Safety of and Immune Response to Two Influenza Vaccines in HIV Infected Children and Adolescents

NCT ID: NCT00091702

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

PHASE1/PHASE2

Total Enrollment

300 participants

Study Classification

INTERVENTIONAL

Study Completion Date

2006-01-31

Brief Summary

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The purpose of this study is to compare two flu vaccines to determine their safety and ability to stimulate an immune response in HIV infected children and adolescents. This study will also determine how often and how long people who receive a vaccine are able to spread flu vaccine virus to other people.

Detailed Description

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Influenza virus infections are common among children, particularly during the winter season. The infections are often mild, but more serious cases can cause a number of complications, including respiratory illnesses and bacterial infections. HIV infected children may have an increased risk for developing influenza-related bacterial complications, and influenza infections among this population may lead to more rapid disease progression. The current standard of care for HIV infected children is vaccination with an inactivated influenza vaccine (IAIV). However, IAIV is limited in its ability to stimulate the immune systems of HIV infected children with advanced disease. FluMist, a cold-adapted live attenuated influenza vaccine, is both immunogenic and effective in HIV infected children; unfortunately, FluMist is associated with viral shedding, a period of time when the influenza virus used to produce the vaccine may be transmitted to other people. This study will compare the safety and immunogenicity of IAIV and FluMist in HIV infected children and adolescents. This study will also determine the prevalence and duration of FluMist viral shedding in HIV infected children and adolescents who have received the vaccination.

Participants in this study will be randomly assigned to one of two arms. Arm A participants will receive FluMist; Arm B participants will receive IAIV. A single immunization will occur on Day 0 of the study. Arm A participants will have study visits on Days 3, 14, and 28 or home visits on Days 3 and 14. Participants in Arm B will have a study visit on Day 28. A physical exam will be performed at the initial study visit; blood will be collected at study start and at each visit thereafter. Phone calls will be made to participants throughout the study. All participants will have a final study visit after 6 months.

Conditions

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HIV Infections Influenza

Keywords

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FluMist Influenza Vaccine Adolescent Treatment Experienced

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Interventions

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Cold-adapted live attenuated influenza vaccine (FluMist)

Intervention Type BIOLOGICAL

Inactivated influenza vaccine (IAIV)

Intervention Type BIOLOGICAL

Eligibility Criteria

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Inclusion Criteria

* HIV infected
* Stable highly active antiretroviral therapy (HAART) regimen for at least 16 weeks with no changes in therapy anticipated
* Meet certain CD4 cell count and CD4% requirements
* Viral load of less than 60,000 copies/ml within 60 days prior to study start
* Received inactivated influenza vaccine (IAIV) in at least one of the past 2 years
* Written informed consent of parent or legal guardian
* Availability of parent or legal guardian to be contacted by phone

Exclusion Criteria

* Immunosuppressive or immunomodulatory therapy within 60 days prior to immunization or immunological testing
* Aspirin or aspirin-containing therapy at the time of vaccination or planned within 42 days after immunization
* History of hypersensitivity to any component of IAIV or FluMist
* History of Guillain-Barre syndrome
* Receipt of any inactivated vaccine within 14 days prior to the study vaccination
* Receipt of any live vaccine within 30 days prior to the study vaccination
* Plans to receive any vaccine within the 30 days following the vaccination
* Receipt of any additional influenza vaccine for the duration of the study
* Prophylactic use of drugs with anti-influenza activity
* Moderate chronic pulmonary disease, obstructive or restrictive
* Cardiopulmonary disease affecting normal childhood activity
* Medically-diagnosed wheezing, bronchodilator use, or steroid use within the past 42 days
* Medical illness associated with suppression of T-cell immunity
* Pregnancy, breast-feeding, or unwillingness to use acceptable methods of contraception for 3 months following vaccination
* Severely immunosuppressed household member
* Receipt of any blood products within 3 months prior to vaccination or expected receipt during the study, including the 6-month follow-up period
* Significant fever or illness within 72 hours prior to vaccination
* Any other condition that would interfere with the study
Minimum Eligible Age

5 Years

Maximum Eligible Age

17 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

NIH

Sponsor Role collaborator

National Institute of Allergy and Infectious Diseases (NIAID)

NIH

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Myron J. Levin, MD

Role: STUDY_CHAIR

University of Colorado, Denver

Locations

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

Birmingham, Alabama, United States

Site Status

Univ. of South Alabama College of Medicine, Southeast Ped. ACTU

Mobile, Alabama, United States

Site Status

Phoenix Children's Hosp.

Phoenix, Arizona, 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

UCLA-Los Angeles/Brazil AIDS Consortium (LABAC) 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

Children's Hosp. of Orange County

Orange, California, United States

Site Status

UCSD Maternal, Child, and Adolescent HIV CRS

San Diego, California, United States

Site Status

UCSF Pediatric AIDS CRS

San Francisco, California, United States

Site Status

Harbor - UCLA Med. Ctr. - Dept. of Peds., Div. of Infectious Diseases

Torrance, 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

Children's National Med. Ctr., ACTU

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

Site Status

Howard Univ. Washington DC NICHD CRS

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

Site Status

South Florida CDC Ft Lauderdale NICHD CRS

Fort Lauderdale, Florida, United States

Site Status

Children's Diagnostic & Treatment Ctr. of South Florida

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

USF - Tampa NICHD CRS

Tampa, Florida, United States

Site Status

Med. College of Georgia School of Medicine, Dept. of Peds., Div. of Infectious Diseases

Augusta, Georgia, United States

Site Status

Columbus Regional HealthCare System, The Med. Ctr.

