Title

HIV Vaccine Trial in Thai Adults
A Phase III Trial of Aventis Pasteur Live Recombinant ALVAC-HIV (vCP1521) Priming With VaxGen gp120 B/E (AIDSVAX B/E) Boosting in HIV-uninfected Thai Adults
  • Phase

    Phase 3
  • Study Type

    Interventional
  • Intervention/Treatment

    vcp1521 ...
  • Study Participants

    16402
The purpose of this study is to determine whether immunizations with an integrated combination of ALVAC-HIV (vCP1521) boosted by AIDSVAX gp120 B/E prevent HIV infection in healthy Thai volunteers.
A vaccine for the prevention of HIV infection remains an urgent need as part of the efforts to control the HIV pandemic. In this phase III efficacy trial, a 'prime-boost' vaccine strategy is evaluated for prevention of infection and amelioration of disease course. ALVAC-HIV (vCP1521) from sanofi pasteur is given as the 'prime' vaccine at months 0, 1, 3 and 6; AIDSVAX gp120 B/E from VaxGen is given as the 'boost' at months 3 and 6. This regimen will be given to 8,000 adult Thai subjects, while another 8,000 will be given placebos in a double-blinded, randomized manner. Following the completion of each subjects immunization phase, he/she will be followed for 3 years with clinic visits every 6 months with HIV testing, pre- and post-test counseling. Subjects who become HIV infected will be counseled, referred to HIV treatment facilities for management according to national guidelines, and offered enrollment in a protocol for extended follow-up.
Study Started
Oct 31
2003
Primary Completion
Jul 31
2006
Study Completion
Jun 30
2009
Results Posted
Oct 19
2018
Last Update
Apr 24
2019

Biological ALVAC-HIV vCP1521 + AIDSVAX

Combined dose of 600 μg (300 μg of each antigen), co-formulated and administered in alumi-um hydroxide gel at a dose of 600 μg/mL

  • Other names: ALVAC-HIV (vCP1521) >106 CCID50 per 1 mL dose, AIDSVAX® B/E, Bivalent HIV gp120 vaccine subtype B (MN), and E (A244)

Other ALVAC Placebo + AIDSVAX Placebo

ALVAC carrier, supplied as a lyophilized product, without virus and Aluminum hydroxide adjuvant, 1.2 mL per vial, given as a 1 mL injection

  • Other names: ALVAC carrier lyophilized product without virus, Aluminum hydroxide adjuvant

Vaccine Active Comparator

ALVAC-HIV vCP1521 + AIDSVAX will both be administered by the intramuscular route (preferably in the deltoid region) on weeks 0, 4, 12, and 24.

Placebo Placebo Comparator

ALVAC Placebo + AIDSVAX Placebo will be administered at week 12 and 24. ALVAC Placebo only was additionally administered at week 0 and 4.

Criteria

Inclusion Criteria:

Possession of the 13-digit Thai National ID card
18-30 years of age (inclusive), male or female
For women, a negative urine pregnancy test on the day of enrollment, as well as assurance that adequate birth control measures would be applied during the course of the injections and the 3 months after the last injection.
Absence of systemic disease or immunodeficiency as determined by medical history and directed physical examination.
Negative serology for HIV-1 infection within 45 days prior to enrollment.
Availability and commitment for 3.5 years of participation.
Able to understand the study (shown by receiving a passing score on the Test of Understanding administered under the screening protocol) and gave written informed consent.
Enrollment in and referral from screening protocol, RV148

Exclusion Criteria:

Previous participation in any HIV vaccine trial (unless the volunteer could provide documentation that he/she received placebo).
Active tuberculosis, other systemic disease process, or immunodeficiency as detected by medical history and directed physical examination that would, in the opinion of the investigator, impede compliance with study requirements or complicate the interpretation of adverse events.
Any significant finding that in the opinion of the investigator would increase the risk of having an adverse outcome from participating in this study or might interfere with the volunteer's ability to successfully complete the study.
Occupational or other responsibilities that would prevent completion of 3.5 years of participation in the study.
History of anaphylaxis or other serious adverse reactions to vaccines, or allergies or reactions likely to be exacerbated by any component of the vaccine or placebo, including egg products and neomycin.
Women breast-feeding or pregnant (positive pregnancy test) or planning to become pregnant during the 9-month window between study enrollment and 3-months after the last vaccination visit.
Study site employees who were involved in the protocol and may have had direct access to trial-related data.
Chronic use of therapies which may modify immune response, such as IV immune globulin and systemic corticosteroids (in doses of > 20 mg prednisone equivalent for periods exceeding 10 days), and use of experimental drugs or vaccines.
Receipt of a non-HIV vaccine or immune globulins within 14 days.

Summary

Vaccine

Placebo

All Events

Event Type Organ System Event Term Vaccine Placebo

Changes in HIV-1 Viral Load in Volunteers Developing HIV Infection During the Trial for the MITT Population

Log10 HIV-1 viral loads for diagnostic specimens for subjects with post-HIV infection. The trial quantitated HIV plasma viral load at the time of diagnosis and through the remainder of the follow-up period. Peri infection results were compared in vaccine and placebo recipients who became HIV-infected during the trial.

