Comparison of Three Hepatitis B Vaccination Regimens in HIV-Positive Youth
A Randomized, Open-Label Trial of Three Hepatitis B Vaccination Schemas in HIV-Positive Youth
Studieöversikt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljerad beskrivning
Suboptimal response to hepatitis B vaccination in HIV+ adults and children has been well documented in the literature. Given the importance of preventing hepatitis B virus (HBV) co-infection in HIV+ youth and the poor response rates in this population, this study will attempt to improve the immediate and long-term sero-response rates by undertaking a randomized, open-label trial of three hepatitis B vaccination schemas, as follows:
- standard adult dosing of HBV-only vaccine: Engerix-B 20 mcg at Entry, Week 4 and Week 24
- increased adult dosing of HBV-only vaccine: Engerix-B 40 mcg at Entry, Week 4 and Week 24
- standard adult dosing of combined HBV/hepatitis A virus (HAV) vaccine: Twinrix 720 enzyme immunoassay (EIA) HAV Ag plus 20 mcg HBsAg at Entry, Week 4 and Week 24.
This study will also describe the safety of administration of an increased dose of the hepatitis B vaccine in this population. In general, patients undergoing dialysis who have received the dosing regimen recommended for immunocompromised individuals have tolerated the vaccine series well.
Design: This is a stratified, block-randomized, open-label trial of three hepatitis B vaccination schemas in HIV-infected and HBV-uninfected youth. Once randomized, there will be a total of 6 study visits in a 72 week period. Vaccination will occur at Entry, Week 4 and Week 24. Primary sero-response will be evaluated at Week 28 and sustainability of response will be evaluated at Weeks 48 and 72 for those who achieve a primary antibody response of >= 10 IU/ml. Primary non-responders (antibody response of < 10 IU/ml) will be provided with a booster vaccine using the increased-dose Engerix-B vaccine at Week 48 and evaluated for responsiveness at Week 72.
Studietyp
Studietyp
Inskrivning (Faktisk)
Inskrivning
Fas
Fas
- Fas 4
Kontakter och platser
Studieorter
-
-
-
Rio de Janeiro, Brasilien, 20221-903
- Hospital dos Sevidores do Estado
-
Rio de Janeiro, Brasilien, 21941590
- Ippmg-Ufrj
-
-
MG
-
Belo Horizonte, MG, Brasilien, 30130-100
- Federal University of Minas Gerais
-
-
SP
-
Ribeirao Preto, SP, Brasilien, 14049-900
- Hospital das Clinicas da Faculdade de Medicina de Ribeirao Preto/USP
-
Sao Paulo, SP, Brasilien, 01246-900
- Instituto de Infectologia Emilio Ribas
-
-
-
-
California
-
Los Angeles, California, Förenta staterna, 90054
- Childrens Hosp of Los Angeles
-
San Fransisco, California, Förenta staterna, 94118
- University of California at San Francisco
-
-
District of Columbia
-
Washington, District of Columbia, Förenta staterna, 20010
- Children's Hosp Natinal Med Center
-
-
Louisiana
-
New Orleans, Louisiana, Förenta staterna, 70112
- Tulane Med Center
-
-
-
-
Cape Town
-
Bellville, Cape Town, Sydafrika, 7505
- Tygerberg Hospital
-
-
Gauteng
-
Johannesburg, Gauteng, Sydafrika, 2013
- Harriet Shezi Childrens Clinic Chris Hani Baragwanth Hospital
-
-
Deltagandekriterier
Urvalskriterier
Urvalskriterier
Åldrar som är berättigade till studier
Tar emot friska volontärer
Kön som är behöriga för studier
Beskrivning
Inclusion Criteria:
- Documented HIV+
- Age 12 to < 25 years
- History of no or one hepatitis B vaccination
- Not pregnant.
- Females engaging in sexual intercourse must be willing to practice an approved method of birth control throughout the completion of the vaccine phase of the study.
Exclusion Criteria:
- History of > 1 hepatitis B vaccination
- Serologic evidence of past or present hepatitis B infection: anti-hepatitis B surface antigen (HBsAg), HBs-Ag or anti- hepatitis B core antigen (HBcAg)
- Previous allergic reaction to hepatitis A or B vaccinations or to yeast, thimerosal or aluminum.
