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HIV 阴性成人中含嵌合免疫原和新型嵌合包膜蛋白的 Ad26 载体 HIV 疫苗的安全性和免疫原性:一项 1/2a 期研究。

Safety and Immunogenicity of Ad26-Vectored HIV Vaccine With Mosaic Immunogens and a Novel Mosaic Envelope Protein in HIV-Uninfected Adults: A Phase 1/2a Study.

机构信息

Janssen Vaccines and Prevention Leiden, the Netherlands.

Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.

出版信息

J Infect Dis. 2023 Apr 18;227(8):939-950. doi: 10.1093/infdis/jiac445.


DOI:10.1093/infdis/jiac445
PMID:36348617
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10202119/
Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86f4/10202119/7ec7c2c6b1c8/jiac445f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86f4/10202119/86f92e1b10d7/jiac445f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86f4/10202119/12b025d18a8f/jiac445f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86f4/10202119/570365e40162/jiac445f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86f4/10202119/98c76f29ea2b/jiac445f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86f4/10202119/7ec7c2c6b1c8/jiac445f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86f4/10202119/86f92e1b10d7/jiac445f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86f4/10202119/12b025d18a8f/jiac445f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86f4/10202119/570365e40162/jiac445f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86f4/10202119/98c76f29ea2b/jiac445f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86f4/10202119/7ec7c2c6b1c8/jiac445f5.jpg

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本文引用的文献

[1]
Analysis of the HIV Vaccine Trials Network 702 Phase 2b-3 HIV-1 Vaccine Trial in South Africa Assessing RV144 Antibody and T-Cell Correlates of HIV-1 Acquisition Risk.

J Infect Dis. 2022-8-24

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N Engl J Med. 2021-9-2

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N Engl J Med. 2021-3-25

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[7]
Safety and immunogenicity of two heterologous HIV vaccine regimens in healthy, HIV-uninfected adults (TRAVERSE): a randomised, parallel-group, placebo-controlled, double-blind, phase 1/2a study.

Lancet HIV. 2020-10

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Nature. 2020-7-15

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Vaccines and Broadly Neutralizing Antibodies for HIV-1 Prevention.

Annu Rev Immunol. 2020-4-26

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Comparison of shortened mosaic HIV-1 vaccine schedules: a randomised, double-blind, placebo-controlled phase 1 trial (IPCAVD010/HPX1002) and a preclinical study in rhesus monkeys (NHP 17-22).

Lancet HIV. 2020-2-17

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