- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00798265
A Phase I Study of Quadrivalent Human Papilloma Virus (HPV) (Types 6, 11, 16, 18) Recombinant Vaccine in HIV-Infected and HIV-Negative Pre-Adolescents, Adolescents, and Young Adults
A Phase I Study of Quadrivalent Human Papilloma Virus (HPV) (Types 6, 11, 16, 18) Recombinant Vaccine in HIV-Infected and HIV-Negative Pre-Adolescents, Adolescents and Young Adults
Background:
- Human papilloma virus (HPV) is a common sexually transmitted disease. There are more than 100 different HPV types, and both males and females can get HPV infection. Most people do not have any symptoms when they become infected and are able to get rid of the infection on their own. However, they can still become re-infected with the same or a different HPV type, and in some people HPV infection persists.
- Persistent HPV infection is associated with the development of precancerous lesions and cancer. HPV types are classified as either high risk or low risk based on whether their persistence will lead to cancer.
- Patients who have suppressed immune systems are at a higher risk for HPV-related complications. They are more likely to contract multiple HPV types and have more persistent infection that can lead to precancerous lesions or cancer, which are then difficult to treat and often recur.
- A recently approved vaccine for HPV induces immunity to HPV 6, 11, 16, and 18. It was shown to be highly effective in preventing infection with these HPV types, and is approved for use in females 9 to 26 years of age. However, much less is known about the vaccine s ability to induce immunity in males or individuals with suppressed immune systems.
Objectives:
- To investigate whether the HPV vaccine is safe to give and able to induce immunity in both female and male adolescents and young adults with HIV infection compared to healthy, HIV-negative persons of the same age.
Eligibility:
- Males and females, 12 to 26 years of age, divided into three groups: (1) Healthy and HIV-negative, (2) HIV-positive and on antiretroviral therapy, and (3) HIV-positive and not on antiretroviral therapy.
Design:
- Before beginning vaccination, participants will have a complete physical examination and blood drawn for routine blood tests, special tests of the immune system, antibody tests, and an HIV test.
- HPV vaccine will be given by injection into the muscle at 0, 2, and 6 months, according to the standard vaccination schedule.
- Patients with HIV infection will be monitored for a week following the first injection to test the level of HIV in the blood 3 days and 5 days after the first injection.
- Participants will also be asked to fill out a 10- to 15-minute Web-based survey about awareness, health behaviors, and personal choices related to risk factors for HIV, HPV, and other sexually transmitted diseases. Participants are not required to fill out the survey to receive the vaccine.
- The total duration of the study is 4 years. During the first year of the study, participants will return for six additional 1-day visits at months 1, 2, 3, 6, 7, and 12. Participants will return for 1-day visits every 6 months for the remaining 3 years.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Background:
Human papilloma virus (HPV) is one of the most common sexually transmitted diseases and a significant cause of cutaneous genital warts and anogenital cancer.
Infection with high-risk, oncogenic HPV types, most commonly types 16 and 18, is associated with low and high-grade cervical cellular abnormalities that are precursors to invasive cervical cancer, as well as vulvar and anal cancer, while HPV types 6 and 11 are associated with genital warts.
Persistence of HPV infection is more common in individuals with or at risk for chronic immunosuppression and HIV-infected individuals have a higher prevalence of HPV infection and HPV-associated anogential disease compared to age-matched HIV-negative controls.
Study Objectives:
To assess the safety and immunogenicity of quadrivalent human papillomavirus (types 6, 11, 16, 18) recombinant vaccine in HIV-infected preadolescents, adolescents and young adults 12-26 years of age.
To determine whether there are differences in HPV vaccine immunogenicity between HIV-infected and HIV negative age-matched controls.
To determine whether there are differences in HPV vaccine immunogenicity between HIV-infected patients receiving highly active antiretroviral therapy (HAART) and those not receiving HAART with similar CD4 and viral load parameters at entry.
To determine whether HPV vaccination alters HIV-1 RNA levels.
To investigate the impact of CD4 count and HIV-1 RNA levels on HPV vaccine immunogenicity.
