Trial Outcomes & Findings for Impact of Everolimus on HIV Persistence Post Kidney or Liver Transplant (NCT NCT02429869)

NCT ID: NCT02429869

Last Updated: 2019-11-19

Results Overview

Peripheral blood mononuclear cells were isolated from whole blood using the Ficoll density gradient technique. Peripheral blood CD4 T cells were enriched by negative selection using antibody-coupled magnetic beads (Stem Cell Technologies) prior to simultaneous RNA and DNA isolation using cell-sparing protocols (AllPrep, Qiagen). Bulk CD4+ T cell or PBMC-associated HIV DNA and unspliced RNA were quantified using real-time PCR methods.The primer and probe sequences targeted conserved regions to enable quantification of a broad range of HIV subtypes. Values were normalized to DNA quantification of a human housekeeping gene (CCR5) in order to determine nucleic acid copies per million CD4+ T cell or PBMC as described. In addition to traditional quantitative PCR, a novel single-cell-in-droplet (scd)PCR method was used to quantify the absolute number or frequency of individual purified CD4+ T cells that express unspliced HIV RNA.

Recruitment status

COMPLETED

Study phase

PHASE4

Target enrollment

10 participants

Primary outcome timeframe

Baseline, Month 2, Month 6, Month 12 (6 months post discontinuation of everolimus)

Results posted on

2019-11-19

Participant Flow

Ten HIV-infected adult solid organ transplant participants on stable ART and were taking non-mTOR based immune suppressive regimens for allograft rejection were recruited at the University of California, San Francisco in this open label, single-arm everolimus trial.

Participant milestones

Participant milestones
Measure
Everolimus
Subjects on mTOR inhibitor (everolimus) for 6 months, added to standard of care immunosuppressive regimen
Overall Study
STARTED
10
Overall Study
COMPLETED
10
Overall Study
NOT COMPLETED
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Impact of Everolimus on HIV Persistence Post Kidney or Liver Transplant

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Everolimus
n=10 Participants
Subjects on mTOR inhibitor (everolimus) for 6 months, added to standard of care immunosuppressive regimen
Age, Continuous
58.5 years
n=5 Participants
Sex: Female, Male
Female
1 Participants
n=5 Participants
Sex: Female, Male
Male
9 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
2 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
2 Participants
n=5 Participants
Race (NIH/OMB)
White
5 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
1 Participants
n=5 Participants
Region of Enrollment
United States
10 participants
n=5 Participants

PRIMARY outcome

Timeframe: Baseline, Month 2, Month 6, Month 12 (6 months post discontinuation of everolimus)

Population: CD4+ T Cell count was not collected at Month 6 for one participant who did not show up for the visit.

Peripheral blood mononuclear cells were isolated from whole blood using the Ficoll density gradient technique. Peripheral blood CD4 T cells were enriched by negative selection using antibody-coupled magnetic beads (Stem Cell Technologies) prior to simultaneous RNA and DNA isolation using cell-sparing protocols (AllPrep, Qiagen). Bulk CD4+ T cell or PBMC-associated HIV DNA and unspliced RNA were quantified using real-time PCR methods.The primer and probe sequences targeted conserved regions to enable quantification of a broad range of HIV subtypes. Values were normalized to DNA quantification of a human housekeeping gene (CCR5) in order to determine nucleic acid copies per million CD4+ T cell or PBMC as described. In addition to traditional quantitative PCR, a novel single-cell-in-droplet (scd)PCR method was used to quantify the absolute number or frequency of individual purified CD4+ T cells that express unspliced HIV RNA.

