Immune System Function Following Vaccination in HIV Infected Children Taking Anti-HIV Drugs

NCT ID: NCT00257127

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

NA

Total Enrollment

101 participants

Study Classification

INTERVENTIONAL

Study Start Date

2006-02-28

Study Completion Date

2006-08-31

Brief Summary

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The purpose of this study is to determine immune system function following vaccination in HIV-infected children currently taking anti-HIV drugs. To test the effectiveness of prior vaccination, patients in this study will receive booster shots of one of two pneumococcal vaccines, a hepatitis B vaccine, and a measles vaccine.

Detailed Description

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With their immunocompromised status, HIV-infected children are at especially high risk for opportunistic infections, including infection by Streptococcus pneumoniae, hepatitis B, and measles. In PACTG P1024, HIV-infected children taking highly active antiretroviral therapy (HAART) received 2 doses of the pneumococcal conjugate vaccine (PCV), 1 dose of the pneumococcal polysaccharide vaccine (PPV), and booster shots of the hepatitis B vaccine (HBV) and measles, mumps, and rubella vaccine (MMR). Early responses to these vaccinations were favorable, but with declining antibody responses within the 18 months after vaccination. It is unknown if additional booster vaccinations in these children will result in a protective immunologic memory upon re-exposure to these pathogens. This study will determine whether HIV-infected children on HAART have evidence of specific immunologic memory 3 to 4 years after vaccination in PACTG P1024.

Patients will be randomly assigned to receive PCV or PPV at study entry. All eligible patients will also receive HBV and MMR at study entry. Patients will be monitored in the clinic for 1 hour after vaccination for any adverse effects. Study staff will contact patients by phone around Day 3 after study entry to ask patients if they have experienced any adverse effects to the vaccinations; patients who received MMR at study entry will be contacted again around Day 21. Some patients may be asked to return to the clinic for further evaluation if they experience side effects.

There will be study visits at study entry and Days 7 and 28. Medical history, a physical exam, blood collection, and an assessment of HIV-related symptoms will occur at all visits. HAART will not be provided by this study.

Conditions

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HIV Infections

Keywords

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Vaccination

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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1

Patients will receive PCV, HBV, and MMR at study entry

Group Type EXPERIMENTAL

Pneumococcal 7-valent conjugate vaccine

Intervention Type BIOLOGICAL

0.5 mL administered intramuscularly

Hepatitis B vaccine

Intervention Type BIOLOGICAL

0.5 mL administered intramuscularly

Measles, mumps, and rubella virus vaccine, live

Intervention Type BIOLOGICAL

0.5 mL administered subcutaneously

2

Patients will receive PPV, HBV, and MMR at study entry

Group Type EXPERIMENTAL

Pneumococcal polysaccharide vaccine

Intervention Type BIOLOGICAL

0.5 mL administered intramuscularly

Hepatitis B vaccine

Intervention Type BIOLOGICAL

0.5 mL administered intramuscularly

Measles, mumps, and rubella virus vaccine, live

Intervention Type BIOLOGICAL

0.5 mL administered subcutaneously

Interventions

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Pneumococcal 7-valent conjugate vaccine

0.5 mL administered intramuscularly

Intervention Type BIOLOGICAL

Pneumococcal polysaccharide vaccine

0.5 mL administered intramuscularly

Intervention Type BIOLOGICAL

Hepatitis B vaccine

0.5 mL administered intramuscularly

Intervention Type BIOLOGICAL

Measles, mumps, and rubella virus vaccine, live

0.5 mL administered subcutaneously

Intervention Type BIOLOGICAL

Other Intervention Names

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PCV PPV HBV MMR

Eligibility Criteria

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Inclusion Criteria

* Completed the 96-week initial study period of PACTG P1024 and had enrolled into that study between June 1, 2001 and March 31, 2002
* Fulfilled PACTG P1024's definition of HAART (taking 3 or more antiretrovirals \[ARVs\] from at least 2 of the available therapeutic drug classes) during PACTG P1024's vaccination period (Weeks 0 to 24). Patients who were taking 3 nucleoside reverse transcriptase inhibitors during that period without a non-nucleoside reverse transcriptase inhibitor or a protease inhibitor (PI) are not eligible for this study. Nontherapeutic boosting doses of ritonavir used in ritonavir-boosted PI regimens are not counted as separate ARVs.
* Stable ARV regimen in the 4 weeks prior to study entry
* No changes anticipated to current ARV regimen during this study
* Willing to complete all study vaccinations and evaluations
* Willing to use acceptable forms of contraception, if applicable
* Parent or guardian willing to provide informed consent, if applicable

