Safety and Immune Response to Preventive HIV Immunization With Adenovirus Serotype 5 or 35 Vector

Study Overview
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Brief Summary
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This study will evaluate the safety and preliminary immune response to recombinant adenoviral serotype 35 and 5 HIV-1 vaccines in HIV-uninfected adults.

Detailed Description
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One of the more promising approaches in the development of a preventive HIV vaccine uses a DNA plasmid to prime the immune response to an adenoviral vector boost. This primary purpose of this study is to evaluate the safety, tolerability, and immune response to recombinant adenoviral serotype 35 (rAd35) and serotype 5 (rAD5) HIV-1 vaccines in Ad-5 naive and Ad-5 exposed HIV-uninfected adults. This study will last approximately 12 months. Participants will include those who are both rAD5-naive and rAD5-exposed and will be stratified into one of four groups. Each group will consist of two arms, one interventional and one control. Participants in Groups 1, 2, and 3 will be rAD5-naive. Participants in Group 4 will be rAD5-exposed. Participants in Group 1 will receive an injection of rAD35 vaccine or placebo at study entry and an injection of rAD5 vaccine or placebo at Month 6 with nine follow-up visits through Month 12. Participants in Groups 2, 3, and 4 will injections of DNA vaccinations or placebo at study entry and at Months 1 and 2, and an injection of rAD35 vaccine, rAD5 vaccine, or placebo at Month 6 with twelve follow-up visits though Month 12. A physical, questionnaire, and counseling will occur at all visits. Blood and urine collection will occur at most visits. A rectal swab will occur at selected visits. For females, a pregnancy test will occur at all visits. Participants will be contacted for safety follow-ups after the injection every year for 5 years. Health and adverse events will be recorded. Participants will not need to return to the study clinic unless HIV confirmatory testing is needed.

Official Title
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A Phase 1B Clinical Trial to Evaluate the Safety and Immunogenicity of Recombinant Adenoviral Subtype 35 (rAd35) and Subtype 5 (rAd5) HIV-1 Vaccines When Given as a Heterologous Prime-boost Regimen or as Boosts to a Recombinant DNA Vaccine in Healthy, Ad5-Naïve and Ad5-Exposed, Low Risk, HIV-1 Uninfected Adult Participants

Conditions
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HIV Infections

Intervention / Treatment
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* Biological: DNA Vaccine
* Biological: DNA Vaccine placebo
* Biological: rAd35
* Biological: rAd35 placebo
* Biological: rAd5
* Biological: rAd5 placebo


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Good general health Access to a participating HVTN clinical research site and willingness to be followed for the duration of the study Assessment of understanding, including understanding of Step Study results Willing to receive HIV test results Willing to discuss HIV infection risks, agree to HIV risk reduction counseling, and willing to continue 5 years of annual follow-up contact Willing to commit to maintaining behavior consistent with low risk of HIV exposure through the last required protocol visit Considered low risk for HIV infection after clinical staff assessment. More information on this criterion can be found in the protocol. Certain laboratory values. More information on this criterion can be found in the protocol. Negative Hepatitis B surface antigen Negative anti-Hepatitis C virus antibodies For females, agree to use effective contraception from at least 21 days prior to enrollment through the last protocol visit. More information on this criterion can be found in the protocol. Exclusion Criteria: HIV-infected Active drug or alcohol abuse within 12 months prior to study entry History of newly acquired sexually transmitted infections. More information on this criterion can be found in the protocol. Experimental vaccines received within 5 years prior to study entry Immunosuppressive medications received within 168 days prior to first vaccination Blood products received within 120 days prior to first vaccination Immunoglobulin received within 60 days prior to first vaccination Live attenuated vaccines received within 30 days prior to first vaccination Investigational research agents received within 30 days prior to first vaccination Intent to participate in another study of an investigational research agent during planned duration of the study Any vaccines that not live attenuated vaccines and were received within 14 days prior to first vaccination Allergy treatment with antigen injections within 30 days prior to first vaccination or scheduled within 14 days after first vaccination Clinically significant medical condition, findings, results, or history with implications for current health. More information on this criterion can be found in the protocol. Serious adverse reactions to vaccines Autoimmune disease Immunodeficiency Active Syphilis infection within the past 6 months Asthma. More information on this criterion can be found in the protocol. Diabetes mellitus Thyroidectomy or thyroid disease requiring medication during the last 12 months Hypertension. More information on this criterion can be found in the protocol. Body mass index greater than 35 or 40. More information on this criterion can be found in the protocol. Bleeding disorder Malignancy Seizure disorder Asplenia Psychiatric condition that precludes compliance with the protocol Any other clinically significant condition or laboratory abnormality that, in the opinion of the investigator, would interfere with the study Pregnant or breastfeeding

