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NCT00013871

Pneumococcal Vaccine and Routine Pediatric Immunizations in HIV-Infected Children Receiving Anti-HIV Drugs

Last Updated: 2021-11-01

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

Total Enrollment

300 participants

Study Classification

INTERVENTIONAL

Study Completion Date

2004-11-30

Brief Summary

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The purpose of this study is to determine if 2 doses of Pneumococcal Conjugate Vaccine (PCV) followed by 1 dose of Pneumococcal Polysaccharide Vaccine (PPV) in HIV-infected children on anti-HIV therapy is helpful and safe in fighting pneumococcal infections in this group of children. This study will also look at the protection provided by childhood vaccination against measles, pertussis, and hepatitis B virus.

Pneumococcal infections are the most common AIDS-related infection in HIV-infected children. PCV may help reduce the chances of HIV-infected children getting pneumococcal infections. This study will look at whether pneumococcal vaccines are safe and effective in HIV-infected children receiving HAART. It will look at whether HIV-infected children are protected by childhood vaccines received previously and if more doses are safe and improve protection.

Detailed Description

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Infection by Streptococcus pneumoniae is the most frequent opportunistic infection observed in HIV-infected children. PCVs are immunogenic and efficacious in normal children and offer hope of reducing pneumococcal infections in HIV-infected children. The degree to which children on HAART are protected by prior immunizations and are responsive to new immunizations is still largely undefined. This study is designed to answer whether PCV immunizations are safe and effective. The immune responses to prior immunizations and responsiveness to booster doses of vaccines against measles, pertussis, and hepatitis B virus of children on HAART will also be examined. Answers to these questions will determine whether these children are likely to be protected against these clinically relevant pathogens and whether they should routinely receive booster doses of these vaccines after a period of HAART.

Patients are stratified on the basis of CD4 percentage and age. Patients that previously received a primary hepatitis B vaccine (HBV) series receive an HBV immunization at entry. Other vaccinations may be given (based on age and/or CD4 cell measurement, and immunization status) for PCV at entry and 2 months, and measles-mumps-rubella (MMR) vaccine and PPV at 4 months. Some patients may be administered DTaP at a 6-month visit on the basis of age, previous immunization history, and negative tetanus antibody status. Follow-up visits are done at 8, 12, and 24 months. Blood samples are collected at all clinic visits for assessment of HIV RNA, immune responses against pneumococcus, measles, pertussis, and hepatitis B virus, as well as for laboratory evaluations.

Conditions

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HIV Infections Hepatitis B Measles Pneumococcal Infections Pertussis

Keywords

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Measles-Mumps-Rubella Vaccine Antibodies, Viral Hepatitis B Vaccines Immunization, Secondary Pneumococcal Vaccines Antiretroviral Therapy, Highly Active Diphtheria-Tetanus-acellular Pertussis Vaccines

Study Design

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Primary Study Purpose

PREVENTION

Interventions

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Diphtheria & Tetanus Toxoids & Acellular Pertussis Vaccine Adsorbed

Intervention Type BIOLOGICAL

Measles-Mumps-Rubella Vaccine (Live)

Intervention Type BIOLOGICAL

Pneumococcal Vaccine, Polyvalent (23-valent)

Intervention Type BIOLOGICAL

Pneumococcal Conjugate Vaccine, Heptavalent

Intervention Type BIOLOGICAL

Hepatitis B Vaccine (Recombinant)

Intervention Type BIOLOGICAL

Eligibility Criteria

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Inclusion Criteria

Patients may be eligible for this study if they:

* Are 2 to 18 years of age.
* Are HIV-infected.
* Have a viral load (amount of HIV in the blood) under 60,000 copies/ml within 30 days of study entry.
* Have been on their current anti-HIV drugs for at least 3 months.
* Have received 4 or more doses of a pertussis vaccine.
* Have received 1 or more doses of measles vaccine unless a CD4 percent or CD4 number ruled out taking the vaccine. (This reflects a change in the CD4 requirement.)
* Expect to be able to complete all study injections and follow-up.
* Have a negative pregnancy test if able to have children and use effective methods of birth control.
* Have parent or guardian's consent if under 18 years of age.
* Have received an approved hepatitis B vaccine series. Not required for study entry, but children who have received this vaccine will be studied.
* (This study was changed to allow patients who became HIV infected after birth, have a viral load between 30,000 and 60,000 copies/ml, and who have been on their current anti-HIV drugs for 3 to 6 months.)