- Active opportunistic infection or current treatment for known or suspected active serious bacterial infection at the pre-entry exam.
Presence of any known grade >= 3 clinical or laboratory toxicity at the time of pre-entry per toxicity tables.
- Anticipation of long-term corticosteroid therapy or within 3 months preceding study randomization. Use of non-steroidal, anti-inflammatory agents and inhaled or topical corticosteroids are allowed.
- Receipt of any restricted medicine listed in the protocol section 8.1.3 within 3 months preceding randomization.
- Receipt of immune globulin product or plasma product within 6 months preceding randomization
- Receipt of licensed blood product or transfusion or any licensed vaccine within 4 weeks preceding randomization.
- Known or suspected diseases of the immune system, other than HIV, or treatment for a malignancy within 3 months of randomization.
- Other serious, acute or chronic medical or surgical conditions must be approved by the protocol chair.
Studieplan
Hur är studien utformad?
Designdetaljer
- Primärt syfte: Förebyggande
- Tilldelning: Randomiserad
- Interventionsmodell: Parallellt uppdrag
- Maskning: Ingen (Open Label)
Antal vapen
Vapen och interventioner
Deltagargrupp / ArmDeltagargrupp / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
|
Aktiv komparator: 1
Standard dose (20 mcg) of Hepatitis B vaccine.
|
A single dose of 1 mL (20 mcg/mL) will be administered in the deltoid muscle at Entry, Weeks 4 and 24.
|
|
Aktiv komparator: 2
40 mcg of Hepatitis B vaccine
|
A single dose of 2 mL (20 mcg/mL) will be administered in the deltoid muscle at Entry, Week 4 and 24.
|
|
Aktiv komparator: 3
20 mgc of Twinrix
|
Arm 3: 720 EIA HAV Ag, 20 mcg HBsAg/ml: A single dose of 1 mL will be administered in the deltoid muscle. |
Vad mäter studien?
Primära resultatmått
Primära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
|
Sero-response to Hepatitis B Surface Antigen
Tidsram: Week 28
|
The primary outcome, percentage positive sero-response, was compared between Arm 1 and each of the two alternative strategy arms (Arm 2 and Arm 3) and measured 4 weeks after the third vaccination at Week 28.
Response is defined as greater than or equal to 10 IU/mL of serum being present; non-response is defined as less than 10 IU/mL.
|
Week 28
|
Sekundära resultatmått
Sekundära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
|
Safety of 3 Hepatitis B Vaccine Regimens in HIV+ Youth - ADVERSE EVENTS BY INTERVENTION ARM ON STUDY - POSSIBLY OR PROBABLY RELATED
Tidsram: Baseline through Week 72
|
The number of adverse events (AE) was described by study arm.
The proportion of subjects with clinical adverse events in Arms 1 and each of the two alternative strategy arms (Arm 2 and Arm 3) were compared to assess whether or not there is a difference in patients with any grade toxicity.
|
Baseline through Week 72
|
|
Safety of 3 Hepatitis B Vaccine Regimens in HIV+ Youth - ADVERSE EVENTS BY INTERVENTION ARM ON STUDY - DEFINITELY RELATED
Tidsram: Baseline through Week 72
|
The number of AEs was described by study arm.
The proportion of subjects with clinical AEs in Arms 1 and each of the two alternative strategy arms (Arm 2 and Arm 3)were compared to assess whether or not there is a difference in subjects with any grade toxicity.
|
Baseline through Week 72
|
|
Safety of 3 Hepatitis B Vaccine Regimens in HIV+ Youth - ABNORMAL LABORATORY VALUES GRADE 2 OR ABOVE BY INTERVENTION ARM ON STUDY
Tidsram: Baseline through Week 72
|
The number of adverse events and subjects with the events were described by study arm.
The proportion of subjects with abnormal labs in Arms 1 and each of the two alternative strategy arms (Arm 2 and Arm 3) were compared to assess whether or not there is a difference in subjects with grade 3 or 4 toxicity.
