Janssen Vaccines and Prevention Leiden, the Netherlands.
Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
J Infect Dis. 2023 Apr 18;227(8):939-950. doi: 10.1093/infdis/jiac445.
BACKGROUND: Developing a cross-clade, globally effective HIV vaccine remains crucial for eliminating HIV. METHODS: This placebo-controlled, double-blind, phase 1/2a study enrolled healthy HIV-uninfected adults at low risk for HIV infection. They were randomized (1:4:1) to receive 4 doses of an adenovirus 26-based HIV-1 vaccine encoding 2 mosaic Gag and Pol, and 2 mosaic Env proteins plus adjuvanted clade C gp140 (referred to here as clade C regimen), bivalent protein regimen (clade C regimen plus mosaic gp140), or placebo. Primary end points were safety and antibody responses. RESULTS: In total 152/155 participants (clade C, n = 26; bivalent protein, n = 103; placebo, n = 26) received ≥1 injection. The highest adverse event (AE) severity was grade 3 (local pain/tenderness, 12%, 2%, and 0% of the respective groups; solicited systemic AEs, 19%, 15%, 0%). HIV-1 mosaic gp140-binding antibody titers were 79 595 ELISA units (EU)/mL and 137 520 EU/mL in the clade C and bivalent protein groups (P < .001) after dose 4 and 16 862 EU/mL and 25 162 EU/mL 6 months later. Antibody response breadth against clade C gp140 and clade C/non-clade C gp120 was highest in the bivalent protein group. CONCLUSIONS: Adding mosaic gp140 to the clade C regimen increased and broadened the elicited immune response without compromising safety or clade C responses. Clinical Trials Registration. NCT02935686.
背景:开发一种跨谱系、具有全球效力的 HIV 疫苗对于消除 HIV 仍然至关重要。
方法:这项安慰剂对照、双盲、1/2a 期研究招募了感染 HIV 风险较低的健康 HIV 未感染者。他们按照 1:4:1 的比例随机分配,接受 4 剂基于腺病毒 26 的 HIV-1 疫苗,该疫苗编码 2 种嵌合 Gag 和 Pol,以及 2 种嵌合 Env 蛋白加佐剂的 clade C gp140(这里称为 clade C 方案)、双价蛋白方案(clade C 方案加嵌合 gp140)或安慰剂。主要终点是安全性和抗体反应。
结果:总共 152/155 名参与者(clade C,n=26;双价蛋白,n=103;安慰剂,n=26)接受了至少 1 次注射。最高不良事件(AE)严重程度为 3 级(局部疼痛/触痛,分别为各自组的 12%、2%和 0%;征询问卷系统 AE,19%、15%、0%)。在第 4 剂和 6 个月后,clade C 和双价蛋白组的 HIV-1 嵌合 gp140 结合抗体滴度分别为 79595 ELISA 单位(EU)/mL 和 137520 EU/mL(P<0.001)和 16862 EU/mL 和 25162 EU/mL。双价蛋白组对 clade C gp140 和 clade C/非 clade C gp120 的抗体反应广度最高。
结论:在 clade C 方案中添加嵌合 gp140 可增加并拓宽所引发的免疫反应,而不会影响安全性或 clade C 反应。临床试验注册。NCT02935686。
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