Combinatorial Therapy to Induce an HIV Remission

NCT ID: NCT04357821

Last Updated: 2025-05-22

Basic Information

• Recruitment Status: ACTIVE_NOT_RECRUITING
• Clinical Phase: PHASE1/PHASE2
• Total Enrollment: 11 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2020-08-01
• Study Completion Date: 2025-12-31

Brief Summary

Combination approaches will almost certainly be required to generate durable control of HIV in the absence of antiretroviral therapy (a "remission"). In this study, 20 individuals will receive a combination regimen administered during ART and then undergo an analytic treatment interruption (ATI).

Detailed Description

The investigators will perform a single arm study of twenty individuals with HIV infection on effective ART. All participants will receive a combination regimen administered during ART and then undergo an analytic treatment interruption. Our strategy has five stages

1. IL-12 adjuvanted p24CE DNA prime (p24CE/IL-12) at Weeks 0 and 4

2. IL-12 adjuvanted DNA boost (p24CE plus p55gag) at Week 12

3. MVA/HIV62B (MVA62B) boost at Week 20

4. single dose of two bNAbs (VRC07-523LS and 10-1074, which target CD4 binding site and V3 loop, respectively) at week 24 with a TLR9 agonist (lefitolimod) administered weekly between Weeks 24 and 33 (10 doses)

5. ATI with single dose of VRC07 and 10-1074 at Week 34

Follow-up off ART will occur through at least Week 46 (expected) and on or off ART (depending on outcome) through Week 86.

Should this approach work, viral load would be expected to rebound in all individuals a few weeks after the bNAb levels decrease to sub-therapeutic levels. This acute rebound would be followed by a new lower viral load set-point and perhaps a long-term remission.

Conditions

HIV/AIDS

Study Design

• Allocation Method: NA
• Intervention Model: SINGLE_GROUP
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

Combination intervention arm

All volunteers will receive the combination intervention outlined above.

Group Type: EXPERIMENTAL

Combination Intervention

Intervention Type: DRUG

1. IL-12 adjuvanted p24CE DNA prime (p24CE/IL-12) at Weeks 0 and 4

2. IL-12 adjuvanted DNA boost (p24CE plus p55gag) at Week 12

3. MVA/HIV62B (MVA62B) boost at Week 20

4. single dose of two bNAbs (VRC07-523LS and 10-1074, which target CD4 binding site and V3 loop, respectively) at week 24 with a TLR9 agonist (lefitolimod) administered weekly between Weeks 24 and 33 (10 doses)

5. ATI with single dose of VRC07 and 10-1074 at Week 34

Interventions

Combination Intervention

1. IL-12 adjuvanted p24CE DNA prime (p24CE/IL-12) at Weeks 0 and 4

2. IL-12 adjuvanted DNA boost (p24CE plus p55gag) at Week 12

3. MVA/HIV62B (MVA62B) boost at Week 20

4. single dose of two bNAbs (VRC07-523LS and 10-1074, which target CD4 binding site and V3 loop, respectively) at week 24 with a TLR9 agonist (lefitolimod) administered weekly between Weeks 24 and 33 (10 doses)

5. ATI with single dose of VRC07 and 10-1074 at Week 34

Intervention Type: DRUG

Eligibility Criteria

Inclusion Criteria

1. Willing and able to provide written informed consent.

2. Age ≤67 years at the time of enrollment for those who started treatment during early infection and <65 years for those who started treatment during chronic infection.

3. Documented HIV-1 infection.

4. On continuous antiretroviral therapy for at least 12 months without any interruptions of greater than 14 consecutive days within the last 1 year, and on a stable regimen that does not include an non-nucleoside reverse transcriptase inhibitor (NNRTI) for at least 4 weeks, without plans to modify ART during the study period.

5. Screening plasma HIV RNA levels below the level of quantification on all available determinations in past 24 months.

6. Screening CD4+ T-cell count ≥ 500 cells/mm3.

Exclusion Criteria

1. Subjects receiving a non-nucleoside reverse transcriptase inhibitor

2. Pregnant, breastfeeding, or unwilling to practice birth control during participation in the study

3. High-level resistance to both 10-1074 and VRC-07 as defined using the PhenoSense Neutralizing Antibody Assay (Monogram Biosciences).

4. Any history of an HIV-associated malignancy, including Kaposi's sarcoma and any type of lymphoma, or virus-associated cancers.

5. Active or recent non-HIV-associated malignancy requiring systemic chemotherapy or surgery in the preceding 36 months or for whom such therapies are expected in the subsequent 12 months.

6. CD4+ T cell nadir <350 cells/mm3 during the chronic phase of infection (beginning 6 months following the estimated infection date and confirmed on repeat testing).

7. Active hepatitis B (HBV) infection defined as positive HBV surface antigen test.

9. Active hepatitis C (HCV) infection. 10. Presence of significant abnormalities on electrocardiogram. 11. History of potential immune-mediated medical conditions. Individuals with isolated Raynaud's phenomenon or localized disease requiring topical therapy alone will not be excluded.

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 67 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

amfAR, The Foundation for AIDS Research

OTHER

Sponsor Role: collaborator

International AIDS Vaccine Initiative

NETWORK

Sponsor Role: collaborator

Ichor Medical Systems Incorporated

INDUSTRY

Sponsor Role: collaborator

National Institute of Allergy and Infectious Diseases (NIAID)

NIH

Sponsor Role: collaborator

Rockefeller University

OTHER

Sponsor Role: collaborator

Mologen AG

INDUSTRY

Sponsor Role: collaborator

GeoVax, Inc.

INDUSTRY

Sponsor Role: collaborator

University of California, San Francisco

OTHER

Sponsor Role: lead

Responsible Party

Steven Deeks

Professor in Residence

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

Zuckerberg San Francisco General Hospital, University of California San Francisco

San Francisco, California, United States

Countries

United States

Other Identifiers

18-26957

Identifier Type: -

Identifier Source: org_study_id