- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00080106
Effectiveness of and Immune Response to HIV Vaccination Followed by Treatment Interruption in HIV Infected Patients
A Phase II Double-Blind, Randomized, Placebo-Controlled Study to Evaluate the Antiretroviral Effect of Immunization With the MRK Ad5 HIV-1 Gag Vaccine in HIV-1 Infected Individuals Who Interrupt Antiretroviral Therapy
HIV vaccines may help the immune systems of HIV infected patients better control the virus. The goal of this study is to determine whether patients on anti-HIV medications can stop taking those medications if they receive an HIV vaccine. While taking anti-HIV medications, participants will receive either an HIV vaccine or a placebo. Participants will then stop taking their anti-HIV medications and the study will compare the viral loads of participants who received the vaccine with the viral loads of participants who received the placebo.
Primary study hypotheses: 1)The Week 12 and Week 16 post-ART interruption geometric mean HIV-1 RNA levels will be lower among participants who had received MRK Ad5 vaccine prior to ART interruption than among participants who received placebo; 2) the time averaged area under the curve of the log10 HIV-1 RNA copies/ml versus day function in the 16 week post-ART interruption step will be lower among participants who received the MRK Ad5 vaccine prior to ART interruption than among participants who receive placebo.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Antiretroviral therapy (ART) has a significant impact on HIV disease; however, HIV cannot be cured with current drug regimens. While the majority of patients initially benefit from ART, drug regimens subsequently fail for many patients due to drug resistance, poor adherence, or toxicity. If given while HIV replication is kept in check by ART, an HIV vaccine may be able to generate an effective long-term immune response capable of controlling the virus, even if ART is discontinued.
The MRK Ad5 HIV-1 gag vaccine uses a replication-defective adenovirus vector and has been found safe in clinical trials of both HIV infected and HIV uninfected adults. This study will evaluate the ability of immunization with the MRK Ad5 HIV-1 gag vaccine to control HIV replication in individuals undergoing treatment interruption. The study will enroll individuals whose HIV replication has been successfully suppressed with ART for at least 2 years.
Participants in this study will be randomly assigned to receive either vaccine or placebo. Both vaccine and placebo will be injected into the upper arm muscle. Participants will take their antiretroviral medications during the first 3 months of the study. Injections will be given on Day 1, Week 4, and Week 26. A study nurse will call participants 1 or 2 days after each injection and participants will be asked to fill out a card with any reactions they have to the injections. About 3 months after the third injection, participants will stop taking their antiretroviral medications for 4 months. Participants will have study visits every 2 to 3 weeks while off medication. After 4 months, participants will have the option of restarting antiretroviral medications or continuing without medication. Participants will then have study visits every 2 months for 8 months. Study visits will include physical exams and blood collection.
All participants will continue to see their primary care provider for HIV treatment and will be restarted on antiretroviral medications if clinically indicated. Participants or their primary care provider will be contacted by phone for updates every 6 months for an additional 3.5 years.
Study Type
Enrollment (Actual)
Phase
- Phase 2
Contacts and Locations
Study Locations
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San Juan, Puerto Rico, 00935
- Puerto Rico-AIDS CRS
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California
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Los Angeles, California, United States, 90035
- UCLA CARE Center CRS
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Palo Alto, California, United States, 94304-5350
- Stanford CRS
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Sacramento, California, United States, 95817
- Univ. of California Davis Med. Ctr., ACTU
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San Diego, California, United States, 92103
- Ucsd, Avrc Crs
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San Francisco, California, United States, 94110
- Ucsf Aids Crs
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Florida
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Miami, Florida, United States, 33136
- Univ. of Miami AIDS CRS
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Hawaii
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Honolulu, Hawaii, United States, 96816
- Univ. of Hawaii at Manoa, Leahi Hosp.