To characterize HPV DNA positivity in the study cohort populations through oral/buccal and anogenital sampling at baseline.
To characterize HPV and HIV knowledge and risk and sexual behaviors in the study cohort populations.
Eligibility:
Individual Cohorts
Cohort 1: HIV-positive, CD4 cell count greater than or equal to 350 cells/mm3, HIV-1 RNA level by RT PCR less than or equal to 20,000 copies/ml, on stable HAART regimen for greater than or equal to 6 months.
Cohort 2: HIV-infected, CD4 cell count greater than or equal to 500 cells/mm3, HIV-1 RNA level by RT PCR less than or equal to 20,000 copies/ml, on no antiretroviral treatment.
Cohort 3: healthy, HIV-negative controls All Cohorts
Females and males age 12 to 26 years
Patients must have a hemoglobin greater than or equal to 10.0 gm/dL, neutrophil count (ANC) greater than or equal to 1500/mm3, platelet count greater than or equal to 75,000/mm3 and PT or PTT less than or equal to 1.5x ULN (with the exception of patients with known clotting disorders or lupus anticoagulant); SGPT/SGOT < 2/5x ULN, total bilirubin less than or equal to 1.5x ULN unless attributable to protease inhibitor therapy.
Patients must test negative for hepatitis B virus and hepatitis C virus, unless the result is consistent with prior vaccination or prior infection with full recovery.
No use of investigational agents within 4 weeks of study enrollment or use of immunosuppressive or immunomodulating agents within 8 weeks of study entry.
Study Design:
This is a non-randomized, prospective, phase I study of quadrivalent human papillomavirus (types 6, 11, 16, 18) recombinant vaccine.
The study includes 3 cohorts of pre-adolescents, adolescents and young adults 12-26 years of age as outlined under Eligibility Criteria. Each cohort will enroll 35 patients.
All study subjects will receive three doses of HPV vaccine at 0, 2 and 6 months administered IM.
Study participants will be monitored at months 0, 1, 2, 3, 6, 7, and 12 (+/- 2 weeks for each visit, and every 6 months (+/- 30 days) thereafter for 48 months total.
Study Type
Enrollment (Actual)
Phase
- Phase 1
Contacts and Locations
Study Locations
-
-
Maryland
-
Bethesda, Maryland, United States, 20892
- National Institutes of Health Clinical Center, 9000 Rockville Pike
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
- ELIGIBILITY CRITERIA:
Cohort 1 Inclusion and Exclusion Eligibility Criteria:
INCLUSION CRITERIA:
2.1.1.1 Age 12 to 26 years
2.1.1.2 Females and males
2.1.1.3 HIV-positive
2.1.1.4 CD4 cell count and HIV-1 RNA level parameters
- CD4 cell count greater than or equal to 350 cells/mm(3)
- HIV-1 RNA level by RT PCR less than or equal to 20,000 copies/ml
2.1.1.5 On stable HAART regimen for greater than or equal to 6 months with CD4 and viral load parameters as outlined in 2.1.1.4
2.1.1.6 Patients greater than or equal to 18 years willing to provide informed consent or parent/guardian willing to provide informed consent for minor children less than 18 years of age.
2.1.1.7 Informed assent for patients 12-17 years of age (Optional at the discretion of the Principal Investigator and Parent/Guardian based on maturity level of minor)
2.1.1.8 Willing to use acceptable forms of contraception, if applicable, or abstinence to prevent pregnancy.
EXCLUSION CRITERIA:
2.1.1.9 Any of the following hematologic abnormalities
- Hemoglobin less than 10.0 g/dL
- Neutrophil count less than 1500/mm(3)
- Platelet count less than 75,000/mm(3)
- PT or PTT greater than or equal to 1.5 times ULN (with the exception of patients with known clotting disorders or known lupus anticoagulant).
2.1.1.10 Any of the following hepatic abnormalities
- ALT/SGPT and/or AST/SGOT greater than 2.5 times ULN
- Total bilirubin greater than 1.5 times ULN unless attributable to protease inhibitor therapy.
