Trial Outcomes & Findings for Immune Responses to Pneumococcal Vaccination Among HIV-infected Subjects (NCT NCT00706550)

NCT ID: NCT00706550

Last Updated: 2014-04-24

Results Overview

Immunoglobulins are antibodies or special proteins that the immune system produces to protect the body against infections. IgG is the most common antibody. We measure baseline levels (before the vaccine is administered) to know how much antibody the subject has at the start point to be able to evaluate how much antibody is produced after the vaccine is administered.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

107 participants

Primary outcome timeframe

Baseline

Results posted on

2014-04-24

Participant Flow

A total of 107 patients were enrolled on the study (11/2008-2/2011 at the Michael E. DeBakey VA Medical Center, at Thomas Street Clinic and at Legacy Clinic, in Houston, TX. Only the patients that completed the 1 month post-PV visit are included in the analysis (N=36 for each arm for a total of 72 out of the 107 initially enrolled).

Participant milestones

Participant milestones
Measure
Immediate: PV Before Starting Antiretroviral Therapy
Immediate group (Arm 1) received PV prior to starting antiretroviral treatment. PV (23-valent pneumococcal polysaccharide vaccine): Currently commercially available pneumococcal polysaccharide vaccine.
Delayed: PV After >6 Months of Antiretroviral Therapy
Delayed group (Arm 2) received PV after at least 6 months of antiretroviral treatment PV (23-valent pneumococcal polysaccharide vaccine): Currently commercially available pneumococcal polysaccharide vaccine.
Overall Study
STARTED
43
64
Overall Study
COMPLETED
36
36
Overall Study
NOT COMPLETED
7
28

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Immune Responses to Pneumococcal Vaccination Among HIV-infected Subjects

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Arm 1: PV Before Starting Antiretroviral Therapy
n=43 Participants
Arm 1 received PV prior to starting antiretroviral treatment. PV (23-valent pneumococcal polysaccharide vaccine): Currently commercially available pneumococcal polysaccharide vaccine
Arm 2: PV After >6 Months of Antiretroviral Therapy
n=64 Participants
Arm 2 received PV after at least 6 months of antiretroviral treatment. PV (23-valent pneumococcal polysaccharide vaccine): Currently commercially available pneumococcal polysaccharide vaccine
Total
n=107 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants
Age, Categorical
Between 18 and 65 years
42 Participants
n=93 Participants
63 Participants
n=4 Participants
105 Participants
n=27 Participants
Age, Categorical
>=65 years
1 Participants
n=93 Participants
1 Participants
n=4 Participants
2 Participants
n=27 Participants
Age, Continuous
43.4 years
STANDARD_DEVIATION 12.9 • n=93 Participants
40.8 years
STANDARD_DEVIATION 11.6 • n=4 Participants
41.8 years
STANDARD_DEVIATION 12.1 • n=27 Participants
Sex: Female, Male
Female
6 Participants
n=93 Participants
15 Participants
n=4 Participants
21 Participants
n=27 Participants
Sex: Female, Male
Male
37 Participants
n=93 Participants
49 Participants
n=4 Participants
86 Participants
n=27 Participants
Region of Enrollment
United States
43 participants
n=93 Participants
64 participants
n=4 Participants
107 participants
n=27 Participants

PRIMARY outcome

Timeframe: Baseline

Immunoglobulins are antibodies or special proteins that the immune system produces to protect the body against infections. IgG is the most common antibody. We measure baseline levels (before the vaccine is administered) to know how much antibody the subject has at the start point to be able to evaluate how much antibody is produced after the vaccine is administered.

Outcome measures

Outcome measures
Measure
Immediate: PV Before Starting Antiretroviral Therapy
n=36 Participants
Immediate group (Arm 1) received PV prior to starting antiretroviral treatment. PV (23-valent pneumococcal polysaccharide vaccine): Currently commercially available pneumococcal polysaccharide vaccine
Delayed: PV After >6 Months of Antiretroviral Therapy
n=36 Participants
Delayed group (Arm 2) received PV after at least 6 months of antiretroviral treatment PV (23-valent pneumococcal polysaccharide vaccine): Currently commercially available pneumococcal polysaccharide vaccine.
Immunoglobulin G (IgG) Levels
IgG levels against CPS 6B
5.12 Micrograms/ml
Full Range 1.0 • Interval 0.71 to 27.6
5.17 Micrograms/ml
Full Range 1.0 • Interval 1.1 to 22.87
Immunoglobulin G (IgG) Levels
IgG levels against CPS 23F
1.80 Micrograms/ml
Full Range 1.0 • Interval 0.44 to 9.35
1.83 Micrograms/ml
Full Range 1.0 • Interval 0.74 to 4.71

PRIMARY outcome

Timeframe: One-month post-vaccine

Immunoglobulins are antibodies or special proteins that the immune system produces to protect the body against infections. IgG is the most common antibody. This point of time (one-month after vaccine), gives the information about how much antibody was produced by the participant's immune system in response to the vaccine.