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Illinois
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Chicago, Illinois, United States, 60612
- Rush Univ. Med. Ctr. ACTG CRS
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Indiana
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Indianapolis, Indiana, United States, 46202-5250
- Indiana Univ. School of Medicine, Infectious Disease Research Clinic
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Maryland
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Baltimore, Maryland, United States, 21201
- IHV Baltimore Treatment CRS
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Massachusetts
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Boston, Massachusetts, United States, 02114
- Massachusetts General Hospital ACTG CRS
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Boston, Massachusetts, United States, 02215
- Beth Israel Deaconess Med. Ctr., ACTG CRS
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Minnesota
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Minneapolis, Minnesota, United States, 55455
- University of Minnesota, ACTU
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Missouri
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Saint Louis, Missouri, United States, 63110
- Washington U CRS
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New York
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New York, New York, United States, 10003
- Beth Israel Med. Ctr., ACTU
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New York, New York, United States, 10016
- NY Univ. HIV/AIDS CRS
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New York, New York, United States, 10021
- Cornell CRS
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Rochester, New York, United States, 14642
- Univ. of Rochester ACTG CRS
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Rochester, New York, United States, 14607
- AIDS Care CRS
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North Carolina
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Chapel Hill, North Carolina, United States, 27514
- Unc Aids Crs
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Ohio
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Cleveland, Ohio, United States, 44106
- Case CRS
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Cleveland, Ohio, United States, 44109
- MetroHealth CRS
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Columbus, Ohio, United States, 43210
- The Ohio State University Medical Center
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Pennsylvania
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Pittsburgh, Pennsylvania, United States, 15213
- Pitt CRS
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Rhode Island
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Providence, Rhode Island, United States, 02906
- The Miriam Hosp. ACTG CRS
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Texas
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Galveston, Texas, United States
- Univ. of Texas Medical Branch, ACTU
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Washington
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Seattle, Washington, United States, 98104
- University of Washington AIDS CRS
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria
- HIV infected
- On a stable antiretroviral medication regimen (no changes to treatment within 4 weeks of study entry)
- Viral load less than 50 copies/ml
- Viral suppression for 2 years prior to study entry (documented viral loads less than 500 copies/ml)
- CD4 count of 500 cells/mm3 or greater
- Ad5 neutralizing antibody less than 200 units at screening
- Willing to stop antiretroviral medications for at least 16 weeks post-vaccination
- Hepatitis B surface antigen negative
- Weight more than 110 lbs
- Willing to use acceptable methods of contraception
Exclusion Criteria
- Two consecutive viral loads of 500 copies/ml or greater at least 14 days apart during the 24 months prior to study entry
- Two consecutive CD4 counts less than 200 cells/mm3 before starting antiretroviral medications
- History of anaphylaxis
- Allergy to vaccine components
- History of cardiac, pulmonary, gastrointestinal, hepatic, renal, pancreatic, or neurologic disease which, in the opinion of the study official, will compromise study participation
- Pregnancy or breastfeeding
- Contraindication to intramuscular injection, such as anticoagulant therapy or thrombocytopenia
- Immune globulin or blood products within 3 months prior to study entry
- Live vaccine within 30 days prior to study entry
- Inactivated vaccine within 14 days prior to study entry
- Previous HIV vaccine
- History of an AIDS-defining illness. Patients with a history of Kaposi's sarcoma limited to the skin may participate.
- Currently taking drugs or other substances not approved by the FDA. Patients may be on antiretroviral agents not yet approved by the FDA as part of a clinical trial or through an expanded access program.
- Immunomodulatory agents (interferon, IL-2, GM-CSF, systemic corticosteroids, etc.) within 30 days prior to study entry
- Active alcohol or substance abuse which may interfere with the study
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
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Experimental: 1
Participants in the experimental arm will receive the MRK Ad5 HIV-1 gag vaccine on Day 1, Week 4 and Week 26.
Participants will take their antiretroviral medications during the first 3 months of the study.
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MRK Ad5 HIV-1 gag vaccine injected into the upper arm muscle.
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Placebo Comparator: 2
Participants in Arm 2 will receive a placebo vaccine on Day 1, Week 4 and Week 26.
Participants will take their antiretroviral medications during the first 3 months of the study.
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MRK Ad5 HIV-1 gag placebo vaccine injected into the upper arm muscle.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
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Analytical treatment interruption (ATI) HIV-1 RNA set-point
Time Frame: Throughout study
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Throughout study
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ATI log10 HIV-1 RNA copies/ml at all scheduled evaluations during Step II (ATI)
Time Frame: Throughout Step 2
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Throughout Step 2
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Collaborators and Investigators
Investigators
- Study Chair: Robert T. Schooley, MD, University of Colorado, Denver
Publications and helpful links
General Publications
- Shiver JW, Fu TM, Chen L, Casimiro DR, Davies ME, Evans RK, Zhang ZQ, Simon AJ, Trigona WL, Dubey SA, Huang L, Harris VA, Long RS, Liang X, Handt L, Schleif WA, Zhu L, Freed DC, Persaud NV, Guan L, Punt KS, Tang A, Chen M, Wilson KA, Collins KB, Heidecker GJ, Fernandez VR, Perry HC, Joyce JG, Grimm KM, Cook JC, Keller PM, Kresock DS, Mach H, Troutman RD, Isopi LA, Williams DM, Xu Z, Bohannon KE, Volkin DB, Montefiori DC, Miura A, Krivulka GR, Lifton MA, Kuroda MJ, Schmitz JE, Letvin NL, Caulfield MJ, Bett AJ, Youil R, Kaslow DC, Emini EA. Replication-incompetent adenoviral vaccine vector elicits effective anti-immunodeficiency-virus immunity. Nature. 2002 Jan 17;415(6869):331-5. doi: 10.1038/415331a.