2.1.1.11 Positive tests (antibody and/or antigen) for hepatitis B and hepatitis C viruses, unless the result is consistent with prior vaccination or prior infection with full recovery.
2.1.1.12 Acute infection requiring therapy at time of enrollment. Participants may be eligible for study after being on stable and appropriate anti-infective therapy.
2.1.1.13 Chemotherapy for active cancer.
2.1.1.14 Documented history of non-adherence to antiretroviral treatment regimen within 12 months of study entry.
2.1.1.15 Pregnancy or breastfeeding.
2.1.1.16 Use of immunosuppressive or immunomodulating agents within 8 weeks of study enrollment. Note: patients receiving oral corticosteroids for management of asthma or contact hypersensitivity for less than or equal to 14 days in duration will be allowed to enroll as long as it has been greater than or equal to 30 days since oral corticosteroid administration.
2.1.1.17 Known immediate hypersensitivity to yeast or any of the vaccine components.
2.1.1.18 Use of investigational agents within 4 weeks prior to study enrollment.
2.1.1.19 Active external genital warts requiring treatment or CIN2/3
2.1.1.20 Any clinically significant diseases (other than HIV infection) or findings during study screening that, in the opinion of the Principal Investigator or Lead Associate Investigator, may interfere with the study.
Cohort 2 Inclusion and Exclusion Eligibility Criteria:
Inclusion Criteria
2.1.2.1 Age 12 to 26 years
2.1.2.2 Females and males
2.1.2.3 HIV-positive
2.1.2.4 CD4 cell count and HIV-1 RNA level parameters
- CD4 cell count greater than or equal to 500 cells/mm(3)
- HIV-1 RNA level by RT PCR less than or equal to 20,000 copies/ml.
2.1.2.5 Not receiving antiretroviral treatment with CD4 and viral load parameters as outlined in 2.1.2.4.
2.1.2.6 Patients greater than or equal to 18 years willing to provide informed consent or parent/guardian willing to provide informed consent for minor children less than 18 years of age.
2.1.2.7 Informed assent for patients 12-17 years of age (Optional at the discretion of the Principal Investigator and Parent/Guardian based on maturity level of minor)
2.1.2.8 Willing to use acceptable forms of contraception, if applicable, or abstinence to prevent pregnancy.
EXCLUSION CRITERIA:
2.1.2.9 Any of the following hematologic abnormalities:
- Hemoglobin less than 10.0 g/dL
- Neutrophil count less than 1500/mm(3)
- Platelet count less than 75,000/mm(3)
- PT or PTT greater than or equal to 1.5 times ULN (with the exception of patients with known clotting disorders or known lupus anticoagulant).
2.1.2.10 Any of the following hepatic abnormalities
- ALT/SGPT and/or AST/SGOT greater than 2.5 times ULN
- Total bilirubin greater than 1.5 times ULN unless attributable to protease inhibitor therapy.
2.1.2.11 Positive tests (antibody and/or antigen) for hepatitis B and hepatitis C viruses, unless the result is consistent with prior vaccination or prior infection with full recovery.
2.1.2.12 Acute infection requiring therapy at time of enrollment. Participants may be eligible for study after being on stable and appropriate anti-infective therapy.
2.1.2.13 Chemotherapy for active cancer.
2.1.2.14 Pregnancy or breastfeeding.
2.1.2.15 Use of immunosuppressive or immunomodulating agents within 8 weeks prior to study enrollment. Note: patients receiving oral corticosteroids for management of asthma or contact hypersensitivity for less than or equal to 14 days in duration will be allowed to enroll as long as it has been greater than or equal to 30 days since oral corticosteroid administration.
2.1.2.16 Known immediate hypersensitivity to yeast or any of the vaccine components.
2.1.2.17 Use of investigational agents within 4 weeks prior to study enrollment.
2.1.2.18 Active external genital warts requiring treatment or CIN2/3
2.1.2.19 Any clinically significant diseases (other than HIV infection) or findings during study screening that, in the opinion of the Principal Investigator or Lead Associate Investigator may interfere with the study.
