Determining Responses to Two Different Vaccines in HIV and HCV Infected Individuals

NCT ID: NCT00393276

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

Total Enrollment

29 participants

Study Classification

INTERVENTIONAL

Study Start Date

2007-08-31

Study Completion Date

2009-07-31

Brief Summary

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Infection with either HIV or hepatitis C virus (HCV) affects immune system responses. The purpose of this study is to investigate the immune responses to two different vaccine formulations in HIV-infected, HCV-infected, and HCV/HIV- coinfected individuals.

Detailed Description

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Individuals with HCV and HIV coinfection are especially hard to treat, and as a result, account for a high rate of deaths each year. Because HCV and HIV share transmission routes, HCV/HIV coinfection is common. Liver disease has emerged as a significant cause of death in individuals coinfected with HCV and HIV. Currently, the mechanisms by which HCV and HIV interact in HCV/HIV-coinfected individuals, including how these infections affect immune responses, are poorly understood. Research suggests that vaccination may prevent other comorbidities associated with HCV/HIV coinfection; however, responses to new vaccine antigens have been shown to be impaired in HCV or HIV-infected individuals. The purpose of this study is to identify the innate and adaptive immune defects present in HCV-infected, HIV-infected, and HCV/HIV-coinfected individuals. This study will evaluate whether these innate and adaptive immune defects predict responses to HBV neoantigen in the form of both a diphtheria/tetanus toxoid immunization (Decavac)and a hepatitis A-hepatitis B immunization (Twinrix).

This study will last approximately 24 weeks. Participants will be stratified to one of three arms, based on their HCV and HIV status:

* Arm A will enroll HCV-infected individuals who are HIV-uninfected
* Arm B will enroll HIV-infected individuals who are HCV-uninfected
* Arm C will enroll HCV/HIV-coinfected individuals

Arms B and C will open for enrollment before Arm A. Opening of enrollment for Arm A will be determined by the accrual progress of Arms B and C as evaluated by the ACTG Scientific Agenda Steering committee.

All participants will receive Decavac vaccination on Day 0, and a Twinrix vaccination on Days 0, 7, and 21. Study visits will occur around Days 0, 7, and 21, and at Weeks 6, 8, 12, and 24; all visits will include medical and medication history, blood collection, and a physical exam. Medication to treat HCV or HIV will not be provided by the study.

Conditions

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HIV Infections Hepatitis C

Keywords

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Treatment Experienced Treatment Naive Immunizations

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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A

HCV-infected defined as a positive result using polymerase chain reaction (PCR) without previous HCV-based therapy and without the presence of Child's B or C cirrhosis. These participants will be HIV-uninfected.

Group Type EXPERIMENTAL

Twinrix

Intervention Type BIOLOGICAL

Combined hepatitis A and hepatitis B immunization

Decavac

Intervention Type BIOLOGICAL

Diphtheria and tetanus toxoid vaccine

B

HIV-infected and ARV naive, with a CD4 cell count of 300 cells/mm3 or greater, with no prior or current opportunistic infection, and with no indication for HIV therapy. These participants will be HCV-uninfected.

Group Type EXPERIMENTAL

Twinrix

Intervention Type BIOLOGICAL

Combined hepatitis A and hepatitis B immunization

Decavac

Intervention Type BIOLOGICAL

Diphtheria and tetanus toxoid vaccine

C

HCV/HIV-coinfected as defined above in Arms A and B.

Group Type EXPERIMENTAL

Twinrix

Intervention Type BIOLOGICAL

Combined hepatitis A and hepatitis B immunization

Decavac

Intervention Type BIOLOGICAL

Diphtheria and tetanus toxoid vaccine

Interventions

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Twinrix

Combined hepatitis A and hepatitis B immunization

Intervention Type BIOLOGICAL

Decavac

Diphtheria and tetanus toxoid vaccine

Intervention Type BIOLOGICAL

Eligibility Criteria

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Inclusion Criteria

* HCV-infected
* HIV-uninfected


* HIV-infected
* HCV-uninfected
* CD4 count greater than or equal to 300 cells/mm3 within 60 days prior to study entry


* HIV-infected
* HCV-infected


* Documented hepatitis B virus (HBV) antibody status. If anti-HBV core antibody positive, documented HBV negative test within 30 days prior to study entry is required.
* Willing to use acceptable forms of contraception for the duration of the study and for 24 weeks after the last vaccination

Exclusion Criteria

* Concurrent or recent treatment for HCV infection (within the past three months)