Columbus, Georgia, United States

Site Status

Chicago Children's CRS

Chicago, Illinois, United States

Site Status

Mt. Sinai Hosp. Med. Ctr. - Chicago, Womens & Childrens HIV Program

Chicago, Illinois, United States

Site Status

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

Chicago, Illinois, United States

Site Status

Tulane/LSU Maternal/Child CRS

New Orleans, Louisiana, United States

Site Status

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

Baltimore, Maryland, United States

Site Status

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

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

Lawrence Family Health Ctr., Essex St. Clinic

Lawrence, Massachusetts, United States

Site Status

Lowell Community Health Ctr.

Lowell, 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

Children's Hospital of Michigan NICHD CRS

Detroit, Michigan, United States

Site Status

Washington Univ. School of Medicine at St. Louis, St. Louis Children's Hosp.

St Louis, Missouri, United States

Site Status

NJ Med. 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

Nyu Ny Nichd Crs

New York, New York, United States

Site Status

Mt. Sinai School of Medicine, Div. of Ped. Infectious Diseases

New York, New York, United States

Site Status

Harlem Hosp. Ctr. NY NICHD CRS

New York, New York, United States

Site Status

Columbia IMPAACT CRS

New York, New York, United States

Site Status

Strong Memorial Hospital Rochester NY NICHD CRS

Rochester, New York, United States

Site Status

SUNY Stony Brook NICHD CRS

Stony Brook, New York, United States

Site Status

SUNY Upstate Med. Univ., Dept. of Peds.

Syracuse, New York, United States

Site Status

Bronx-Lebanon Hosp. IMPAACT CRS

The Bronx, New York, United States

Site Status

Jacobi Med. Ctr. Bronx NICHD CRS

The Bronx, New York, United States

Site Status

Jacobi Med. Ctr.

The Bronx, New York, United States

Site Status

UNC at Chapel Hill School of Medicine - Dept. of Peds., Div. of Immunology & Infectious Diseases

Chapel Hill, North Carolina, United States

Site Status

DUMC Ped. CRS

Durham, North Carolina, United States

Site Status

The Children's Hosp. of Philadelphia IMPAACT CRS

Philadelphia, Pennsylvania, United States

Site Status

St. Jude/UTHSC CRS

Memphis, Tennessee, United States

Site Status

Texas Children's Hosp. CRS

Houston, Texas, United States

Site Status

Children's Hosp. of the King's Daughters, Infectious Disease

Norfolk, Virginia, United States

Site Status

Seattle Children's Hospital CRS

Seattle, Washington, United States

Site Status

UW School of Medicine - CHRMC

Seattle, Washington, United States

Site Status

Univ. of Puerto Rico Ped. HIV/AIDS Research Program CRS

San Juan, , Puerto Rico

Site Status

San Juan City Hosp. PR NICHD CRS

San Juan, , Puerto Rico

Site Status

Countries

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United States Puerto Rico

References

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Gunthard HF, Wong JK, Spina CA, Ignacio C, Kwok S, Christopherson C, Hwang J, Haubrich R, Havlir D, Richman DD. Effect of influenza vaccination on viral replication and immune response in persons infected with human immunodeficiency virus receiving potent antiretroviral therapy. J Infect Dis. 2000 Feb;181(2):522-31. doi: 10.1086/315260.

Reference Type BACKGROUND
PMID: 10669335 (View on PubMed)

Belshe RB, Mendelman PM, Treanor J, King J, Gruber WC, Piedra P, Bernstein DI, Hayden FG, Kotloff K, Zangwill K, Iacuzio D, Wolff M. The efficacy of live attenuated, cold-adapted, trivalent, intranasal influenzavirus vaccine in children. N Engl J Med. 1998 May 14;338(20):1405-12. doi: 10.1056/NEJM199805143382002.

Reference Type BACKGROUND
PMID: 9580647 (View on PubMed)

King JC Jr, Fast PE, Zangwill KM, Weinberg GA, Wolff M, Yan L, Newman F, Belshe RB, Kovacs A, Deville JG, Jelonek M; HIV Influenza Study Group. Safety, vaccine virus shedding and immunogenicity of trivalent, cold-adapted, live attenuated influenza vaccine administered to human immunodeficiency virus-infected and noninfected children. Pediatr Infect Dis J. 2001 Dec;20(12):1124-31. doi: 10.1097/00006454-200112000-00006.

Reference Type BACKGROUND
PMID: 11740317 (View on PubMed)

King JC Jr, Treanor J, Fast PE, Wolff M, Yan L, Iacuzio D, Readmond B, O'Brien D, Mallon K, Highsmith WE, Lambert JS, Belshe RB. Comparison of the safety, vaccine virus shedding, and immunogenicity of influenza virus vaccine, trivalent, types A and B, live cold-adapted, administered to human immunodeficiency virus (HIV)-infected and non-HIV-infected adults. J Infect Dis. 2000 Feb;181(2):725-8. doi: 10.1086/315246.

Reference Type BACKGROUND
PMID: 10669363 (View on PubMed)

Weinberg A, Song LY, Walker R, Allende M, Fenton T, Patterson-Bartlett J, Nachman S, Kemble G, Yi TT, Defechereux P, Wara D, Read JS, Levin M; IMPAACT P1057 Team. Anti-influenza serum and mucosal antibody responses after administration of live attenuated or inactivated influenza vaccines to HIV-infected children. J Acquir Immune Defic Syndr. 2010 Oct;55(2):189-96. doi: 10.1097/QAI.0b013e3181e46308.

Reference Type RESULT
PMID: 20581690 (View on PubMed)

Other Identifiers

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10612

Identifier Type: REGISTRY

Identifier Source: secondary_id

PACTG P1057

Identifier Type: -

Identifier Source: secondary_id

P1057

Identifier Type: -

Identifier Source: org_study_id