A Study to Assess the Efficacy of a Heterologous Prime/Boost Vaccine Regimen of Ad26.Mos4.HIV and Aluminum Phosphate-Adjuvanted Clade C gp140 in Preventing Human Immunodeficiency Virus (HIV) -1 Infection in Women in Sub-Saharan Africa

A Multicenter, Randomized, Double-blind, Placebo-controlled Phase 2b Efficacy Study of a Heterologous Prime/Boost Vaccine Regimen of Ad26.Mos4.HIV and Aluminum Phosphate-adjuvanted Clade C gp140 in Preventing HIV-1 Infection in Adult Women in Sub-Saharan Africa

The primary purpose of this study is to assess the preventive vaccine efficacy (VE), safety and tolerability of a heterologous prime/boost regimen utilizing Ad26.Mos4.HIV and aluminum-phosphate adjuvanted Clade C gp 140 for the prevention of Human Immuno Virus (HIV) infection in HIV-seronegative women residing in sub-Saharan Africa from confirmed HIV-1 infections diagnosed between the Month 7 and Month 24 visits.

Study Overview

• Status: Terminated
• Conditions: HIV-1
• Intervention / Treatment: Biological: Placebo; Biological: Ad26.Mos4.HIV; Biological: Clade C gp140

• Study Type: Interventional
• Enrollment (Actual): 2636
• Phase: Phase 2

Contacts and Locations

Study Locations

• Malawi
  • Lilongwe, Malawi
    • UNC Lilongwe Project
• Mozambique
  • Maputo, Mozambique
    • Polana Caniço Health Research and Training Center (CISPOC)
• South Africa
  • Bloemfontein, South Africa, 9301
    • Josha Research
  • Cape Town, South Africa, 7975
    • Masiphumelele Research Centre
  • Dennilton, South Africa, 0485
    • Ndlovu Elandsdoorn Site
  • Diepkloof, South Africa, 1862
    • Perinatal HIV Research Unit, Chris Hani Baragwanath Hospital
  • Johannesburg, South Africa, 1862
    • Perinatal HIV Research Unit, Chris Hani Baragwanath Hospital
  • Klerksdorp, South Africa, 2571
    • The Aurum Institute Klerksdorp Clinical Research Centre
  • KwaZulu-Natal, South Africa, 4030
    • Qhakaza Mbokodo Research Centre
  • KwaZulu-Natal, South Africa, 4030
    • South African Medical Research Council Chatsworth Clinical Research Site
  • KwaZulu-Natal, South Africa, 4110
    • Centre for the AIDS Programme of Research in South Africa
  • KwaZulu-Natal, South Africa, 4399
    • South African Medical Research Council Tongaat Clinical Research Site
  • Mamelodi East, South Africa, 122
    • Stanza Clinical Research Centre : Mamelodi
  • Mthatha, South Africa, 5099
    • Nelson Mandela Academic Clinical Research Unit 'NeMACRU'
  • Pretoria, South Africa, 204
    • MeCRU Clinical Research Unit
  • Rustenburg, South Africa, 300
    • The Aurum Institute Rustenburg Clinical Research Site
  • Soshanguve, South Africa, 152
    • Setshaba Research Centre
  • Tembisa, South Africa, 1632
    • The Aurum Institute: Tembisa - Clinic 4
• Zambia
  • Lusaka, Zambia, 10101
    • Centre for Infectious Disease Research in Zambia (CIDRZ)
  • Lusaka, Zambia, P/BagE891
    • Center for Family Health Research in Zambia (CFHRZ)
  • Ndola, Zambia, 240262
    • Center for Family Health Research in Zambia (CFHRZ)
• Zimbabwe
  • Chitungwiza, Zimbabwe
    • St Mary's Clinic
  • Harare - Seke South, Zimbabwe
    • University of Zimbabwe-UCSF

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 35 years (Adult)
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Sexually active, defined as having had sexual intercourse with a male partner at least twice in the past 30 days prior to screening, and is considered by the site staff to be at risk for Human Immunodeficiency Virus (HIV) infection
• Access to a participating HIV Vaccine Trials Network (HVTN) Clinical Research Sites (CRS) and willingness to be followed for the planned duration of the study
• Willingness to discuss HIV infection risks and willing to receive HIV risk reduction counseling and appropriate referrals to minimize HIV acquisition, as applicable
• Negative beta human chorionic gonadotropin (beta-HCG) pregnancy test performed prior to vaccination on the day of initial vaccination. Persons who are NOT of reproductive potential due to having undergone total hysterectomy or bilateral oophorectomy (verified by medical records), are not required to undergo pregnancy testing
• Participants must also agree not to seek pregnancy through alternative methods, such as artificial insemination or in vitro fertilization until 3 months after the last vaccination