Outcome measures

Outcome measures
Measure
Immediate: PV Before Starting Antiretroviral Therapy
n=36 Participants
Immediate group (Arm 1) received PV prior to starting antiretroviral treatment. PV (23-valent pneumococcal polysaccharide vaccine): Currently commercially available pneumococcal polysaccharide vaccine
Delayed: PV After >6 Months of Antiretroviral Therapy
n=36 Participants
Delayed group (Arm 2) received PV after at least 6 months of antiretroviral treatment PV (23-valent pneumococcal polysaccharide vaccine): Currently commercially available pneumococcal polysaccharide vaccine.
IgG Levels
IgG levels against CPS 6B
7.85 Micrograms/ml
Full Range 1.0 • Interval 2.94 to 43.58
5.79 Micrograms/ml
Full Range 1.0 • Interval 1.23 to 21.42
IgG Levels
IgG levels against CPS 23F
2.50 Micrograms/ml
Full Range 1.0 • Interval 0.62 to 23.37
2.41 Micrograms/ml
Full Range 1.0 • Interval 0.8 to 7.94

PRIMARY outcome

Timeframe: Baseline

Immunoglobulins are antibodies or special proteins that the immune system produces to protect the body against infections. IgM is the first antibody produced by the immune system to fight a new infection. We measure baseline levels (before the vaccine is administered) to know how much antibody the subject has at the start point to be able to evaluate how much antibody is produced after the vaccine is administered.

Outcome measures

Outcome measures
Measure
Immediate: PV Before Starting Antiretroviral Therapy
n=36 Participants
Immediate group (Arm 1) received PV prior to starting antiretroviral treatment. PV (23-valent pneumococcal polysaccharide vaccine): Currently commercially available pneumococcal polysaccharide vaccine
Delayed: PV After >6 Months of Antiretroviral Therapy
n=36 Participants
Delayed group (Arm 2) received PV after at least 6 months of antiretroviral treatment PV (23-valent pneumococcal polysaccharide vaccine): Currently commercially available pneumococcal polysaccharide vaccine.
Immunoglobulin M (IgM) Levels
IgM levels against CPS 6B
1.89 Micrograms/ml
Interval 0.4 to 7.56
1.85 Micrograms/ml
Interval 0.39 to 4.86
Immunoglobulin M (IgM) Levels
IgM levels against CPS 23F
0.59 Micrograms/ml
Interval 0.01 to 4.29
0.78 Micrograms/ml
Interval 0.09 to 3.18

PRIMARY outcome

Timeframe: One-month post-vaccine

Immunoglobulins are antibodies or special proteins that the immune system produces to protect the body against infections. IgM is the first antibody produced by the immune system to fight a new infection. This point of time (one-month after vaccine), gives the information about how much antibody was produced by the participant's immune system in response to the vaccine.

Outcome measures

Outcome measures
Measure
Immediate: PV Before Starting Antiretroviral Therapy
n=36 Participants
Immediate group (Arm 1) received PV prior to starting antiretroviral treatment. PV (23-valent pneumococcal polysaccharide vaccine): Currently commercially available pneumococcal polysaccharide vaccine
Delayed: PV After >6 Months of Antiretroviral Therapy
n=36 Participants
Delayed group (Arm 2) received PV after at least 6 months of antiretroviral treatment PV (23-valent pneumococcal polysaccharide vaccine): Currently commercially available pneumococcal polysaccharide vaccine.
IgM Levels
IgM levels against CPS 6B
2.18 Micrograms/ml
Interval 0.42 to 9.0
2.26 Micrograms/ml
Interval 0.59 to 6.29
IgM Levels
IgM levels against CPS 23F
0.65 Micrograms/ml
Interval 0.02 to 3.2
0.84 Micrograms/ml
Interval 0.23 to 2.86

PRIMARY outcome

Timeframe: Baseline

This assay helps us to know how the antibody produced by the body are working to kill the bacteria against which the antibody is produced. As explained previously for the immunoglobulins' assays, we measure the baseline point to be able to determine the increase after the vaccine is administered.

