对感染 HIV 的孕妇和未感染 HIV 的孕妇接种 B 族链球菌疫苗的研究
一项评估两剂 B 族链球菌疫苗 (GBS-NN/NN2) 在怀孕和感染 HIV 的妇女和怀孕但未感染 HIV 的妇女中的安全性、耐受性和免疫原性的多中心研究
研究概览
详细说明
100 名怀孕并感染 HIV 的女性将随机接受两次 0.5 mL(毫升)GBS-NN/NN2 疫苗(60 名女性)或安慰剂(15 名女性)肌肉注射。
100 名未感染 HIV 的孕妇将随机接受两次 0.5 mL 肌肉注射 GBS-NN/NN2 疫苗(60 名女性)或安慰剂(15 名女性)。
将在妊娠 24 至 28 周(第 -14 天至第 -1 天)时对参与者进行筛查,并同时对各组进行给药。 第一剂疫苗或安慰剂将在第 0 天给药,第二剂将在 28±2 天后给药。 预计在第一剂疫苗后约 10 至 14 周交付。
为了分析免疫反应,将合并安慰剂组。 为了安全起见,将单独分析安慰剂组,并将合并起来与潜在的疫苗组进行比较。
研究类型
注册 (实际的)
阶段
- 阶段2
联系人和位置
学习地点
-
-
-
Kawempe、乌干达
- MUJHU Research Collaboration/MUJHU Care Ltd, Kawempe National Referral Hospital
-
-
-
-
-
Johannesburg、南非
- Empilweni Services and Research Unit (ESRU), Rahima Moosa Mother and Child Hospital
-
Johannesburg、南非
- University of the Witwatersrand, Johannesburg (Respiratory and Meningeal Pathogens Research unit)
-
-
参与标准
资格标准
适合学习的年龄
接受健康志愿者
描述
纳入标准:
- 参与者至少 18 岁且不超过 40 岁。
在计划接种疫苗之日妊娠 26 周至 30 周(含)的孕妇,单胎,无并发症的妊娠。 根据 GAIA(全球妊娠期免疫安全评估联盟)标准的指导,根据以下等级制度确定孕龄:
- 超声估计胎龄,
- 最后一次月经日期
- 宫底高度
- HIV 状态基于快速、确认的测试,除非参与者的 HIV 血清阳性测试记录在案且病史记录在笔记中。
- 感染 HIV、HIV 病毒载量 <1000、在筛选前接受抗逆转录病毒治疗至少 3 个月并且临床表现良好的女性。
- 预计在研究期间可以参加预定的门诊就诊,同意在研究参与期间通过电话联系,并愿意为她的婴儿参加研究提供父母同意
排除标准:
- HBSAg 和/或 HCV(丙型肝炎病毒)阳性的女性
- 根据标准测试梅毒测试呈阳性的女性
- 女性在筛查时根据超声波故意携带畸形或基因异常的胎儿
- 在分娩前经历过死产的妇女
- 前置胎盘女性
- 筛查时有慢性或妊娠高血压病史的女性
- 尿蛋白 1+ 和高血压的女性(定义为收缩压≥140 mmHg 和/或舒张压≥90 mmHg)在妊娠 ≥ 20 周之前血压正常的女性
- 尿液中蛋白质含量 >1+ 的女性(无论血压如何)
- 患有妊娠期 1 型或 2 型糖尿病的女性。
- 试纸上有糖尿的女性
- 已知对疫苗的任何成分过敏、已知对铝过敏或对之前的任何疫苗接种有过敏反应的女性。
- 筛查时 HIV 病毒载量 >1000 的女性。
- 在筛选前接受抗逆转录病毒治疗不到 3 个月的 HIV 感染女性。 (在筛查和给药之间被诊断出患有 HIV 的女性将不符合资格。)
- 有或存在重大心血管疾病、肺病、肝病、胆囊病或胆道病、肾病、血液病、胃肠道病、内分泌病、免疫病学、皮肤病学、神经病学、精神病学、自身免疫性疾病、认知障碍或当前感染和重大疾病的女性 4 周前随机化。
- 在过去两年内有吸毒或酗酒史的女性。
- 在接受第一剂 GBS NN/NN2 或安慰剂后 28 天内接种过疫苗的女性,或预计在研究过程中需要接种疫苗的女性。 (建议在怀孕期间接种的疫苗,例如 破伤风类毒素、百日咳和流感是允许的。 同时接种疫苗不得在研究性疫苗接种后 7 天内。)
- 服药当天发烧(腋温>37.9°C)或服药前7天内有过急性感染的女性。
- 患有任何会延长出血时间的出血性疾病的女性。
- 正在接受免疫抑制药物治疗的女性,包括全身性类固醇(吸入和局部类固醇是可以接受的)。
- 在筛选前 12 周内接受过血液或血液制品和/或血浆衍生物或任何免疫球蛋白制剂的女性。
- 患有严重贫血的女性,根据谢菲尔德分级系统,血红蛋白 < 9g/dL (90 g/L)(> 1 级)
- 目前正在母乳喂养的妇女
- 属于研究人员或研究人员近亲的女性。
- 研究者认为不适合参加研究的女性。
- 同时参与另一项临床试验,在此期间受试者将接触研究产品。
学习计划
研究是如何设计的?