- Ortiz GM, Wellons M, Brancato J, Vo HT, Zinn RL, Clarkson DE, Van Loon K, Bonhoeffer S, Miralles GD, Montefiori D, Bartlett JA, Nixon DF. Structured antiretroviral treatment interruptions in chronically HIV-1-infected subjects. Proc Natl Acad Sci U S A. 2001 Nov 6;98(23):13288-93. doi: 10.1073/pnas.221452198. Epub 2001 Oct 30.
- Moss RB, Brandt C, Giermakowska WK, Savary JR, Theofan G, Zanetti M, Carlo DJ, Wallace MR. HIV-specific immunity during structured antiviral drug treatment interruption. Vaccine. 2003 Mar 7;21(11-12):1066-71. doi: 10.1016/s0264-410x(02)00610-2.
- Schooley RT, Spritzler J, Wang H, Lederman MM, Havlir D, Kuritzkes DR, Pollard R, Battaglia C, Robertson M, Mehrotra D, Casimiro D, Cox K, Schock B; AIDS Clinical Trials Group 5197 Study Team. AIDS clinical trials group 5197: a placebo-controlled trial of immunization of HIV-1-infected persons with a replication-deficient adenovirus type 5 vaccine expressing the HIV-1 core protein. J Infect Dis. 2010 Sep 1;202(5):705-16. doi: 10.1086/655468.
- Li JZ, Heisey A, Ahmed H, Wang H, Zheng L, Carrington M, Wrin T, Schooley RT, Lederman MM, Kuritzkes DR; ACTG A5197 Study Team. Relationship of HIV reservoir characteristics with immune status and viral rebound kinetics in an HIV therapeutic vaccine study. AIDS. 2014 Nov 28;28(18):2649-57. doi: 10.1097/QAD.0000000000000478.
- Li JZ, Christensen JA, Wang H, Spritzler J, Kuritzkes DR; AIDS Clinical Trials Group A5197 Study Team. Evaluation of HIV-1 ambiguous nucleotide frequency during antiretroviral treatment interruption. J Acquir Immune Defic Syndr. 2012 Sep 1;61(1):19-22. doi: 10.1097/QAI.0b013e318264460f.
- Li JZ, Brumme CJ, Lederman MM, Brumme ZL, Wang H, Spritzler J, Carrington M, Medvik K, Walker BD, Schooley RT, Kuritzkes DR; AIDS Clinical Trials Group A5197 Study Team. Characteristics and outcomes of initial virologic suppressors during analytic treatment interruption in a therapeutic HIV-1 gag vaccine trial. PLoS One. 2012;7(3):e34134. doi: 10.1371/journal.pone.0034134. Epub 2012 Mar 30.
- Li JZ, Brumme ZL, Brumme CJ, Wang H, Spritzler J, Robertson MN, Lederman MM, Carrington M, Walker BD, Schooley RT, Kuritzkes DR; AIDS Clinical Trials Group A5197 Study Team. Factors associated with viral rebound in HIV-1-infected individuals enrolled in a therapeutic HIV-1 gag vaccine trial. J Infect Dis. 2011 Apr 1;203(7):976-83. doi: 10.1093/infdis/jiq143. Erratum In: J Infect Dis. 2011 Aug;204(4):664.
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- RNA Virus Infections
- Virus Diseases
- Infections
- Blood-Borne Infections
- Communicable Diseases
- Sexually Transmitted Diseases, Viral
- Sexually Transmitted Diseases
- Lentivirus Infections
- Retroviridae Infections
- Immunologic Deficiency Syndromes
- Immune System Diseases
- HIV Infections
- Physiological Effects of Drugs
- Immunologic Factors
- Vaccines
Other Study ID Numbers
- A5197
- 10014 (Other Identifier: CTEP)
- ACTG A5197
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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