Exclusion Criteria:

• Investigational research agents received within 30 days before first vaccination
• HIV vaccine(s) received in a prior HIV vaccine trial. For volunteers who have received control/placebo in an HIV vaccine trial, the HVTN 705/HPX2008 (Protocol Safety Review Team) PSRT will determine eligibility on a case-by-case basis
• Live attenuated vaccines received within 30 days before first vaccination or scheduled within 14 days after injection (example: measles, mumps, and rubella [MMR]; oral polio vaccine [OPV]; varicella; yellow fever)
• Any vaccines that are not live attenuated vaccines and were received within 14 days prior to first vaccination (example, tetanus, pneumococcal, Hepatitis A or B)
• Immunosuppressive medications received within 6 months before first vaccination

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Group 1; Participants will receive Ad26.Mos4.HIV 5*10^10 virus particles (vp) as 0.5 milliliter (mL) via Intramuscular (IM) injection into the left deltoid on Months 0, 3, 6, and 12 and Clade C gp140 (250 [microgram] mcg) mixed with Aluminum phosphate adjuvant as 0.5 mL IM into the right deltoid on Months 6 and 12.	Biological: Ad26.Mos4.HIV; Participants will receive Ad26.Mos4.HIV 5x10^10 virus particles (vp) as 0.5 milliliter (mL) via Intramuscular (IM) into the left deltoid on Months 0, 3, 6, and 12.; Biological: Clade C gp140; Participants will receive Clade C gp140 (250 mcg) mixed with Aluminum phosphate adjuvant as 0.5 mL IM into the right deltoid on Months 6 and 12.
Placebo Comparator: Group 2; Participants will receive Placebo for Ad26.Mos4.HIV as 0.5 mL into the left deltoid on Months 0, 3, 6, and 12 and Placebo for Clade C gp140 / Aluminum phosphate adjuvant as 0.5 mL IM into the right deltoid on Months 6 and 12.	Biological: Placebo; Participants will receive matching placebo.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of Participants With Human Immuno Deficiency Virus-1 (HIV-1) Infection Diagnosed Between Month 7 to Month 24 Post Enrollment	Number of participants with HIV-1 infection diagnosed between Month 7 to Month 24 post enrollment was reported. The data represents the cumulative incidence of HIV-1 infections.	Month 7 up to Month 24
Percentage of Participants With Local Reactogenicity Signs and Symptoms After First Vaccination	Percentage of participants with local reactogenicity signs and symptoms after first vaccination were reported. Local reactogenicity events (solicited local adverse events) were defined as events at the injection site. Local reactogenicity signs and symptoms included pain and/or tenderness proximal to the injection site.	Up to 7 days after first vaccination on Day 0 (Day 7)
Percentage of Participants With Local Reactogenicity Signs and Symptoms After Second Vaccination	Percentage of participants with local reactogenicity signs and symptoms after second vaccination was reported. Local reactogenicity events (solicited local adverse events) were defined as events at the injection site. Local reactogenicity signs and symptoms included pain and/or tenderness proximal to the injection site.	Up to 7 days after second vaccination on Day 84 (Day 91)
Percentage of Participants With Local Reactogenicity Signs and Symptoms After Third Vaccination	Percentage of participants with local reactogenicity signs and symptoms after third vaccination was reported. Local reactogenicity events (solicited local adverse events) were defined as events at the injection site. Local reactogenicity signs and symptoms included pain and/or tenderness proximal to the injection site.	Up to 7 days after third vaccination on Day 168 (Up to Day 175)
Percentage of Participants With Local Reactogenicity Signs and Symptoms After Fourth Vaccination	Percentage of participants with local reactogenicity signs and symptoms after fourth vaccination was reported. Local reactogenicity events (solicited local adverse events) were defined as events at the injection site. Local reactogenicity signs and symptoms included pain and/or tenderness proximal to the injection site.	Up to 7 days after fourth vaccination on Day 364 (Up to Day 371)
Percentage of Participants With Systematic Reactogenicity Signs and Symptoms After First Vaccination	Percentage of participants with systematic reactogenicity signs and symptoms after first vaccination was reported. Systemic reactogenicity events (solicited systemic adverse events) defined as events occurred in a predefined post-vaccination period for which the subject was specifically questioned. Systemic reactogenicity signs and symptoms included increased body temperature, malaise and/or fatigue, myalgia, headache, chills, arthralgia, nausea, and vomiting.	Up to 7 days after first vaccination on Day 0 (Day 7)
Percentage of Participants With Systematic Reactogenicity Signs and Symptoms After Second Vaccination	Percentage of participants with systematic reactogenicity signs and symptoms after second vaccination was reported. Systemic reactogenicity events (solicited systemic adverse events) defined as events occurred in a predefined post-vaccination period for which the subject was specifically questioned. Systemic reactogenicity signs and symptoms included increased body temperature, malaise and/or fatigue, myalgia, headache, chills, arthralgia, nausea, and vomiting.	Up to 7 days after second vaccination on Day 84 (Day 91)
Percentage of Participants With Systematic Reactogenicity Signs and Symptoms After Third Vaccination	Percentage of participants with systematic reactogenicity signs and symptoms after third vaccination was reported. Systemic reactogenicity events (solicited systemic adverse events) defined as events occurred in a predefined post-vaccination period for which the subject was specifically questioned. Systemic reactogenicity signs and symptoms included increased body temperature, malaise and/or fatigue, myalgia, headache, chills, arthralgia, nausea, and vomiting.	Up to 7 days after third vaccination on Day 168 (Up to Day 175)
