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Combination antiretroviral treatment (cART) effectively suppresses virus replication and partially restores immune functions. However, cART cannot cure HIV infection.
This study aim to investigate whether the antiviral immune response can be enhanced and/or viral transcription reactivated with MGN1703. MGN1703 is an agonist to toll-like receptor (TLR) 9. Activation of TLR9 has been shown to augment innate and adaptive immune effector functions, most notably enhanced NK cell and T cell functions.
Furthermore, TLR9 agonists have been shown in vitro to reactivate viral transcription in latently infected cells, potentially leading to enhanced recognition of infected cells by the immune effector cells.
In Part A, participants will receive 4 weeks MGN1703 therapy (60 mg s.c. twice weekly). During the 4 weeks, participants will be closely monitored for safety and therapeutic effects of the drug. Targeted enrolment in Part A is 14-16 study subjects.
In Part B, participants will receive 24 weeks of MGN1703 therapy (60 mg s.c. twice weekly). During the 24 weeks, participants will be frequently monitored for safety and therapeutic effects of the drug. Targeted enrolment in Part B is 10-12 study subjects, preferentially recruited from part A.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| MGN1703 | Experimental | TLR-9 agonist MGN1703 administered to HIV-1 positive patients on cART |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| MGN1703 | Drug | 60 mg s.c. twice weekly for 4 weeks |
|
|
| Measure | Description | Time Frame |
|---|---|---|
| Part A: NK cell activation | As measured by CD69 expression | 12 weeks |
| Part B: Quantification of the size of the HIV reservoir | As measured by quantitative viral outgrowth (qVOA) and total HIV DNA | 32 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Safety and tolerability, as measured by adverse events (AE), adverse reactions (AR), serious adverse events (SAE), serious adverse reactions (SAR) and suspected unexpected serious adverse reactions (SUSAR). | Safety evaluation, as measured by adverse events (AE), adverse reactions (AR), serious adverse events (SAE), serious adverse reactions (SAR) and suspected unexpected serious adverse reactions (SUSAR). |
| Measure | Description | Time Frame |
|---|---|---|
| Effects of MGN1703 on T and NK cell activation in the gut | Changes in the expression of activation markers such as CD69. | 12 weeks |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Lars J Østergaard, MD,PhD,DMSc | Department for Infectious Diseases, Aarhus University Hospital, Denmark | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department for Infectious Diseases, Aarhus University Hospital | Aarhus N | 8200 | Denmark | |||
| Department for Infectious Diseases, Amager and Hvidovre Hospitals |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 30932955 | Derived | Vibholm LK, Konrad CV, Schleimann MH, Frattari G, Winckelmann A, Klastrup V, Jensen NM, Jensen SS, Schmidt M, Wittig B, Zuwala K, Mack K, Olesen R, Hua S, Lichterfeld M, Ostergaard L, Denton PW, Tolstrup M, Sogaard OS. Effects of 24-week Toll-like receptor 9 agonist treatment in HIV type 1+ individuals. AIDS. 2019 Jul 1;33(8):1315-1325. doi: 10.1097/QAD.0000000000002213. | |
| 28329286 |
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| ID | Term |
|---|---|
| C000597235 | MGN1703 |
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| MGN1703 | Drug | 60 mg s.c. twice weekly for 24 weeks |
|
|
| 12 weeks |
| The size of the HIV-1 reservoir | HIV DNA and others measures | 12 weeks |
| Viral transcription | Plasma HIV RNA and cell-associated unspliced HIV RNA | 12 weeks |
| Hvidovre |
| 2650 |
| Denmark |
| Derived |
| Vibholm L, Schleimann MH, Hojen JF, Benfield T, Offersen R, Rasmussen K, Olesen R, Dige A, Agnholt J, Grau J, Buzon M, Wittig B, Lichterfeld M, Petersen AM, Deng X, Abdel-Mohsen M, Pillai SK, Rutsaert S, Trypsteen W, De Spiegelaere W, Vandekerchove L, Ostergaard L, Rasmussen TA, Denton PW, Tolstrup M, Sogaard OS. Short-Course Toll-Like Receptor 9 Agonist Treatment Impacts Innate Immunity and Plasma Viremia in Individuals With Human Immunodeficiency Virus Infection. Clin Infect Dis. 2017 Jun 15;64(12):1686-1695. doi: 10.1093/cid/cix201. |