设计细节
- 主要用途:预防
- 分配:随机化
- 介入模型:并行分配
- 屏蔽:双倍的
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
|
实验性的:感染 HIV 的孕妇中的 GBS-NN/NN2
2 剂 0.5mL 肌内注射 GBS-NN/NN2,其中包含 50 µg GBS-NN 和 50 µg NN2,间隔 28 天在感染 HIV 的孕妇中给药
|
GBS-NN/NN2 作为佐剂与 Alhydrogel 结合。
|
|
安慰剂比较:感染 HIV 的孕妇的安慰剂对照药
HIV感染孕妇间隔28天肌肉注射0.5mL 0.9%生理盐水2次
|
生理盐水 0.9%
|
|
实验性的:未感染 HIV 的孕妇中的 GBS-NN/NN2
2 剂 0.5mL 肌内注射 GBS-NN/NN2,其中包含 50 µg GBS-NN 和 50 µg NN2,间隔 28 天在未感染 HIV 的孕妇中给药
|
GBS-NN/NN2 作为佐剂与 Alhydrogel 结合。
|
|
安慰剂比较:未感染 HIV 的孕妇的安慰剂对照药
2剂0.5mL肌肉注射0.9%生理盐水,间隔28天给没有感染HIV的孕妇
|
生理盐水 0.9%
|
研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Incidence of Treatment Emergent Adverse Events (TEAEs) in Maternal Participants
大体时间:From first vaccination (26 to 30 weeks of gestation) up to 28 days post-delivery, up to 24 weeks
|
Incidence of all TEAEs in maternal participants from first vaccination up to 28 days post-delivery.
|
From first vaccination (26 to 30 weeks of gestation) up to 28 days post-delivery, up to 24 weeks
|
|
Incidence of Adverse Events (AEs) in Newborn Babies
大体时间:From birth to first visit after birth (28±4 days post-delivery)
|
Incidence of AEs in Newborn babies From birth to first visit after birth (visit 6).
|
From birth to first visit after birth (28±4 days post-delivery)
|
|
Number of Maternal Participants With Solicited Local AEs Within 7 Days After Each Study Vaccine Dose
大体时间:For 7 days after each study vaccine dose (first vaccine administered at baseline, second vaccine administered 28 days post baseline)
|
Number of maternal participants with solicited local AEs within 7 Days after each study vaccine dose, defined as: injection site redness, bruising, swelling, itching, pain and tenderness.
Injection-site redness was graded based on measurements in centimeter (cm) as grade 0 (no visible redness), grade 1 (mild; 0-2 cm), grade 2 (moderate; 2.1-5 cm) or grade 3 (severe; > 5 cm).
Swelling was graded as grade 0 (no swelling detected), grade 1 (palpable "firmness" only), grade 2 (0-4 cm) or grade 3 (> 4 cm).
Pain at the injection site was rated on a visual analogue scale of 0 to 10, where 0 is no pain and 10 is extreme pain/worst possible pain.
Bruising, itching and tenderness were categorised as either yes (present) or no (absent).
|
For 7 days after each study vaccine dose (first vaccine administered at baseline, second vaccine administered 28 days post baseline)
|
|
Number of Maternal Participants With Solicited Systemic AEs Within 7 Days After Each Study Vaccine Dose
大体时间:For 7 days after each study vaccine dose (first vaccine administered at baseline, second vaccine administered 28 days post baseline)
|
Number of maternal participants with solicited systemic AEs within 7 days after each study vaccine dose, defined as: headache, sore throat, "flu-like" symptoms, muscle aches, fever in the 72 hours post dose.
|
For 7 days after each study vaccine dose (first vaccine administered at baseline, second vaccine administered 28 days post baseline)
|
|
Gestational Age of Newborn Baby
大体时间:At birth
|
Gestational age of newborn baby
|
At birth
|
|
Weight of Newborn Baby
大体时间:At birth
|
Weight of newborn baby
|
At birth
|
|
Length of Newborn Baby
大体时间:At birth
|
Length of newborn baby
|
At birth
|
|
Head Circumference of Newborn Baby
大体时间:At birth
|
Head circumference of newborn baby
|
At birth
|
|
Apgar Score for Newborn Baby
大体时间:At birth
|
APGAR (Appearance, Pulse, Grimace, Activity, Respiration) score of newborn baby were measured at 1, 5 and 10 minutes. The APGAR score is a rapid clinical assessment tool used immediately after birth to evaluate a newborn's physical condition. It evaluates five criteria : Appearance (skin color), Pulse (heart rate), Grimace (Reflex irritability), Activity (muscle tone), Respiration (breathing effort), each category is scored 0, 1, or 2, where 2 indicates optimal function. Total score ranges from 0 to 10: 7-10: Normal / Reassuring - baby adapting well 4-6: Moderately abnormal - may need assisted breathing or additional monitoring 0-3: Low - requires immediate resuscitation and urgent intervention |
At birth
|
|
Transfer Rate (Baby/Mother) of IgG Antibody Concentrations
大体时间:At delivery
|
For each of the specific IgG antibody concentrations, the transfer rate is defined as concentration in baby at birth/concentration in mother at delivery, expressed as a percentage.
