Indicators of therapeutic effect in FIT-06, a Phase II trial of a DNA vaccine, GTU®-Multi-HIVB, in untreated HIV-1 infected subjects

► FIT GTU®-multi-HIVB was the first therapeutic HIV-1 vaccine trial conducted in South Africa. ► This plasmid DNA vaccine is safe and well-tolerated in HIV-1 infected, anteretrovial naive subjects. ► Cross subtype reactivity of subtype B derived vaccine in subtype C infected subjects was shown. ► Si...

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Published inVaccine Vol. 30; no. 27; pp. 4046 - 4054
Main Authors Vardas, Eftyhia, Stanescu, Ioana, Leinonen, Mika, Ellefsen, Kim, Pantaleo, Giuseppe, Valtavaara, Minna, Ustav, Mart, Reijonen, Kalevi
Format Journal Article
LanguageEnglish
Published Netherlands Elsevier Ltd 08.06.2012
Elsevier Limited
Subjects
Online AccessGet full text
ISSN0264-410X
1873-2518
1873-2518
DOI10.1016/j.vaccine.2012.04.007

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Abstract ► FIT GTU®-multi-HIVB was the first therapeutic HIV-1 vaccine trial conducted in South Africa. ► This plasmid DNA vaccine is safe and well-tolerated in HIV-1 infected, anteretrovial naive subjects. ► Cross subtype reactivity of subtype B derived vaccine in subtype C infected subjects was shown. ► Significant CD4 increases and VL decreases after IM vaccine were maintained for more than 2 years. ► This DNA HIV vaccine may be used as affordable prime/boost regimens alone or as an adjunct to HAART. Combination highly active antiretroviral therapy (HAART) has significantly decreased HIV-1 related morbidity and mortality globally transforming HIV into a controllable condition. HAART has a number of limitations though, including limited access in resource constrained countries, which have driven the search for simpler, affordable HIV-1 treatment modalities. Therapeutic HIV-1 vaccines aim to provide immunological support to slow disease progression and decrease transmission. We evaluated the safety, immunogenicity and clinical effect of a novel recombinant plasmid DNA therapeutic HIV-1 vaccine, GTU®-multi-HIVB, containing 6 different genes derived from an HIV-1 subtype B isolate. 63 untreated, healthy, HIV-1 infected, adults between 18 and 40 years were enrolled in a single-blinded, placebo-controlled Phase II trial in South Africa. Subjects were HIV-1 subtype C infected, had never received antiretrovirals, with CD4≥350cells/mm3 and pHIV-RNA≥50copies/mL at screening. Subjects were allocated to vaccine or placebo groups in a 2:1 ratio either administered intradermally (ID) (0.5mg/dose) or intramuscularly (IM) (1mg/dose) at 0, 4 and 12 weeks boosted at 76 and 80 weeks with 1mg/dose (ID) and 2mg/dose (IM), respectively. Safety was assessed by adverse event monitoring and immunogenicity by HIV-1-specific CD4+ and CD8+ T-cells using intracellular cytokine staining (ICS), pHIV-RNA and CD4 counts. Vaccine was safe and well tolerated with no vaccine related serious adverse events. Significant declines in logpHIV-RNA (p=0.012) and increases in CD4+ T cell counts (p=0.066) were observed in the vaccine group compared to placebo, more pronounced after IM administration and in some HLA haplotypes (B*5703) maintained for 17 months after the final immunisation. The GTU®-multi-HIVB plasmid recombinant DNA therapeutic HIV-1 vaccine is safe, well tolerated and favourably affects pHIV-RNA and CD4 counts in untreated HIV-1infected individuals after IM administration in subjects with HLA B*57, B*8101 and B*5801haplotypes.