Cohort 3 Inclusion and Exclusion Eligibility Criteria:
INCLUSION CRITERIA:
2.1.3.1 Age 12 to 26 years
2.1.3.2 Females and males
2.1.3.3 HIV-negative
2.1.3.4 Patients greater than or equal to 18 years willing to provide informed consent or parent/guardian willing to provide informed consent for minor children less than 18 years of age.
2.1.3.5 Informed assent for patients 12-17 years of age (Optional at the discretion of the Principal Investigator and Parent/Guardian based on maturity level of minor)
2.1.3.6 Willing to use acceptable forms of contraception, if applicable, or abstinence to prevent pregnancy.
EXCLUSION CRITERIA:
2.1.3.7 Any of the following hematologic abnormalities:
- Hemoglobin less than 10.0 g/dL
- Neutrophil count less than 1500/mm(3)
- Platelet count less than 75,000/mm(3)
- PT or PTT greater than or equal to 1.5 times ULN (with the exception of patients with known clotting disorders or known lupus anticoagulant).
2.1.3.8 Any of the following hepatic abnormalities
- ALT/SGPT and/or AST/SGOT greater than 2.5 times ULN
- Total Bilirubin greater than 1.5 times ULN unless attributable to protease inhibitor therapy.
2.1.3.9 Positive tests (antibody and/or antigen) for HIV, hepatitis B and hepatitis C viruses, unless the result is consistent with prior vaccination or prior infection with full recovery.
2.1.3.10 Acute infection requiring therapy at time of enrollment. Participants may be eligible for study after being on stable and appropriate anti-infective therapy.
2.1.3.11 Chemotherapy for active cancer.
2.1.3.12 Pregnancy or breastfeeding
2.1.3.13 Use of immunosuppressive or immunomodulating agents within 8 weeks prior to study enrollment. Note: patients receiving oral corticosteroids for management of asthma or contact hypersensitivity for less than or equal to 14 days in duration will be allowed to enroll as long as it has been greater than or equal to 30 days since oral corticosteroid administration.
2.1.3.14 Known immediate hypersensitivity to yeast or any of the vaccine components.
2.1.3.15 Use of investigational agents within 4 weeks prior to study enrollment.
2.1.3.16 Active external genital warts requiring treatment or CIN2/3
2.1.3.17 Any clinically significant diseases or findings during study screening that, in the opinion of the Principal Investigator or Lead Associate Investigator may interfere with the study.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: 1
.5 mL dose injected IM at 0, 2 and 6 months (+/- 2 weeks) and knowledge survey at week 0
|
.5 mL dose injected IM at 0, 2 and 6 months
Administration of online risk behavior and knowledge survey done at week 0.
|
Experimental: 2
.5 mL dose injected IM at 0, 2 and 6 months (+/- 2 weeks) and knowledge survey at week 0
|
.5 mL dose injected IM at 0, 2 and 6 months
Administration of online risk behavior and knowledge survey done at week 0.
|
Active Comparator: 3
.5 mL dose injected IM at 0, 2 and 6 months (+/- 2 weeks) and knowledge survey at week 0
|
.5 mL dose injected IM at 0, 2 and 6 months
Administration of online risk behavior and knowledge survey done at week 0.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
To assess the immunogenicity and safety of the quadrivalent human papillomavirus recombinant vaccine in HIV- infected preadolescents, adolescents and young adults 12-26 years of age
Time Frame: screening and months 1, 2, 3, 6, 7, 12, 18, 24, 30, 36, 42 and 48 post first vaccination
|
Assessment of adverse events, their characteristics, duration and quantity for the entire study population.
|
screening and months 1, 2, 3, 6, 7, 12, 18, 24, 30, 36, 42 and 48 post first vaccination
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Hoyoung M Maeng, M.D., National Cancer Institute (NCI)
Publications and helpful links
General Publications
- Munoz N, Bosch FX, de Sanjose S, Herrero R, Castellsague X, Shah KV, Snijders PJ, Meijer CJ; International Agency for Research on Cancer Multicenter Cervical Cancer Study Group. Epidemiologic classification of human papillomavirus types associated with cervical cancer. N Engl J Med. 2003 Feb 6;348(6):518-27. doi: 10.1056/NEJMoa021641.