|
At delivery
|
次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Incidence of Significant Adverse Reactions in Mothers
大体时间:From delivery to 6 months post-delivery
|
Incidence of significant adverse reactions in maternal participants
|
From delivery to 6 months post-delivery
|
|
Developmental Milestones of Babies
大体时间:At 6 months
|
Developmental milestones at 6 months were assessed using the Ages and Stages Questionnaire, Third Edition (ASQ-3), a validated developmental screening tool designed to evaluate early childhood development across 5 key domains: communication, gross motor, fine motor, problem solving, and personal-social.
Each domain includes 6 items scored as Yes (10), Sometimes (5), or Not yet (0).
Domain scores are calculated by summing item scores (range: 0-60 per domain); higher scores indicate better development.
A total score (sum of all domains) may be calculated (range: 0-300), though interpretation relies primarily on domain scores.
For each domain, the cut-offs are 29.65 for Communication, 22.25 for Gross Motor, 25.14 for Fine Motor, 27.72 for Problem Solving, and 25.34 for Personal-Social.
Scores above these thresholds generally indicate development on schedule, while scores near the cutoff suggest monitoring, and scores below warrant additional assessment or referral.
|
At 6 months
|
|
Geometric Mean Antibody Concentration in Maternal Participants (4 Weeks)
大体时间:At 4 weeks post first injection and at 4 weeks post second injection
|
Geometric mean IgG antibody concentration in the maternal participants specific to Alpha Like Protein 1 (Alp1), Alpha Like Protein 2 (Alp2), Alpha Like Protein C (AlpC) and Rib protein (Rib).
|
At 4 weeks post first injection and at 4 weeks post second injection
|
|
Geometric Mean Antibody Concentration in Maternal Blood at 6 Months Post-delivery
大体时间:6 months post-delivery
|
Geometric mean antibody concentration specific to Alp1, Alp2, AlpC and Rib in maternal blood at 6 months post-delivery
|
6 months post-delivery
|
|
Geometric Mean Antibody Concentration in Infant Blood at 1, 2, and 3 Months Post-delivery
大体时间:At 1, 2, and 3 months post-delivery
|
Geometric mean antibody concentration specific to Alp1, Alp2, AlpC and Rib in infant blood at 1, 2, and 3 months post-delivery
|
At 1, 2, and 3 months post-delivery
|
|
Geometric Mean Antibody Concentration in Newborns
大体时间:Within 48 hours of birth.
|
Geometric mean antibody concentration specific to Alp1, Alp2, AlpC and Rib in newborn blood within 48 hours of birth.
|
Within 48 hours of birth.
|
|
Geometric Mean Antibody Concentration From Maternal Blood at Delivery
大体时间:At delivery
|
Geometric mean antibody concentration specific to Alp1, Alp2, AlpC and Rib from maternal blood at delivery
|
At delivery
|
|
Geometric Mean Fold Increase in Antibody Concentration in Maternal Blood
大体时间:At 4 weeks post first injection and at 4 weeks post second injection
|
Geometric mean fold increase in IgG specific antibody concentration (Alp1, Alp2, AlpC and Rib) in maternal blood from baseline to 4 weeks after vaccination with the first and second dose.
|
At 4 weeks post first injection and at 4 weeks post second injection
|
|
Geometric Mean Fold Increase in Antibody Concentration in Maternal Blood
大体时间:Baseline (Gestational Age 26 to 30 weeks) pre-vaccination to delivery, up to 24 weeks
|
Geometric mean fold increase in IgG specific antibody concentration (Alp1, Alp2, AlpC and Rib) in maternal blood from baseline to delivery.
|
Baseline (Gestational Age 26 to 30 weeks) pre-vaccination to delivery, up to 24 weeks
|
|
Proportion of Mothers Achieving Vaccine Specific IgG Antibody Concentrations
大体时间:At delivery
|
Proportion of mothers achieving vaccine specific IgG antibody concentrations in maternal samples respectively, above pre-defined arbitrary thresholds (0.5, 1, 2 μg/mL).
|
At delivery
|
|
Proportion of Newborn Babies Achieving Vaccine Specific IgG Antibody Concentrations
大体时间:At birth
|
Proportion of newborn babies achieving vaccine specific IgG antibody concentrations above pre-defined arbitrary thresholds (0.5, 1, 2 μg/mL).
|
At birth
|
合作者和调查者
赞助
调查人员
- 研究主任:Cornelia Oostvogels、Minervax ApS
出版物和有用的链接
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (实际的)
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
此信息直接从 clinicaltrials.gov 网站检索,没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求,请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改,我们的网站上也会自动更新.