The laboratory events included are AEs classified as probably, possibly, or definitely related to study drug as classified by the Site Investigator.
|
Baseline through Week 72
|
|
Response Rates in HIV+ Youth Within Each Study Arm by Study Duration
Tidsram: Entry through Week 72
|
Within each arm, the duration of response in HIV-infected youth was analyzed for all subjects who were responders at 28 weeks.
The possible values for response duration could be 20 weeks or less (responder at 28 weeks but not at 48 weeks), 20 to 44 weeks (responder at 28 and 48 weeks but not at 72 weeks), or greater than 44 weeks (responder at 28, 48, and 72 weeks).
A response of greater than 20 weeks includes those who responded after 20 weeks, but whose exact response duration was unknown.
|
Entry through Week 72
|
|
Sero-Response to Hepatitis B Surface Antigen; Predictor: STUDY ARM
Tidsram: Week 28
|
Response rate associated with the participant's study arm, baseline CD4 count, and interaction term that reflects how subjects in Arm 2 responded differently depending on their CD4 count.
Response is defined as greater than or equal to 10 IU/mL of serum being present; non-response is defined as less than 10 IU/mL.
|
Week 28
|
Samarbetspartners och utredare
Sponsor
Sponsor
Samarbetspartners
Samarbetspartners
Utredare
Utredare
- Huvudutredare: Patricia Emmanuel, MD, University of South Florida, Peds. Div. of Infectious Disease
- Huvudutredare: Diane M. Straub, MD, University of South Florida, Peds. Div. of Infectious Disease
- Huvudutredare: Jorge Lujuan-Ziberman, MD, University of South Florida, Peds. Div. of Infectious Disease
- Huvudutredare: Lawrence D'Angelo, MD, Children's National Medical Center, Div. of Aldol & Young Adult Medicine
- Huvudutredare: Carleen Townsend-Akpan, CPNP, Children's National Medical Center, Div. of Aldol & Young Adult Medicine
- Huvudutredare: Jaime Martinez, MD, John H. Stroger Jr. Hospital
- Huvudutredare: Lisa Henry- Reid, MD, John H. Stroger Jr. Hospital
- Huvudutredare: Irma Febo, MD, University Pediatric Hospital
- Huvudutredare: LLeana Blasini, MD, University Pediatric Hospital
- Huvudutredare: Donna Futterman, MD, Montefiore Medical Center
- Huvudutredare: Marina Catallozzi, MD, Montifiore Medical Center
- Huvudutredare: Linda Levin, MD, Icahn School of Medicine at Mount Sinai
- Huvudutredare: Barbara Moscicki, MD, Univ. of California at San Franciso
- Huvudutredare: Coco Auerswald, MD, Univ. of California at San Franciso
- Huvudutredare: Sue Ellen Abdalian, MD, Tulane Medical Center
- Huvudutredare: Ligia Peralta, MD, University of Maryland
- Huvudutredare: Lawrence Friedman, MD, University of Miami
- Huvudutredare: Ana Puga, MD, Children's Diagnostic & Treatment Center
- Huvudutredare: Stephen Spector, MD, University of California, San Diego
- Huvudutredare: Rolando M Viani, MD, University of California, San Diego
Publikationer och användbara länkar
Användbara länkar
Studieavstämningsdatum
Studera stora datum
Studiestart
Studiestart
Primärt slutförande (Faktisk)
Primärt slutförande
Avslutad studie (Faktisk)
Avslutad studie
Studieregistreringsdatum
Först inskickad
Först inskickad
Först inskickad som uppfyllde QC-kriterierna
Först inskickad som uppfyllde QC-kriterierna
Första postat (Uppskatta)
Första postat
Uppdateringar av studier
Senaste uppdatering publicerad (Faktisk)
Senaste uppdatering publicerad
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
Senast verifierad
Senast verifierad
Mer information
Termer relaterade till denna studie
Ytterligare relevanta MeSH-villkor
Andra studie-ID-nummer
Andra studie-ID-nummer
- ATN 024
Denna information hämtades direkt från webbplatsen clinicaltrials.gov utan några ändringar. Om du har några önskemål om att ändra, ta bort eller uppdatera dina studieuppgifter, vänligen kontakta register@clinicaltrials.gov. Så snart en ändring har implementerats på clinicaltrials.gov, kommer denna att uppdateras automatiskt även på vår webbplats .