Outcome measures

Outcome measures
Measure
Immediate: PV Before Starting Antiretroviral Therapy
n=23 Participants
Immediate group (Arm 1) received PV prior to starting antiretroviral treatment. PV (23-valent pneumococcal polysaccharide vaccine): Currently commercially available pneumococcal polysaccharide vaccine
Delayed: PV After >6 Months of Antiretroviral Therapy
n=36 Participants
Delayed group (Arm 2) received PV after at least 6 months of antiretroviral treatment PV (23-valent pneumococcal polysaccharide vaccine): Currently commercially available pneumococcal polysaccharide vaccine.
Opsonophagocytic Killing Activity (OPA)
OPA titers against CPS 6B
4.5 Titers
Interval 2.0 to 512.0
6.0 Titers
Interval 2.0 to 512.0
Opsonophagocytic Killing Activity (OPA)
OPA titers against CPS 23F
2.9 Titers
Interval 2.0 to 32.0
2.9 Titers
Interval 2.0 to 256.0

PRIMARY outcome

Timeframe: One-month post-vaccine

This assay helps us to know how the antibody produced by the body are working to kill the bacteria against which the antibody is produced. This point of time (one-month after vaccine), gives the information about how much the killing activity increased 1 month after the vaccine was administered.

Outcome measures

Outcome measures
Measure
Immediate: PV Before Starting Antiretroviral Therapy
n=23 Participants
Immediate group (Arm 1) received PV prior to starting antiretroviral treatment. PV (23-valent pneumococcal polysaccharide vaccine): Currently commercially available pneumococcal polysaccharide vaccine
Delayed: PV After >6 Months of Antiretroviral Therapy
n=36 Participants
Delayed group (Arm 2) received PV after at least 6 months of antiretroviral treatment PV (23-valent pneumococcal polysaccharide vaccine): Currently commercially available pneumococcal polysaccharide vaccine.
Opsonophagocytic Killing Activity (OPA)
OPA titers against CPS 6B
23.0 Titers
Interval 2.0 to 512.0
13.7 Titers
Interval 2.0 to 512.0
Opsonophagocytic Killing Activity (OPA)
OPA titers against CPS 23F
4.7 Titers
Interval 2.0 to 128.0
3.3 Titers
Interval 2.0 to 64.0

Adverse Events

Arm 1: PV Before Starting Antiretroviral Therapy

Serious events: 6 serious events
Other events: 2 other events
Deaths: 0 deaths

Arm 2: PV After >6 Months of Antiretroviral Therapy

Serious events: 8 serious events
Other events: 1 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Arm 1: PV Before Starting Antiretroviral Therapy
n=43 participants at risk
Arm 1 received PV prior to starting antiretroviral treatment. PV (23-valent pneumococcal polysaccharide vaccine): Currently commercially available pneumococcal polysaccharide vaccine
Arm 2: PV After >6 Months of Antiretroviral Therapy
n=64 participants at risk
Arm 2 received PV after at least 6 months of antiretroviral treatment. PV (23-valent pneumococcal polysaccharide vaccine): Currently commercially available pneumococcal polysaccharide vaccine
Cardiac disorders
CHF, arrhythmia
2.3%
1/43 • Number of events 1
1.6%
1/64 • Number of events 2
Nervous system disorders
Cerebrovascular accident
0.00%
0/43
1.6%
1/64 • Number of events 1
General disorders
Death
2.3%
1/43 • Number of events 1
3.1%
2/64 • Number of events 2
General disorders
Dehydration, electrolite abnormalities
0.00%
0/43
1.6%
1/64 • Number of events 2
Surgical and medical procedures
Elective surgery
0.00%
0/43
1.6%
1/64 • Number of events 1
Gastrointestinal disorders
Gastrointestinal infections and other disorders
0.00%
0/43
3.1%
2/64 • Number of events 5
Psychiatric disorders
Mental health related
4.7%
2/43 • Number of events 3
0.00%
0/64
Infections and infestations
Other infections
2.3%
1/43 • Number of events 1
1.6%
1/64 • Number of events 2
Respiratory, thoracic and mediastinal disorders
Respiratory infection
7.0%
3/43 • Number of events 3
6.2%
4/64 • Number of events 4
Skin and subcutaneous tissue disorders
Skin infection
2.3%
1/43 • Number of events 1
1.6%
1/64 • Number of events 1

Other adverse events

Other adverse events
Measure
Arm 1: PV Before Starting Antiretroviral Therapy
n=43 participants at risk
Arm 1 received PV prior to starting antiretroviral treatment. PV (23-valent pneumococcal polysaccharide vaccine): Currently commercially available pneumococcal polysaccharide vaccine
Arm 2: PV After >6 Months of Antiretroviral Therapy
n=64 participants at risk
Arm 2 received PV after at least 6 months of antiretroviral treatment. PV (23-valent pneumococcal polysaccharide vaccine): Currently commercially available pneumococcal polysaccharide vaccine
Blood and lymphatic system disorders
Anemia
2.3%
1/43 • Number of events 1
0.00%
0/64
Skin and subcutaneous tissue disorders
Rash
0.00%
0/43
1.6%
1/64 • Number of events 1
Infections and infestations
Upper respiratory infection
2.3%
1/43 • Number of events 1
1.6%
1/64 • Number of events 1

Additional Information

Dr. Maria C. Rodriguez-Barradas

Michael E. DeBakey Veterans Affairs Medical Center

Phone: 713-794-7384

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place