A Double-Blind, Randomized, Placebo-Controlled Clinical Trial of Combination HIV-Specific Broadly Neutralizing Monoclonal Antibodies Combined With ART Initiation During Acute HIV Infection to Induce HIV Remission

Status: Recruiting
Location: See all (36) locations...
Intervention Type: Drug, Biological, Other
Study Type: Interventional
Study Phase: Phase 2
SUMMARY

A5388 is a phase II, two-arm, randomized, double-blind, placebo-controlled study that will enroll 48 antiretroviral therapy (ART)-naïve adults with acute HIV infection (AHI) in order to determine whether: * Administration of combination HIV-specific broadly neutralizing antibody (bNAb) therapy in addition to ART during acute HIV infection (AHI) will be safe. * Participants who receive combination bNAb therapy in addition to ART during AHI will be more likely to demonstrate a delay in time to HIV-1 RNA ≥1,000 copies/mL for 4 consecutive weeks compared to participants who receive placebo plus ART. * Participants who receive combination bNAb therapy in addition to ART during AHI will demonstrate lower viral reservoirs and enhanced HIV-specific immunity compared to participants who receive placebo plus ART.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 18
Maximum Age: 70
Healthy Volunteers: f
View:

⁃ Step 1:

• Appropriate documentation from medical records of diagnosis of AHI prior to enrollment that includes one of the following:

∙ A detectable HIV-1 RNA within 28 days prior to study entry AND a non-reactive HIV-1 antibody within 7 days prior to entry; OR

‣ A detectable HIV-1 RNA or a reactive HIV-1 antibody within 28 days prior to study entry AND a negative/indeterminate Western Blot (WB) or negative/indeterminate Geenius HIV-1/HIV-2 Supplemental Assay within 7 days prior to entry; OR

‣ A documented non-reactive HIV-1 antibody or negative HIV-1 RNA within 90 days prior to study entry AND a documented reactive HIV-1 antibody or positive WB that is negative for p31 band or a positive Geenius HIV-1/HIV-2 Supplemental Assay that is negative for p31 band within 7 days prior to entry; OR

‣ ARCHITECT or GSCOMBO S/CO ≥10 within 7 days prior to entry AND a non-reactive HIV-1 antibody within 7 days prior to entry; OR

‣ ARCHITECT or GSCOMBO S/CO ≥1 within 7 days prior to entry AND a non-reactive HIV-1 antibody within 7 days prior to entry AND a known prior S/CO \<0.5 within 90 days prior to entry; OR

‣ ARCHITECT or GSCOMBO S/CO \>0.5 but \<10 within 7 days prior to entry AND a non-reactive HIV-1 antibody within 7 days prior to entry AND detectable HIV-1 RNA within 7 days prior to entry

• The following laboratory values obtained within 21 days prior to entry:

‣ Absolute neutrophil count (ANC) ˃1,000/mm3

⁃ Hemoglobin:

• \>10 g/dL for cisgender men and transgender women

∙ \>9 g/dL for cisgender women and transgender men

⁃ Platelet count ˃100,000/mm3

⁃ Estimated glomerular filtration rate (eGFR) ≥50 mL/min/1.73m2 using the Chronic Kidney Disease Epidemiology Collaboration (CKD-Epi) equation, with consideration for lower rates in special circumstances.

⁃ ALT (SGPT) ≤2.5 x ULN

⁃ AST (SGOT) ≤2.5 x ULN

⁃ Total bilirubin \<1.5 x ULN

• For persons who are able to become pregnant, negative urine or serum pregnancy test within 24 hours prior to study entry.

• Persons who are able to become pregnant must agree to use two methods of contraception throughout Step 1 if participating in sexual activity that could lead to pregnancy. One contraceptive method must be a highly effective method and the second method of contraception must be a barrier method.

• Participants of reproductive potential who engage in sexual activity that could lead to their partner's becoming pregnant must agree to use a barrier method of contraception throughout Step 1.

• Ability and willingness to use a barrier method or abstinence from sexual intercourse with all partners who are vulnerable to HIV or whose HIV serostatus is unknown in order to prevent HIV transmission during Step 2, Step 3, and until plasma HIV-1 RNA is less than the limit of detection after ART restart in Step 4.

• Age ≥18 and ≤70 years.

• Ability and willingness to initiate ART at enrollment.

• Ability and willingness to participate in scheduled study visits, including during the ATI, per Schedule of Evaluations (SOE).

⁃ Ability and willingness of participant to provide informed consent.

⁃ Step 2:

• Documented negative hepatitis B virus (HBV) surface antigen (HBsAg) obtained within 16 weeks prior to Step 2 registration.

• Documented negative hepatitis C virus (HCV) antibody (anti-HCV) or negative HCV RNA PCR obtained within 16 weeks prior to Step 2 registration.

• Receipt of full doses of study infusions at enrollment (VRC07-523LS + PGT121.414.LS or placebo \[Sodium Chloride for Injection USP, 0.9%\]).

• HIV-1 RNA \<200 copies/mL obtained within 6 weeks prior to Step 2 registration.

• CD4+ T-cell count ≥450 cells/mm3 obtained within 6 weeks prior to Step 2 registration.

• For participants who are able to become pregnant, negative serum or urine pregnancy test within 48 hours prior to Step 2 entry.

• To avoid pregnancy, participants who are able to become pregnant must agree to use contraception or practice abstinence from sexual activity that could lead to pregnancy throughout Step 2.