- Koutsky LA, Galloway DA, Holmes KK. Epidemiology of genital human papillomavirus infection. Epidemiol Rev. 1988;10:122-63. doi: 10.1093/oxfordjournals.epirev.a036020.
- Koshiol JE, Laurent SA, Pimenta JM. Rate and predictors of new genital warts claims and genital warts-related healthcare utilization among privately insured patients in the United States. Sex Transm Dis. 2004 Dec;31(12):748-52. doi: 10.1097/01.olq.0000145851.76025.ad.
Helpful Links
Study record dates
Study Major Dates
Study Start (Actual)
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
Keywords
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
- Neoplasms by Histologic Type
- Neoplasms
- Neoplasms, Glandular and Epithelial
- Slow Virus Diseases
- Neoplasms, Squamous Cell
- HIV Infections
- Acquired Immunodeficiency Syndrome
- Papilloma
Other Study ID Numbers
- 090024
- 09-C-0024
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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.
Clinical Trials on Adolescent
-
University of CoimbraRecruitingAdolescent Behavior | Adolescent - Emotional ProblemPortugal
-
National Institute of Environmental Health Sciences...RecruitingAdolescent Health | Pediatrics | Adolescent Development | Reproductive Physiological ProcessesUnited States
-
University of MinnesotaNational Institute on Minority Health and Health Disparities (NIMHD); SoLaHmoCompletedAdolescent Health | Adolescent School Connectedness | Community Based Participatory Research MethodsUnited States
-
World Health OrganizationLondon School of Hygiene and Tropical Medicine; University of Ghana; Biomedical... and other collaboratorsRecruitingHealth-Related Behavior | Adolescent Behavior | Adolescent Development | Health Care Seeking BehaviorGhana, Tanzania, Zimbabwe
-
Friends Research Institute, Inc.Conrad N. Hilton FoundationCompletedAdolescent Behavior | Adolescent Health ServicesUnited States
-
Aksaray UniversityEskisehir Osmangazi UniversityRecruiting
-
Eastern Mediterranean UniversityRecruiting
-
The Hong Kong Polytechnic UniversityNot yet recruiting
-
Eunice Kennedy Shriver National Institute of Child...Completed
-
University of KlagenfurtCardiff University; Medical University of Vienna; Bielefeld University; Institute... and other collaboratorsRecruitingParent-Child Relations | Parenting | Adolescent Behavior | Adolescent - Emotional Problem | Psychological Well-BeingMoldova, Republic of, North Macedonia
Clinical Trials on Gardasil
-
Laval UniversityCenters for Disease Control and PreventionCompletedHuman Papillomavirus VaccinesCanada
-
Kenya Medical Research InstituteMerck Sharp & Dohme LLC; University of WashingtonCompletedHIV-1 Infection | Human Papillomavirus
-
H. Lee Moffitt Cancer Center and Research InstituteMerck Sharp & Dohme LLCCompleted
-
National Heart, Lung, and Blood Institute (NHLBI)CompletedStem Cell Transplant | Immunogenicity | Gardasil VaccineUnited States
-
Preventive Oncology International, Inc.Merck Sharp & Dohme LLC; Peru Instituto Nacional de Enfermadades Neoplasticas...CompletedCervical Cancer | Cervical Intraepithelial Neoplasia | Human Papillomavirus | Cervical Dysplasia | Cervical NeoplasmPeru
-
Tuen Mun HospitalCompletedSystemic Lupus ErythematosusChina
-
PfizerCompletedVaccines | Meningococcal VaccinesUnited States
-
PharmaJet, Inc.National Cancer Institute (NCI); National Institutes of Health (NIH)Not yet recruiting
-
Partha BasuAll India Institute of Medical Sciences, New Delhi; Tata Memorial Centre; Deutsches... and other collaboratorsActive, not recruitingCervical Cancer | Cervical Precancerous LesionsIndia