Vaccine

3-weeks post identificaiton

4.229
log [HIV-1 viral load (unitless)] (Mean)
Standard Error: 0.130

~6-weeks post identification

4.274
log [HIV-1 viral load (unitless)] (Mean)
Standard Error: 0.125

First positive serology

4.379
log [HIV-1 viral load (unitless)] (Mean)
Standard Error: 0.127

Placebo

3-weeks post identificaiton

4.235
log [HIV-1 viral load (unitless)] (Mean)
Standard Error: 0.095

~6-weeks post identification

4.167
log [HIV-1 viral load (unitless)] (Mean)
Standard Error: 0.104

First positive serology

4.187
log [HIV-1 viral load (unitless)] (Mean)
Standard Error: 0.101

Vaccine Efficacy as Determined by Acquisition of Infection in the Per-protocol Population

Cumulative Number of HIV Infections. Detection of HIV-1 infection was defined according to the HIV diagnostic algorithm utilizing serologic and nucleic acid technologies. Incidence of HIV infection was compared in the vaccine and placebo-recipient groups.

Vaccine

12 months

0.08
Percentage of subjects
95% Confidence Interval: 0.01 to 0.15

24 months

0.36
Percentage of subjects
95% Confidence Interval: 0.21 to 0.51

36 months

0.52
Percentage of subjects
95% Confidence Interval: 0.34 to 0.71

42 months

0.59
Percentage of subjects
95% Confidence Interval: 0.4 to 0.78

Placebo

12 months

0.25
Percentage of subjects
95% Confidence Interval: 0.13 to 0.38

24 months

0.49
Percentage of subjects
95% Confidence Interval: 0.32 to 0.66

36 months

0.7
Percentage of subjects
95% Confidence Interval: 0.49 to 0.91

42 months

0.8
Percentage of subjects
95% Confidence Interval: 0.58 to 1.02

Kaplan-Meier Estimate of HIV-1 Infection Rate in Intent to Treat Population

HIV-1 infection rate. Detection of HIV-1 infection was defined according to the HIV diagnostic algorithm utilizing serologic and nucleic acid technologies. Incidence of HIV infection was compared in the vaccine and placebo-recipient groups.

Vaccine

12 months

0.15
Percetage of subjects
95% Confidence Interval: 0.07 to 0.24

24 months

0.41
Percetage of subjects
95% Confidence Interval: 0.27 to 0.55

36 months

0.58
Percetage of subjects
95% Confidence Interval: 0.41 to 0.75

42 months

0.68
Percetage of subjects
95% Confidence Interval: 0.49 to 0.87

Placebo

12 months

0.38
Percetage of subjects
95% Confidence Interval: 0.24 to 0.52

24 months

0.64
Percetage of subjects
95% Confidence Interval: 0.46 to 0.82

36 months

0.84
Percetage of subjects
95% Confidence Interval: 0.63 to 1.04

42 months

0.96
Percetage of subjects
95% Confidence Interval: 0.74 to 1.18

Changes in HIV-1 Viral Load in Volunteers Developing HIV Infection During the Trial for the Per Protocol Population

Log10 HIV-1 viral loads for diagnostic specimens for subjects with post-HIV infection. The trial quantitated HIV plasma viral load at the time of diagnosis and through the remainder of the follow-up period. Peri infection results were compared in vaccine and placebo recipients who became HIV-infected during the trial.

Vaccine

3-weeks post identificaiton

4.128
log [HIV-1 viral load (unitless)] (Mean)
Standard Error: 0.161

~6-weeks post identification

4.28
log [HIV-1 viral load (unitless)] (Mean)
Standard Error: 0.152

First positive serology

4.307
log [HIV-1 viral load (unitless)] (Mean)
Standard Error: 0.154

Placebo

3-weeks post identificaiton

4.276
log [HIV-1 viral load (unitless)] (Mean)
Standard Error: 0.118

~6-weeks post identification

4.143
log [HIV-1 viral load (unitless)] (Mean)
Standard Error: 0.143

First positive serology

4.153
log [HIV-1 viral load (unitless)] (Mean)
Standard Error: 0.136

Change in HIV Risk Behaviors Associated With Participation in the Vaccine Trial (MITT)

Self Report of Risk Behavior Status by Treatment and Time. Specifically, this is the responses to the question "Do you think that your everyday behavior puts you at risk for HIV infection?" Modified intent to treat population (MITT)

Vaccine

Don't know/Not sure

473.0
participants

Missing value

1.0
participants

No

6223.0
participants

Yes

702.0
participants

Placebo

Don't know/Not sure

502.0
participants

Missing value

No

6130.0
participants

Yes

763.0
participants

Changes in CD4 T Cell Count in Volunteers Who Developed HIV Infection During the Trial for MITT Population

Two CD4 cell counts were obtained (at the verification blood draw and the notification blood draw) and through the remainder of the follow-up period. Results were compared in vaccine and placebo recipients who became HIV-infected during the trial.

Vaccine

1st verification

565.4
cells / µL (Mean)
Standard Error: 43.5

Notification

539.6
cells / µL (Mean)
Standard Error: 37.1

Placebo

1st verification

566.7
cells / µL (Mean)
Standard Error: 26.5

Notification

570.6
cells / µL (Mean)
Standard Error: 29.2

Safety Assessment (SAE's and AEs)

The intent-to-treat population is used for analysis of AEs and treatment emergent events are reported. Participant AE rates for all AEs, SAEs and treatment-related AEs are summarized

Vaccine

30-day post dose interval 1

1277.0
adverse events

30-day post dose interval 2

816.0
adverse events

30-day post dose interval 3

614.0
adverse events

30-day post dose interval 4

599.0
adverse events

All treatment emergent

5627.0
adverse events

Placebo

30-day post dose interval 1

1336.0
adverse events

30-day post dose interval 2

860.0
adverse events

30-day post dose interval 3

597.0
adverse events

30-day post dose interval 4

630.0
adverse events

All treatment emergent

5685.0
adverse events

Total

16395
Participants

Age, Customized

Marital status

Number of sex partners

Province

Risk group

Sex: Female, Male

Overall Study

Vaccine

Placebo

Drop/Withdrawal Reasons

Vaccine

Placebo