Exclusion Criteria

Patients will not be eligible for this study if they:

* Had a certain CD4 level before beginning anti-HIV drugs and at screening.
* Have received any killed vaccine within 4 weeks, or any live vaccine within 6 weeks, of entering the study.
* Have received pneumococcal vaccines or had a reaction to PPV.
* Have had an allergic reaction to any measles or hepatitis B vaccines, or to other routine childhood immunizations if 13 years of age or less.
* Have any other condition that would make receiving study vaccines inadvisable.
* Are currently on medications that affect the immune system, except for G-CSF and erythropoietin. This includes the equivalent to more than 1 mg/kg/day of prednisone in the 2 weeks preceding study screening. Nonsteroidal anti-inflammatory agents and inhaled corticosteroids are not excluded.
* Have received certain blood products within the previous 6 months.
* Have other diseases of the immune system.
* Have had cancer within 3 months of study screening or are being treated or have been treated for cancer within 3 months of study entry.
* Are pregnant.
* Have any other disease or previous surgery that would interfere with study treatment.
* Are likely to have bleeding disorders.
* Show certain side effects to vaccines at screening.

Minimum Eligible Age

2 Years

Maximum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Mark Abzug

Role: STUDY_CHAIR

Locations

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UAB, Dept. of Ped., Div. of Infectious Diseases

Birmingham, Alabama, United States

Site Status

Long Beach Memorial Med. Ctr., Miller Children's Hosp.

Long Beach, California, United States

Site Status

Usc La Nichd Crs

Los Angeles, California, United States

Site Status

Children's Hosp. & Research Ctr. Oakland, Ped. Clinical Research Ctr. & Research Lab.

Oakland, California, United States

Site Status

UCSD Mother-Child-Adolescent Program CRS

San Diego, California, United States

Site Status

UCSF Pediatric AIDS CRS

San Francisco, California, United States

Site Status

Univ. of Colorado Denver NICHD CRS

Aurora, Colorado, United States

Site Status

Connecticut Children's Med. Ctr.

Hartford, Connecticut, United States

Site Status

Yale Univ. School of Medicine - Dept. of Peds., Div. of Infectious Disease

New Haven, Connecticut, United States

Site Status

Children's National Med. Ctr. Washington DC NICHD CRS

Washington D.C., District of Columbia, United States

Site Status

South Florida CDTC Ft Lauderdale NICHD CRS

Fort Lauderdale, Florida, United States

Site Status

Univ. of Florida College of Medicine-Dept of Peds, Div. of Immunology, Infectious Diseases & Allergy

Gainesville, Florida, United States

Site Status

Univ. of Florida Jacksonville NICHD CRS

Jacksonville, Florida, United States

Site Status

Univ. of Miami Ped. Perinatal HIV/AIDS CRS

Miami, Florida, United States

Site Status

Columbus Regional HealthCare System, The Med. Ctr.

Columbus, Georgia, United States

Site Status

Univ. of Chicago - Dept. of Peds., Div. of Infectious Disease

Chicago, Illinois, United States

Site Status

Chicago Children's CRS

Chicago, Illinois, United States

Site Status

Univ. of Maryland Med. Ctr., Div. of Ped. Immunology & Rheumatology

Baltimore, Maryland, United States

Site Status

Johns Hopkins Hosp. & Health System - Dept. of Peds., Div. of Infectious Diseases

Baltimore, Maryland, United States

Site Status

HMS - Children's Hosp. Boston, Div. of Infectious Diseases

Boston, Massachusetts, United States

Site Status

BMC, Div. of Ped Infectious Diseases

Boston, Massachusetts, United States

Site Status

Baystate Health, Baystate Med. Ctr.

Springfield, Massachusetts, United States

Site Status

WNE Maternal Pediatric Adolescent AIDS CRS

Worcester, Massachusetts, United States

Site Status

Rutgers - New Jersey Medical School CRS

Newark, New Jersey, United States

Site Status

SUNY Downstate Med. Ctr., Children's Hosp. at Downstate NICHD CRS

Brooklyn, New York, United States

Site Status