scholarly journals Expectation of Volunteers Towards the Vaccine Efficacy of the Prime-Boost HIV Vaccine Phase III Trial During Unblinding

2014 ◽  
Vol 30 (11) ◽  
pp. 1041-1045 ◽  
Author(s):  
Kessuda Khowsroy ◽  
Jittima Dhitavat ◽  
Yupa Sabmee ◽  
Pataramon Laowarakul ◽  
Jutarat Wattanakitwichai ◽  
...  
Retrovirology ◽  
2012 ◽  
Vol 9 (S2) ◽  
Author(s):  
O Penezina ◽  
D Clapham ◽  
J Collins ◽  
V Kovalenko ◽  
N Krueger ◽  
...  

AIDS ◽  
1994 ◽  
Vol 8 (9) ◽  
pp. 1285-1291 ◽  
Author(s):  
William L. Heyward ◽  
Saladin Osmanov ◽  
Joseph Saba ◽  
Jose Esparza ◽  
Elizabeth Belsey ◽  
...  

Vaccine ◽  
1999 ◽  
Vol 17 (7-8) ◽  
pp. 989-1004 ◽  
Author(s):  
M.-C. Boily ◽  
B.R. Mâsse ◽  
K. Desai ◽  
M. Alary ◽  
R.M. Anderson

2019 ◽  
Vol 4 (Suppl 3) ◽  
pp. A10.1-A10
Author(s):  
Sarah Joseph ◽  
Pontiano Kaleebu ◽  
Eugene Ruzagira ◽  
Christian Holm Hansen ◽  
Janet Seeley ◽  
...  

BackgroundThere remains an urgent need for a prophylactic HIV vaccine to control generalised epidemics. PrEP has demonstrated effectiveness of 86% and is recommended by WHO; uptake is generally high, but retention is disappointing in some settings. The EDCTP2 project PrEPVacc will assess the efficacy of two combination prophylactic vaccine regimens (DNA, MVA and Env protein/adjuvant) each compared to placebo and the proportion of infections averted by F/TAF in comparison to TDF/FTC. A Registration Cohort, recruiting HIV negative volunteers at risk of HIV will precede the trial.MethodsThe PrEPVacc partnership agreed that 70% vaccine efficacy had public health relevance. The trial uses nstage software for multi-arm, multi-stage designs (MAMS) and the averted infections ratio (AIR) methodology with participants randomised (i) 1:1:1 to active product or placebo (ii) 1:1 to TDF/FTC : F/TAF until week 26 (presumed peak immunogenicity). Access to PrEP in the Registration Cohort and after week 26 will be standard of care. HIV seroconversions occurring between weeks 0–26 will inform the PrEP analysis, incorporating HIV incidence amongst those who do not take up PrEP locally in the Registration Cohort. Seroconversions after week 26 will inform vaccine analyses.ResultsUp to 556 participants per group affords 92% power to detect vaccine efficacy of 70% at the final analysis, assuming incidence of 4/100-person years and 10% loss with 81% and 97% power to conclude that F/TAF can avert half or more of the infections prevented by TDF/FTC if effectiveness of TDF/FTC is 70% and 80%, respectively.ConclusionPrEPVacc adopts a pragmatic approach to uncertainties around HIV incidence in settings where PrEP is increasingly available. This innovative adaptive trial design uses validated software to determine vaccine efficacy and a novel methodology to evaluate a new PrEP agent, overcoming the challenge of demonstrating non-inferiority when adherence to TDF/FTC is high and the number of outcome events very low.


2018 ◽  
Author(s):  
Lily Liu ◽  
Liuzhe Li ◽  
Aubin Nanfack ◽  
Luzia M. Mayr ◽  
Sonal Soni ◽  
...  

ABSTRACTThe positive correlation of high levels of plasma anti-V2 antibodies (Abs) with protective immunity in the Phase III anti-HIV RV144 vaccine trial generated interest in the induction of these Abs for HIV vaccine development. We analyzed plasma samples from 79 chronically infected Cameroonian individuals for Ab reactivity against three V1V2 fusion proteins and five cyclic V2 peptides and found that HIV-1 infection induces different levels of anti-V2 Abs. While the majority of plasma samples reacted strongly with one or more V2 antigens, 10% (8) of the samples were nonreactive. Deficiency of anti-V2 Abs was consistently found in longitudinal plasma samples tested over 8 to 54 months of HIV infection. There was a strong correlation between binding activities of plasma anti-V2 Abs and anti-gp120 and anti-gp41 Abs, suggesting that deficiency of V2 Abs could be related, in part, to a limited ability to elicit strong Ab responses. Analysis of gp120 sequences revealed that the V2 region of viruses from donors with V2-deficient versus V2-reactive Abs displayed a tendency toward longer length, more glycans, and lower isoelectric point and charge. No differences between these two patient groups were noted in the same parameters measured in the V1 region. These data suggest that immunogens containing a shorter V2 region with fewer glycosylation sites and higher electrostatic charges would be beneficial for induction of anti-V2 Abs, but the ability to mount a strong general Ab response to HIV-1 appears to be a dominant factor.IMPORTANCEThe results of the RV144 vaccine clinical trial showed a correlation between plasma Abs against a V1V2 fusion protein and a decreased risk of acquiring HIV-1 infection. This turned the focus of some HIV vaccine design to the induction of elevated levels of anti-V2 Abs to increase vaccine efficacy. In plasma samples from Cameroonian individuals infected with HIV-1, we observed broad variations in levels of anti-V2 Abs, and 8 of the 79 plasma samples tested displayed substantial deficiency of V2 Abs. Sequence analysis of the V2 region from plasma viruses and multivariate analyses of V2 characteristics showed a significant difference in several features between V2-deficient and V2-reactive plasma Abs. These results suggest that HIV vaccine immunogens containing a V2 region with shorter length, fewer glycosylation sites, and higher electrostatic charges may be beneficial for induction of a higher level of anti-V2 Abs and thus contribute to HIV vaccine efficacy.


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