Percentage of Participants With Systematic Reactogenicity Signs and Symptoms After Fourth Vaccination	Percentage of participants with systematic reactogenicity signs and symptoms after fourth vaccination was reported. Systemic reactogenicity events (solicited systemic adverse events) defined as events occurred in a predefined post-vaccination period for which the subject was specifically questioned. Systemic reactogenicity signs and symptoms included increased body temperature, malaise and/or fatigue, myalgia, headache, chills, arthralgia, nausea, and vomiting.	Up to 7 days after fourth vaccination on Day 364 (Up to Day 371)
Percentage of Participants With Unsolicited Adverse Events (AEs) for 30 Days After First Vaccination	An AE is any untoward medical occurrence in a clinical investigation participant administered a study product and which does not necessarily have a causal relationship with the study treatment. The most frequent unsolicited AEs were upper respiratory tract infection, back pain, cough, and hypertension.	30 days after first vaccination on Day 0 (Up to Day 30)
Percentage of Participants With Unsolicited AEs for 30 Days After Second Vaccination	An AE is any untoward medical occurrence in a clinical investigation participant administered a study product and which does not necessarily have a causal relationship with the study treatment. The most frequent unsolicited AEs were upper respiratory tract infection, back pain, cough, and hypertension.	30 days after second vaccination on Day 84 (Up to Day 114)
Percentage of Participants With Unsolicited AEs for 30 Days After Third Vaccination	An AE is any untoward medical occurrence in a clinical investigation participant administered a study product and which does not necessarily have a causal relationship with the study treatment. The most frequent unsolicited AEs were upper respiratory tract infection, back pain, cough, and hypertension.	30 days after third vaccination on Day 168 (Up to Day 198)
Percentage of Participants With Unsolicited AEs for 30 Days After Fourth Vaccination	An AE is any untoward medical occurrence in a clinical investigation participant administered a study product and which does not necessarily have a causal relationship with the study treatment. The most frequent unsolicited AEs were upper respiratory tract infection, back pain, cough, and hypertension.	30 days after fourth vaccination on Day 364 (Up to Day 394)
Percentage of Participants With Serious Adverse Events (SAEs)	An AE is any untoward medical occurrence in a clinical investigation participant administered a study product and which does not necessarily have a causal relationship with the study treatment. An SAE is any untoward medical occurrence that at any dose results in death, is life-threatening, requires inpatient hospitalization or prolongation of existing hospitalization, results in persistent or significant disability/incapacity, is a congenital anomaly/birth defect, is a suspected transmission of any infectious agent via a medicinal product.	Up to Month 36 (up to end of the study)
Percentage of Participants With Adverse Events of Special Interest (AESIs)	Percentage of participants with AESIs was reported. Immune-mediated diseases were considered as AESIs in this study.	Up to Month 36 (up to end of the study)
Percentage of Participants With AEs Leading to Early Participant Withdrawal or Early Discontinuation of Study Product	Percentage of participants with AEs leading to early participant withdrawal or early discontinuation of study product were reported. An AE is any untoward medical occurrence in a clinical investigation participant administered a study product and which does not necessarily have a causal relationship with this treatment.	Up to Month 36 (up to end of the study)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of Participants With HIV-1 Infection Diagnosed From Enrollment (Baseline) Through Month 24 Post Enrollment	Number of participants with HIV-1 infection diagnosed from enrollment (baseline) through month 24 post enrollment was reported. The data represents the cumulative incidence of HIV-1 infections.	Baseline up to Month 24
Number of Participants With HIV-1 Infection Diagnosed From Enrollment (Baseline) Through Month 36 (End of Study) Post Enrollment	Number of participants with HIV-1 infection diagnosed from enrollment (baseline) through Month 36 post enrollment was reported. The data represents the cumulative incidence of HIV-1 infections.	Baseline up to Month 36 (End of study)
Number of Participants With HIV-1 Infection Diagnosed From Month 13 Through Month 24 Post Enrollment	Number of participants with HIV-1 infection diagnosed from Month 13 through Month 24 post enrollment was reported. The data represents the cumulative incidence of HIV-1 infections.	Month 13 up to Month 24
Number of Participants With HIV-1 Infection Diagnosed From Month 13 Through Month 36 (End of Study) Post Enrollment	Number of participants with HIV-1 infection diagnosed from Month 13 through Month 36 (end of study) post enrollment was reported. The data represents the cumulative incidence of HIV-1 infections.	Month 13 up to Month 36 (End of study)
Geometric Mean of Binding Antibody Responses to HIV Envelop (ENV) Clade (gp140) C (ZA) Analyzed by Enzyme-linked Immunosorbent Assay (ELISA)	A weighted geometric mean of the binding antibody responses to HIV envelope (ENV) gp140 Clade C 97ZA protein analyzed by ELISA was reported.	Months 0, 7, 13 and 24
Geometric Mean of Interferon-gamma (IFN-gamma) T-Cells Responses Analyzed by Enzyme-linked Immunospot Assay (ELISpot)	Geometric mean of IFN-gamma T-cells responses analyzed by ELISpot were reported. A weighted geometric mean of the number of spot-forming cells (SFC) per million peripheral blood mononuclear cells (PBMCs) producing Interferon-gamma upon stimulation with potential T-cell epitope (PTE) ENV peptide pools analyzed by ELISpot was reported. Reported responses are the sum of the number of SFCs/10^6 PBMCS for PTE Env1, Env2 and Env3 sub-pools.	Months 0, 7, 13 and 24
Number of Participants With Viral Sequences	Number of participants with viral sequences were reported. Viral sequencing was conducted on the earliest available plasma specimens with positive HIV-1 ribose nucleic acid polymerase chain reaction (RNA PCR) tests from study participants who were diagnosed with HIV-1 infection.	Month 7 up to Month 24