* Current, prior, or clinical need for antiretroviral therapy (within the past three months prior to study entry)
* Opportunistic infection other than HCV


* Concurrent or recent treatment for HCV infection (within the past three months)
* Current, prior, or clinical need for antiretroviral therapy (within the past three months prior to study entry). More information on this criterion can be found in the protocol.
* Opportunistic infection other than HCV


* History of exposure to hepatitis A vaccine, hepatitis B vaccine, or combined hepatitis A-hepatitis B vaccines
* Immunomodulatory agents for 7 days or more within 30 days prior to study entry. More information on this criterion can be found in the protocol.
* Concurrent immunizations (e.g., influenza, pneumococcal, other vaccine)within 3 days prior to study entry
* Active or recent (in the last six months prior to study entry) CDC Category C event. More information on this criterion can be found in the protocol
* Systemic anticancer chemotherapy or radiation within 24 weeks prior to study entry, or anticipated need to begin such treatment
* Past or current immunologically-mediated disease. More information on this criterion can be found in the protocol.
* Current bacterial infection requiring treatment, therapy, or hospitalization within 1 week prior to study entry
* Serious illness requiring systemic treatment and/or hospitalization. Participants who complete therapy or are clinically stable on therapy for at least 14 days prior to study entry are not excluded.
* Current uncontrolled seizure disorders
* Active bleeding varices, or Child's B or C cirrhosis. More information on this criterion can be found in the protocol.
* Serious bleeding disorder that poses a risk to a participant for intramuscular injections
* Known allergy or sensitivity to study vaccines or their formulations
* Current drug or alcohol use that, in the opinion of the investigator, interferes with study participation
* Pregnant or breastfeeding
* Use of systemic investigational agents within 30 days prior to entry
* History of any hepatitis A vaccine within one year
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Advancing Clinical Therapeutics Globally for HIV/AIDS and Other Infections

NETWORK

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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Donald D. Anthony, MD, PhD

Role: STUDY_CHAIR

Case Western Reserve University

Benigno Rodriguez, MD

Role: STUDY_CHAIR

Division of Infectious Diseases, University Hospital of Cleveland

Locations

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UCSD Antiviral Research Center CRS

San Diego, California, United States

Site Status

Ucsf Aids Crs

San Francisco, California, United States

Site Status

University of Colorado Hospital CRS

Aurora, Colorado, United States

Site Status

IHV Baltimore Treatment CRS

Baltimore, Maryland, United States

Site Status

Massachusetts General Hospital Clinical Research Site (MGH CRS) CRS

Boston, Massachusetts, United States

Site Status

Columbia P&S CRS

New York, New York, United States

Site Status

Duke Univ. Med. Ctr. Adult CRS

Durham, North Carolina, United States

Site Status

Case CRS

Cleveland, Ohio, United States

Site Status

MetroHealth CRS

Cleveland, Ohio, United States

Site Status

The Ohio State University Medical Center

Columbus, Ohio, United States

Site Status

Trinity Health and Wellness Center CRS

Dallas, Texas, United States

Site Status

Puerto Rico AIDS Clinical Trials Unit CRS

San Juan, , Puerto Rico

Site Status

Countries

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United States Puerto Rico

References

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Maier I, Wu GY. Hepatitis C and HIV co-infection: a review. World J Gastroenterol. 2002 Aug;8(4):577-9. doi: 10.3748/wjg.v8.i4.577.

Reference Type BACKGROUND
PMID: 12174359 (View on PubMed)

Rockstroh JK. Management of hepatitis B and C in HIV co-infected patients. J Acquir Immune Defic Syndr. 2003 Sep;34 Suppl 1:S59-65. doi: 10.1097/00126334-200309011-00009.

Reference Type BACKGROUND
PMID: 14562859 (View on PubMed)

Sulkowski MS, Mast EE, Seeff LB, Thomas DL. Hepatitis C virus infection as an opportunistic disease in persons infected with human immunodeficiency virus. Clin Infect Dis. 2000 Apr;30 Suppl 1:S77-84. doi: 10.1086/313842.

Reference Type BACKGROUND
PMID: 10770916 (View on PubMed)

Other Identifiers

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10154

Identifier Type: REGISTRY

Identifier Source: secondary_id

1R21AI066957-01

Identifier Type: NIH

Identifier Source: secondary_id

View Link

ACTG A5232

Identifier Type: -

Identifier Source: secondary_id

A5232

Identifier Type: -

Identifier Source: org_study_id