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 50 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: 1A<br>rAD5-naive participants will receive rAd35 intramuscularly at study entry and rAd5 intramuscularly at Month 6 | Biological: rAd35<br>* VRC-HIVADV027-00-VP 1 x 10^10 PU administered as 1 mL<br>Biological: rAd5<br>* 4 mg VRC-HIVADV038-00-VP administered as 1 mL<br>|
| Placebo Comparator: 1B<br>Participants will receive rAd35 placebo intramuscularly at study entry and rAd5 placebo intramuscularly at Month 6 | Biological: rAd35 placebo<br>* 1 mL VRC-PBSPLA043-00-0VP<br>Biological: rAd5 placebo<br>* 1 mL VRC-DILUENT013-DIL-VP<br>|
| Experimental: 2A<br>rAD5-naive participants will receive DNA vaccine intramuscularly at study entry and Months 1 and 2 and rAd5 intramuscularly at Month 6 | Biological: DNA Vaccine<br>* 4 mg VRC-HIVDNA044-00-VP administered as 1 mL<br>Biological: rAd5<br>* 4 mg VRC-HIVADV038-00-VP administered as 1 mL<br>|
| Placebo Comparator: 2B<br>Participants will receive DNA vaccine placebo intramuscularly at study entry and Months 1 and 2 and rAd5 placebo intramuscularly at Month 6 | Biological: DNA Vaccine placebo<br>* 1 mL VRC-PBSPLA043-00-VP<br>Biological: rAd5 placebo<br>* 1 mL VRC-DILUENT013-DIL-VP<br>|
| Experimental: 3A<br>Participants will receive DNA vaccine intramuscularly at study entry and Months 1 and 2 and rAd35 intramuscularly at Month 6 | Biological: DNA Vaccine<br>* 4 mg VRC-HIVDNA044-00-VP administered as 1 mL<br>Biological: rAd35<br>* VRC-HIVADV027-00-VP 1 x 10^10 PU administered as 1 mL<br>|
| Placebo Comparator: 3B<br>Participants will receive DNA vaccine placebo intramuscularly at study entry and Months 1 and 2 and rAd35 placebo intramuscularly at Month 6 | Biological: DNA Vaccine placebo<br>* 1 mL VRC-PBSPLA043-00-VP<br>Biological: rAd35 placebo<br>* 1 mL VRC-PBSPLA043-00-0VP<br>|
| Experimental: 4A<br>Participants will receive DNA vaccine intramuscularly at study entry and Months 1 and 2 and rAd35 intramuscularly at Month 6 | Biological: DNA Vaccine<br>* 4 mg VRC-HIVDNA044-00-VP administered as 1 mL<br>Biological: rAd35<br>* VRC-HIVADV027-00-VP 1 x 10^10 PU administered as 1 mL<br>|
| Placebo Comparator: 4B<br>Participants will receive DNA vaccine placebo intramuscularly at study entry and Months 1 and 2 and rAd35 placebo intramuscularly at Month 6 | Biological: DNA Vaccine placebo<br>* 1 mL VRC-PBSPLA043-00-VP<br>Biological: rAd35 placebo<br>* 1 mL VRC-PBSPLA043-00-0VP<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Local and systemic reactogenicity signs and symptoms, laboratory measures of safety, and adverse and expedited adverse events |  | Throughout study | 
| Magnitude and frequency of immune responses between HIV-1 clade A env rAD35 and rAd5 vaccines when given as a boost after DNA vaccine |  | At Week 4 following the fourth vaccination | 
| Magnitude and frequency of immune responses between clade A env rAD35 vaccine primed by Ad35 versus DNA |  | At Week 4 following the last vaccination | 
| Magnitude and frequency of immune responses of HIV-1 clade A env rAD35 vaccine when given as a boost |  | At Week 4 following the fourth vaccination | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Immunogenicity of HIV-1 clade A env rAD35 vaccine given as a prime |  | At Week 4 following the first vaccination | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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HIV Seronegativity, HIV Preventive Vaccine, Adenovirus