Exclusion Criteria

* Abnormal blood or chemistry values on most recent laboratory tests. More information on this criterion can be found in the protocol.
* Received PCV, HBV, PPV, or MMR vaccines during PACTG P1024 in a sequence other than specified in PACTG P1024
* Received one or more doses of each of PCV, PPV, MMR, or HBV vaccines since the end of PACTG P1024's vaccination period
* Previous Grade 3 or higher adverse events or allergic reactions judged to be possibly or definitely related to the PCV, PPV, MMR, or HBV vaccines
* Received any killed vaccine within the 4 weeks prior to study entry
* Received any live vaccine within the 6 weeks prior to study entry
* Planning to receive any killed or live vaccine other than study vaccines between the first and third study visits
* Presence of an underlying condition that contraindicates use of any of the study vaccines. Patients who have a CD4% less than 15% will not be given the MMR vaccine, but such patients will not be excluded from this study.
* Current immunomodulatory therapy, including IL-2, any interferon product, GM-CSF, or thalidomide. Patients taking G-CSF or erythropoietin are not excluded.
* Anticipated need for immunomodulatory treatment during this study
* Any intramuscular immune globulin product within the 6 months prior to study entry
* Intravenous immune globulin within the 11 months prior to study entry
* Platelets or plasma products within the 7 months prior to study entry
* Anticipated need for immune globulin products during this study
* Current systemic immunosuppressive therapy, including the equivalent of 1 mg/kg/day or greater of prednisone in the 2 weeks prior to study entry. Patients using inhaled corticosteroids only are not excluded from this study. More information on this criterion can be found in the protocol.
* Anticipated need for systemic immunosuppressive therapy during this study
* Other known or suspected diseases of the immune system
* Cancer in the 3 months prior to study entry or treatment for cancer within the 3 months prior to study entry
* Other acute or chronic medical or surgical conditions or contraindications that, in the opinion of the investigator, may interfere with the study
* Known bleeding disorder
* Any Grade 2 or higher clinical toxicity at study screening. More information on this criterion can be found in the protocol.
* Require certain medications
* Pregnancy
Minimum Eligible Age

6 Years

Maximum Eligible Age

23 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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Mark Abzug, MD

Role: STUDY_CHAIR

The Children's Hospital, Denver, CO

Locations

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

Birmingham, Alabama, United States

Site Status

Usc La Nichd Crs

Alhambra, California, United States

Site Status

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

Long Beach, California, United States

Site Status

UCSD Mother-Child-Adolescent Program CRS

San Diego, California, United States

Site Status

Univ. of Colorado Denver NICHD CRS

Aurora, Colorado, United States

Site Status

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

New Haven, Connecticut, 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

Chicago Children's CRS

Chicago, Illinois, United States

Site Status

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

Chicago, Illinois, United States

Site Status

Children's Hosp.

New Orleans, Louisiana, 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

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

Nyu Ny Nichd Crs

New York, New York, United States

Site Status

Metropolitan Hosp. Ctr.

New York, New York, United States

Site Status

Harlem Hosp. Ctr. NY NICHD 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

Bronx-Lebanon Hosp. IMPAACT CRS

The Bronx, New York, United States

Site Status

St. Christopher's Hosp. for Children

Philadelphia, Pennsylvania, 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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Obaro SK, Pugatch D, Luzuriaga K. Immunogenicity and efficacy of childhood vaccines in HIV-1-infected children. Lancet Infect Dis. 2004 Aug;4(8):510-8. doi: 10.1016/S1473-3099(04)01106-5.

Reference Type BACKGROUND
PMID: 15288824 (View on PubMed)

Abzug MJ, Song LY, Levin MJ, Nachman SA, Borkowsky W, Pelton SI; International Maternal Pediatric Adolescent AIDS Clinical Trials Group P1024 and P1061s Protocol Teams. Antibody persistence and immunologic memory after sequential pneumococcal conjugate and polysaccharide vaccination in HIV-infected children on highly active antiretroviral therapy. Vaccine. 2013 Oct 1;31(42):4782-90. doi: 10.1016/j.vaccine.2013.08.002. Epub 2013 Aug 14.

Reference Type DERIVED
PMID: 23954381 (View on PubMed)

Related Links

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http://www.clinicaltrials.gov/ct/show/NCT00013871

Click here for more information about PACTG P1024

Other Identifiers

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10132

Identifier Type: REGISTRY

Identifier Source: secondary_id

PACTG P1061s

Identifier Type: -

Identifier Source: secondary_id

P1061s

Identifier Type: -

Identifier Source: org_study_id