AbstractList Combination highly active antiretroviral therapy (HAART) has significantly decreased HIV-1 related morbidity and mortality globally transforming HIV into a controllable condition. HAART has a number of limitations though, including limited access in resource constrained countries, which have driven the search for simpler, affordable HIV-1 treatment modalities. Therapeutic HIV-1 vaccines aim to provide immunological support to slow disease progression and decrease transmission. We evaluated the safety, immunogenicity and clinical effect of a novel recombinant plasmid DNA therapeutic HIV-1 vaccine, GTU(®)-multi-HIVB, containing 6 different genes derived from an HIV-1 subtype B isolate. 63 untreated, healthy, HIV-1 infected, adults between 18 and 40 years were enrolled in a single-blinded, placebo-controlled Phase II trial in South Africa. Subjects were HIV-1 subtype C infected, had never received antiretrovirals, with CD4 ≥ 350 cells/mm(3) and pHIV-RNA ≥ 50 copies/mL at screening. Subjects were allocated to vaccine or placebo groups in a 2:1 ratio either administered intradermally (ID) (0.5mg/dose) or intramuscularly (IM) (1mg/dose) at 0, 4 and 12 weeks boosted at 76 and 80 weeks with 1mg/dose (ID) and 2mg/dose (IM), respectively. Safety was assessed by adverse event monitoring and immunogenicity by HIV-1-specific CD4+ and CD8+ T-cells using intracellular cytokine staining (ICS), pHIV-RNA and CD4 counts. Vaccine was safe and well tolerated with no vaccine related serious adverse events. Significant declines in log pHIV-RNA (p=0.012) and increases in CD4+ T cell counts (p=0.066) were observed in the vaccine group compared to placebo, more pronounced after IM administration and in some HLA haplotypes (B*5703) maintained for 17 months after the final immunisation. The GTU(®)-multi-HIVB plasmid recombinant DNA therapeutic HIV-1 vaccine is safe, well tolerated and favourably affects pHIV-RNA and CD4 counts in untreated HIV-1 infected individuals after IM administration in subjects with HLA B*57, B*8101 and B*5801 haplotypes.
BACKGROUND: Combination highly active antiretroviral therapy (HAART) has significantly decreased HIV-1 related morbidity and mortality globally transforming HIV into a controllable condition. HAART has a number of limitations though, including limited access in resource constrained countries, which have driven the search for simpler, affordable HIV-1 treatment modalities. Therapeutic HIV-1 vaccines aim to provide immunological support to slow disease progression and decrease transmission. We evaluated the safety, immunogenicity and clinical effect of a novel recombinant plasmid DNA therapeutic HIV-1 vaccine, GTU®-multi-HIVB, containing 6 different genes derived from an HIV-1 subtype B isolate. METHODS: 63 untreated, healthy, HIV-1 infected, adults between 18 and 40 years were enrolled in a single-blinded, placebo-controlled Phase II trial in South Africa. Subjects were HIV-1 subtype C infected, had never received antiretrovirals, with CD4≥350cells/mm³ and pHIV-RNA≥50copies/mL at screening. Subjects were allocated to vaccine or placebo groups in a 2:1 ratio either administered intradermally (ID) (0.5mg/dose) or intramuscularly (IM) (1mg/dose) at 0, 4 and 12 weeks boosted at 76 and 80 weeks with 1mg/dose (ID) and 2mg/dose (IM), respectively. Safety was assessed by adverse event monitoring and immunogenicity by HIV-1-specific CD4+ and CD8+ T-cells using intracellular cytokine staining (ICS), pHIV-RNA and CD4 counts. RESULTS: Vaccine was safe and well tolerated with no vaccine related serious adverse events. Significant declines in logpHIV-RNA (p=0.012) and increases in CD4+ T cell counts (p=0.066) were observed in the vaccine group compared to placebo, more pronounced after IM administration and in some HLA haplotypes (B*5703) maintained for 17 months after the final immunisation. CONCLUSIONS: The GTU®-multi-HIVB plasmid recombinant DNA therapeutic HIV-1 vaccine is safe, well tolerated and favourably affects pHIV-RNA and CD4 counts in untreated HIV-1infected individuals after IM administration in subjects with HLA B*57, B*8101 and B*5801haplotypes.
