISPOT responders | up to 6 months after last immunisation |
|
|
|
| Secondary | Lowering of HIV-1 RNA Viral-load in HIV-1 Immune Responders More Than 1 Log | changes (lowering) in Plasma HIV-1 RNA viral-load (measured by Quantitative RT-PCR kit, ROCHE) of more than 1 log | Participants minus drop outs and participants withdrawn by them selves or by the physicians | Posted | Number | participants with lowering of VL | up to 6 months post immunization |
|
|
|
| Secondary | Increase in Blood CD4 T-cell Counts | Analyzed: Participants (minus drop-outs and withdrawn) with measured blood CD4 T-cell counts (cells/microliter). Reported: Numbers of participants obtaining an increase in measured blood CD4 T-cell counts post vaccination of >100 CD4 Tcell per microliter | Participants minus drop-outs and withdrawn participants | Posted | Number | participants with increased CD4 count | up to 6 months post vaccination |
|
|
|
| 1 |
| 18 |
| 0 |
| 18 |
| EG001 | Saline | Saline injection | 1 | 5 | 0 | 5 |
|
| Increase in liver enzymes | Infections and infestations | CTCAE (3.0) | Non-systematic Assessment | One placebo (saline) participant got elevation of liverenzymes (unrelated to the placebo) |
|
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| D015229 |
| Sexually Transmitted Diseases, Viral |
| D012749 | Sexually Transmitted Diseases |
| D016180 | Lentivirus Infections |
| D012192 | Retroviridae Infections |
| D012327 | RNA Virus Infections |
| D014777 | Virus Diseases |
| D012897 | Slow Virus Diseases |
| D000091662 | Genital Diseases |
| D000091642 | Urogenital Diseases |
| D007153 | Immunologic Deficiency Syndromes |
| D007154 | Immune System Diseases |
| D017670 |
| Sodium Compounds |