Collaborators and Investigators

• Sponsor: Janssen Vaccines & Prevention B.V.

Publications and helpful links

General Publications

• Barouch DH, Tomaka FL, Wegmann F, Stieh DJ, Alter G, Robb ML, Michael NL, Peter L, Nkolola JP, Borducchi EN, Chandrashekar A, Jetton D, Stephenson KE, Li W, Korber B, Tomaras GD, Montefiori DC, Gray G, Frahm N, McElrath MJ, Baden L, Johnson J, Hutter J, Swann E, Karita E, Kibuuka H, Mpendo J, Garrett N, Mngadi K, Chinyenze K, Priddy F, Lazarus E, Laher F, Nitayapan S, Pitisuttithum P, Bart S, Campbell T, Feldman R, Lucksinger G, Borremans C, Callewaert K, Roten R, Sadoff J, Scheppler L, Weijtens M, Feddes-de Boer K, van Manen D, Vreugdenhil J, Zahn R, Lavreys L, Nijs S, Tolboom J, Hendriks J, Euler Z, Pau MG, Schuitemaker H. Evaluation of a mosaic HIV-1 vaccine in a multicentre, randomised, double-blind, placebo-controlled, phase 1/2a clinical trial (APPROACH) and in rhesus monkeys (NHP 13-19). Lancet. 2018 Jul 21;392(10143):232-243. doi: 10.1016/S0140-6736(18)31364-3. Epub 2018 Jul 6.

Study record dates

Study Major Dates

• Study Start (Actual): November 3, 2017
• Primary Completion (Actual): February 2, 2022
• Study Completion (Actual): February 2, 2022

Study Registration Dates

• First Submitted: February 17, 2017
• First Submitted That Met QC Criteria: February 17, 2017
• First Posted (Actual): February 23, 2017

Study Record Updates

• Last Update Posted (Actual): April 18, 2023
• Last Update Submitted That Met QC Criteria: March 24, 2023
• Last Verified: March 1, 2023

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Infections
• Other Study ID Numbers: CR108263; VAC89220HPX2008 (Other Identifier: Janssen Vaccines & Prevention B.V.); HVTN 705 (Other Identifier: Janssen Vaccines & Prevention B.V.); HVTN 705/VAC89220HPX2008 (Other Identifier: Janssen Vaccines & Prevention B.V.)

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: Yes
• Studies a U.S. FDA-regulated device product: No