Outcome measures

Outcome measures
Measure
Everolimus
n=10 Participants
This is a single arm study. Subjects on mTOR inhibitor (everolimus) for 6 months, added to standard of care immunosuppressive regimen
Cell-associated HIV DNA
Baseline
35 nucleic acid copies per million cells
Interval 8.0 to 173.0
Cell-associated HIV DNA
Month 2
43 nucleic acid copies per million cells
Interval 21.0 to 417.0
Cell-associated HIV DNA
Month 6
81 nucleic acid copies per million cells
Interval 28.0 to 210.0
Cell-associated HIV DNA
Month 12
16 nucleic acid copies per million cells
Interval 9.0 to 804.0

SECONDARY outcome

Timeframe: Baseline, Month 2, Month 6, Month 12 (6 months post discontinuation of everolimus)

Population: CD4+ T Cell count was not collected at Month 6 for one participant who did not show up for the visit.

Peripheral blood mononuclear cells were isolated from whole blood using the Ficoll density gradient technique. Peripheral blood CD4 T cells were enriched by negative selection using antibody-coupled magnetic beads (Stem Cell Technologies) prior to simultaneous RNA and DNA isolation using cell-sparing protocols (AllPrep, Qiagen). Bulk CD4+ T cell or PBMC-associated HIV DNA and unspliced RNA were quantified using real-time PCR methods.The primer and probe sequences targeted conserved regions to enable quantification of a broad range of HIV subtypes. Values were normalized to DNA quantification of a human housekeeping gene (CCR5) in order to determine nucleic acid copies per million CD4+ T cell or PBMC as described. In addition to traditional quantitative PCR, a novel single-cell-in-droplet (scd)PCR method was used to quantify the absolute number or frequency of individual purified CD4+ T cells that express unspliced HIV RNA.

Outcome measures

Outcome measures
Measure
Everolimus
n=10 Participants
This is a single arm study. Subjects on mTOR inhibitor (everolimus) for 6 months, added to standard of care immunosuppressive regimen
Cell-associated Total HIV RNA
Baseline HIV RNA CD4+
423 nucleic acid copies per million cells
Interval 148.0 to 1702.0
Cell-associated Total HIV RNA
Month 2 HIV RNA CD4+
310 nucleic acid copies per million cells
Interval 228.0 to 789.0
Cell-associated Total HIV RNA
Month 6 HIV RNA CD4+
702 nucleic acid copies per million cells
Interval 417.0 to 1299.0
Cell-associated Total HIV RNA
Month 12 HIV RNA CD4+
354 nucleic acid copies per million cells
Interval 165.0 to 633.0

SECONDARY outcome

Timeframe: Baseline, Month 2, Month 6, Month 12 (6 months post discontinuation of everolimus)

Population: CD4+ T Cell count was not collected at Month 6 for one participant who did not show up for the visit.

Plasma HIV RNA was quantified in a highly sensitive single-copy assay (SCA) using repetitive sampling in the Panther system (Hologic) at the Blood Systems Research Institute. Up to 18 replicates were tested for each sample in order to determine plasma RNA levels as low as 0.18 copies/mL.

Outcome measures

Outcome measures
Measure
Everolimus
n=10 Participants
This is a single arm study. Subjects on mTOR inhibitor (everolimus) for 6 months, added to standard of care immunosuppressive regimen
Plasma HIV RNA
Baseline
0.291 nucleic acid copies per million cells
Interval 0.0 to 0.9283
Plasma HIV RNA
Month 2
0.584 nucleic acid copies per million cells
Interval 0.0 to 1.547
Plasma HIV RNA
Month 6
1.042 nucleic acid copies per million cells
Interval 0.189 to 2.05
Plasma HIV RNA
Month 12
0.941 nucleic acid copies per million cells
Interval 0.191 to 1.576

Adverse Events

Everolimus

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

Serious adverse events

Serious adverse events
Measure
Everolimus
n=10 participants at risk
Subjects on mTOR inhibitor (everolimus) for 6 months, added to standard of care immunosuppressive regimen
Gastrointestinal disorders
Gastritis
10.0%
1/10 • Number of events 1 • 1 year
Gastrointestinal disorders
Diarrhea
10.0%
1/10 • Number of events 1 • 1 year

Other adverse events

Adverse event data not reported

Additional Information

Rodney Rogers

University of California, San Francisco

Phone: 415-514-6454

Results disclosure agreements

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