Combination highly active antiretroviral therapy (HAART) has significantly decreased HIV-1 related morbidity and mortality globally transforming HIV into a controllable condition. HAART has a number of limitations though, including limited access in resource constrained countries, which have driven the search for simpler, affordable HIV-1 treatment modalities. Therapeutic HIV-1 vaccines aim to provide immunological support to slow disease progression and decrease transmission. We evaluated the safety, immunogenicity and clinical effect of a novel recombinant plasmid DNA therapeutic HIV-1 vaccine, GTU(®)-multi-HIVB, containing 6 different genes derived from an HIV-1 subtype B isolate.BACKGROUNDCombination highly active antiretroviral therapy (HAART) has significantly decreased HIV-1 related morbidity and mortality globally transforming HIV into a controllable condition. HAART has a number of limitations though, including limited access in resource constrained countries, which have driven the search for simpler, affordable HIV-1 treatment modalities. Therapeutic HIV-1 vaccines aim to provide immunological support to slow disease progression and decrease transmission. We evaluated the safety, immunogenicity and clinical effect of a novel recombinant plasmid DNA therapeutic HIV-1 vaccine, GTU(®)-multi-HIVB, containing 6 different genes derived from an HIV-1 subtype B isolate.63 untreated, healthy, HIV-1 infected, adults between 18 and 40 years were enrolled in a single-blinded, placebo-controlled Phase II trial in South Africa. Subjects were HIV-1 subtype C infected, had never received antiretrovirals, with CD4 ≥ 350 cells/mm(3) and pHIV-RNA ≥ 50 copies/mL at screening. Subjects were allocated to vaccine or placebo groups in a 2:1 ratio either administered intradermally (ID) (0.5mg/dose) or intramuscularly (IM) (1mg/dose) at 0, 4 and 12 weeks boosted at 76 and 80 weeks with 1mg/dose (ID) and 2mg/dose (IM), respectively. Safety was assessed by adverse event monitoring and immunogenicity by HIV-1-specific CD4+ and CD8+ T-cells using intracellular cytokine staining (ICS), pHIV-RNA and CD4 counts.METHODS63 untreated, healthy, HIV-1 infected, adults between 18 and 40 years were enrolled in a single-blinded, placebo-controlled Phase II trial in South Africa. Subjects were HIV-1 subtype C infected, had never received antiretrovirals, with CD4 ≥ 350 cells/mm(3) and pHIV-RNA ≥ 50 copies/mL at screening. Subjects were allocated to vaccine or placebo groups in a 2:1 ratio either administered intradermally (ID) (0.5mg/dose) or intramuscularly (IM) (1mg/dose) at 0, 4 and 12 weeks boosted at 76 and 80 weeks with 1mg/dose (ID) and 2mg/dose (IM), respectively. Safety was assessed by adverse event monitoring and immunogenicity by HIV-1-specific CD4+ and CD8+ T-cells using intracellular cytokine staining (ICS), pHIV-RNA and CD4 counts.Vaccine was safe and well tolerated with no vaccine related serious adverse events. Significant declines in log pHIV-RNA (p=0.012) and increases in CD4+ T cell counts (p=0.066) were observed in the vaccine group compared to placebo, more pronounced after IM administration and in some HLA haplotypes (B*5703) maintained for 17 months after the final immunisation.RESULTSVaccine was safe and well tolerated with no vaccine related serious adverse events. Significant declines in log pHIV-RNA (p=0.012) and increases in CD4+ T cell counts (p=0.066) were observed in the vaccine group compared to placebo, more pronounced after IM administration and in some HLA haplotypes (B*5703) maintained for 17 months after the final immunisation.The GTU(®)-multi-HIVB plasmid recombinant DNA therapeutic HIV-1 vaccine is safe, well tolerated and favourably affects pHIV-RNA and CD4 counts in untreated HIV-1 infected individuals after IM administration in subjects with HLA B*57, B*8101 and B*5801 haplotypes.CONCLUSIONSThe GTU(®)-multi-HIVB plasmid recombinant DNA therapeutic HIV-1 vaccine is safe, well tolerated and favourably affects pHIV-RNA and CD4 counts in untreated HIV-1 infected individuals after IM administration in subjects with HLA B*57, B*8101 and B*5801 haplotypes.