• Ability and willingness to use a barrier method or abstinence from sexual intercourse with partners who are vulnerable to HIV or whose HIV serostatus is unknown in order to prevent HIV transmission throughout Step 2.

• Ability and willingness to interrupt ART.

⁃ Completion of Step 1.

⁃ Step 3:

• Has not met ART restart criteria.

• Completion of Step 2.

• Willing to continue ATI.

• To avoid pregnancy, participants who are able to become pregnant must agree to use contraception or practice abstinence from sexual activity that could lead to pregnancy throughout Step 3.

• Ability and willingness to use a barrier method or abstinence from sexual intercourse with all partners who are vulnerable to HIV or whose HIV serostatus is unknown in order to prevent HIV transmission throughout Step 3.

⁃ Step 4:

• Has met any of the ART restart criteria during Step 2 or Step 3. -OR- Has completed Step 3 and is not enrolling to ACTG A5385.

• To avoid pregnancy, participants who are able to become pregnant must agree to use contraception or practice abstinence from sexual activity that could lead to pregnancy throughout Step 4.

• Ability and willingness to use a barrier method or abstinence from sexual intercourse with all partners who are vulnerable to HIV or whose HIV serostatus is unknown in order to prevent HIV transmission until plasma HIV-1 RNA is less than the limit of detection after ART restart.

Locations
United States
Alabama
31788, Alabama CRS
NOT_YET_RECRUITING
Birmingham
California
1201, University of Southern California CRS
NOT_YET_RECRUITING
Los Angeles
601, University of California, Los Angeles CARE Center CRS
NOT_YET_RECRUITING
Los Angeles
701, UCSD Antiviral Research Center CRS
NOT_YET_RECRUITING
San Diego
801, University of California, San Francisco HIV/AIDS CRS
NOT_YET_RECRUITING
San Francisco
603, Harbor University of California Los Angeles Center CRS
NOT_YET_RECRUITING
Torrance
Colorado
6101, University of Colorado Hospital CRS
NOT_YET_RECRUITING
Aurora
Washington, D.c.
31791, Whitman-Walker Institute, Inc. CRS
NOT_YET_RECRUITING
Washington D.c.
Georgia
5802, The Ponce de Leon Center CRS
RECRUITING
Atlanta
Illinois
2701, Northwestern University CRS
NOT_YET_RECRUITING
Chicago
2702, Rush University CRS
NOT_YET_RECRUITING
Chicago
Massachusetts
101, Massachusetts General Hospital CRS (MGH CRS)
NOT_YET_RECRUITING
Boston
107, Brigham and Women's Hospital Therapeutics (BWH TCRS) CRS
NOT_YET_RECRUITING
Boston
Maryland
201, Johns Hopkins University CRS
NOT_YET_RECRUITING
Baltimore
Missouri
2101, Washington University Therapeutics (WT) CRS
NOT_YET_RECRUITING
St Louis
North Carolina
3201, Chapel Hill CRS
NOT_YET_RECRUITING
Chapel Hill
3203, Greensboro CRS
NOT_YET_RECRUITING
Greensboro
New Jersey
31786, New Jersey Medical School Clinical Research Center CRS
NOT_YET_RECRUITING
Newark
New York
30329, Columbia Physicians & Surgeons (P&S) CRS
NOT_YET_RECRUITING
New York
7803, Weill Cornell Uptown CRS
NOT_YET_RECRUITING
New York
7804, Weill Cornell Chelsea CRS
NOT_YET_RECRUITING
New York
31787, University of Rochester Adult HIV Therapeutic Strategies Network CRS
NOT_YET_RECRUITING
Rochester
Ohio
2401, Cincinnati CRS
NOT_YET_RECRUITING
Cincinnati
2501, Case CRS
NOT_YET_RECRUITING
Cleveland
2301, Ohio State University CRS
NOT_YET_RECRUITING
Columbus
Pennsylvania
6201, Penn Therapeutics CRS
NOT_YET_RECRUITING
Philadelphia
1001, University of Pittsburgh CRS
NOT_YET_RECRUITING
Pittsburgh
Rhode Island
2951, The Miriam Hospital (TMH) CRS
NOT_YET_RECRUITING
Providence
Tennessee
3652, Vanderbilt Therapeutics (VT) CRS
NOT_YET_RECRUITING
Nashville
Texas
31443, Trinity Health and Wellness Center CRS
NOT_YET_RECRUITING
Dallas
31473, Houston AIDS Research Team CRS
NOT_YET_RECRUITING
Houston
Washington
1401, University of Washington Positive Research CRS
RECRUITING
Seattle
Other Locations
Brazil
12201, Hospital Nossa Senhora da Conceicao CRS
NOT_YET_RECRUITING
Porto Alegre
12101, Instituto de Pesquisa Clinica Evandro Chagas (IPEC) CRS
RECRUITING
Rio De Janeiro
Peru
11301, Barranco CRS
NOT_YET_RECRUITING
Lima
11302, San Miguel CRS
NOT_YET_RECRUITING
San Miguel
Time Frame
Start Date: 2024-08-19
Estimated Completion Date: 2028-09-06
Participants
Target number of participants: 48
Treatments
Experimental: Arm 1: VRC07-523LS + PGT121.414.LS + ART
Placebo_comparator: Arm 2: Placebo + ART
Related Therapeutic Areas
Sponsors
Leads: National Institute of Allergy and Infectious Diseases (NIAID)

This content was sourced from clinicaltrials.gov

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