Highlights► FIT GTU ®-multi-HIVB was the first therapeutic HIV-1 vaccine trial conducted in South Africa. ► This plasmid DNA vaccine is safe and well-tolerated in HIV-1 infected, anteretrovial naive subjects. ► Cross subtype reactivity of subtype B derived vaccine in subtype C infected subjects was shown. ► Significant CD4 increases and VL decreases after IM vaccine were maintained for more than 2 years. ► This DNA HIV vaccine may be used as affordable prime/boost regimens alone or as an adjunct to HAART.
Highlights * FIT GTU®-multi-HIVB was the first therapeutic HIV-1 vaccine trial conducted in South Africa. * This plasmid DNA vaccine is safe and well-tolerated in HIV-1 infected, anteretrovial naive subjects. * Cross subtype reactivity of subtype B derived vaccine in subtype C infected subjects was shown. * Significant CD4 increases and VL decreases after IM vaccine were maintained for more than 2 years. * This DNA HIV vaccine may be used as affordable prime/boost regimens alone or as an adjunct to HAART.
► FIT GTU®-multi-HIVB was the first therapeutic HIV-1 vaccine trial conducted in South Africa. ► This plasmid DNA vaccine is safe and well-tolerated in HIV-1 infected, anteretrovial naive subjects. ► Cross subtype reactivity of subtype B derived vaccine in subtype C infected subjects was shown. ► Significant CD4 increases and VL decreases after IM vaccine were maintained for more than 2 years. ► This DNA HIV vaccine may be used as affordable prime/boost regimens alone or as an adjunct to HAART. Combination highly active antiretroviral therapy (HAART) has significantly decreased HIV-1 related morbidity and mortality globally transforming HIV into a controllable condition. HAART has a number of limitations though, including limited access in resource constrained countries, which have driven the search for simpler, affordable HIV-1 treatment modalities. Therapeutic HIV-1 vaccines aim to provide immunological support to slow disease progression and decrease transmission. We evaluated the safety, immunogenicity and clinical effect of a novel recombinant plasmid DNA therapeutic HIV-1 vaccine, GTU®-multi-HIVB, containing 6 different genes derived from an HIV-1 subtype B isolate. 63 untreated, healthy, HIV-1 infected, adults between 18 and 40 years were enrolled in a single-blinded, placebo-controlled Phase II trial in South Africa. Subjects were HIV-1 subtype C infected, had never received antiretrovirals, with CD4≥350cells/mm3 and pHIV-RNA≥50copies/mL at screening. Subjects were allocated to vaccine or placebo groups in a 2:1 ratio either administered intradermally (ID) (0.5mg/dose) or intramuscularly (IM) (1mg/dose) at 0, 4 and 12 weeks boosted at 76 and 80 weeks with 1mg/dose (ID) and 2mg/dose (IM), respectively. Safety was assessed by adverse event monitoring and immunogenicity by HIV-1-specific CD4+ and CD8+ T-cells using intracellular cytokine staining (ICS), pHIV-RNA and CD4 counts. Vaccine was safe and well tolerated with no vaccine related serious adverse events. Significant declines in logpHIV-RNA (p=0.012) and increases in CD4+ T cell counts (p=0.066) were observed in the vaccine group compared to placebo, more pronounced after IM administration and in some HLA haplotypes (B*5703) maintained for 17 months after the final immunisation. The GTU®-multi-HIVB plasmid recombinant DNA therapeutic HIV-1 vaccine is safe, well tolerated and favourably affects pHIV-RNA and CD4 counts in untreated HIV-1infected individuals after IM administration in subjects with HLA B*57, B*8101 and B*5801haplotypes.
Author Stanescu, Ioana
Vardas, Eftyhia
Leinonen, Mika
Pantaleo, Giuseppe
Ustav, Mart
Valtavaara, Minna
Ellefsen, Kim
Reijonen, Kalevi
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  surname: Vardas
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  email: eftyxia.vardas@lancet.co.za, vardas@sun.ac.za
  organization: Lancet Laboratories, Richmond, Johannesburg, South Africa
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  givenname: Ioana
  surname: Stanescu
  fullname: Stanescu, Ioana
  organization: FIT Biotech Ltd., Tampere, Finland
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  surname: Leinonen
  fullname: Leinonen, Mika
  organization: 4 Pharma Ltd., Turku, Finland
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  fullname: Ellefsen, Kim
  organization: Centre Hospitalier Universitaire Vaudois, CH - 1011 Lausanne, Switzerland
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  organization: Centre Hospitalier Universitaire Vaudois, CH - 1011 Lausanne, Switzerland
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  organization: FIT Biotech Ltd., Tampere, Finland
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  surname: Ustav
  fullname: Ustav, Mart
  organization: FIT Biotech Ltd., Tartu, Estonia
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  givenname: Kalevi
  surname: Reijonen
  fullname: Reijonen, Kalevi
  organization: FIT Biotech Ltd., Tampere, Finland
BackLink https://www.ncbi.nlm.nih.gov/pubmed/22549090$$D View this record in MEDLINE/PubMed
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IsPeerReviewed true
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Issue 27
Keywords South Africa
Untreated
Chronic HIV-1
Therapeutic HIV-1 vaccines
Language English
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Copyright © 2012 Elsevier Ltd. All rights reserved.
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Snippet ► FIT GTU®-multi-HIVB was the first therapeutic HIV-1 vaccine trial conducted in South Africa. ► This plasmid DNA vaccine is safe and well-tolerated in HIV-1...
Highlights► FIT GTU ®-multi-HIVB was the first therapeutic HIV-1 vaccine trial conducted in South Africa. ► This plasmid DNA vaccine is safe and well-tolerated...
BACKGROUND: Combination highly active antiretroviral therapy (HAART) has significantly decreased HIV-1 related morbidity and mortality globally transforming...
Combination highly active antiretroviral therapy (HAART) has significantly decreased HIV-1 related morbidity and mortality globally transforming HIV into a...
Highlights * FIT GTU®-multi-HIVB was the first therapeutic HIV-1 vaccine trial conducted in South Africa. * This plasmid DNA vaccine is safe and well-tolerated...
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SubjectTerms Acquired immune deficiency syndrome
Acquired Immunodeficiency Syndrome - therapy
Acquired Immunodeficiency Syndrome - virology
Adult
adults
AIDS
AIDS Vaccines - administration & dosage
AIDS Vaccines - adverse effects
AIDS Vaccines - immunology
Allergy and Immunology
antiretroviral agents
Antiretroviral drugs
CD4 Lymphocyte Count
CD4-positive T-lymphocytes
CD8-positive T-lymphocytes
Chronic HIV-1
cytokines
Deoxyribonucleic acid
disease course
DNA
Drug-Related Side Effects and Adverse Reactions - epidemiology
Female
genes
Genotype
haplotypes
HIV
HIV infections
HIV-1 - classification
HIV-1 - genetics
HIV-1 - isolation & purification
Human immunodeficiency virus
Human immunodeficiency virus 1
Humans
immune response
immunization
Immunotherapy - methods
Injections, Intradermal
Injections, Intramuscular
Male
monitoring
morbidity
mortality
Placebos - administration & dosage
plasmids
Plasmids - administration & dosage
recombinant DNA
recombinant vaccines
RNA, Viral - blood
screening
South Africa
Therapeutic HIV-1 vaccines
Treatment Outcome
Untreated
Vaccines
Vaccines, DNA - administration & dosage
Vaccines, DNA - adverse effects
Vaccines, DNA - immunology
Vaccines, Synthetic - administration & dosage
Vaccines, Synthetic - adverse effects
Vaccines, Synthetic - immunology
Viral Load
Young Adult
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Title Indicators of therapeutic effect in FIT-06, a Phase II trial of a DNA vaccine, GTU®-Multi-HIVB, in untreated HIV-1 infected subjects
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