Trial record 17 of 5372 for:    "Acquired Immunodeficiency Syndrome"

Differences in Response to the Flu Vaccine Among Adults With HIV and Without HIV in Uganda

This study has been completed.
Sponsor:
Collaborator:
Makerere University
Information provided by (Responsible Party):
Saad B. Omer, PhD, Emory University
ClinicalTrials.gov Identifier:
NCT01916759
First received: February 25, 2013
Last updated: April 22, 2014
Last verified: April 2014
  Purpose

To use a systems biological approach to study the molecular signatures of innate and adaptive responses to vaccination in a HIV infected versus uninfected adult population in Kampala, Uganda.


Condition Intervention
HIV
Acquired Immunodeficiency Syndrome
Influenza
Drug: Seasonal trivalent inactivated influenza vaccine (Vaxigrip®)

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Basic Science
Official Title: Systems Biological Responses to Influenza Vaccination in an HIV-infected and HIV-uninfected Adult Population in Kampala, Uganda

Resource links provided by NLM:


Further study details as provided by Emory University:

Primary Outcome Measures:
  • In group and between group comparison of immune parameters and gene expressions that change significantly following vaccination with the seasonal trivalent influenza vaccine (Vaxigrip®) [ Time Frame: From baseline (Day 0) to 100 days post vaccination ] [ Designated as safety issue: No ]
    Immune parameters or gene expressions that change significantly in groups over baseline post immunization and between the study groups will be analyzed. For immune parameters, we will use a two-sided paired t-test. Fold-change will be combined with the test p-value in a selection criterion as appropriate. The tentative selection criterion is p-value ≤ 0.01 and fold change ≥ 3. For the gene/miRNA expression data, we will use the method Significance Analysis of Microarrays (SAM) with paired design to find differentially expressed genes. False discovery rate (FDR) will be used as selection criterion. The tentative selection criterion is FDR ≤ 0.1.

  • Proportion of subjects achieving 4-fold or greater hemagglutination inhibition (HAI)antibody titer increases. [ Time Frame: From baseline (Day 0) to 100 days following primary vaccination ] [ Designated as safety issue: No ]
    Proportion of subjects in different study groups achieving 4-fold or greater hemagglutination inhibition (HAI)antibody titer increases will be tabulated at each time point (Days 0, 1, 3, 7, 14, 28 and 100) and plotted across time. Fisher's exact test will be used to make comparisons between the study groups.

  • Calculating correlation coefficient between the immune parameter and vaccine immunogenicity, as measured by the humoral immune response against seasonal influenza. [ Time Frame: From baseline (Day 0) to 100 days post vaccination ] [ Designated as safety issue: No ]
    For immune parameters, we will calculate the correlation coefficient between the immune parameter and vaccine immunogenicity, as measured by the humoral immune response against seasonal influenza. The p-values associated with the correlation coefficients will be used to select immune parameters that are associated with the respective adaptive immune responses. The tentative selection criterion is p-value ≤ 0.01. For gene expression data, we will use the method Significance Analysis of Microarrays (SAM) with quantitative outcome to identify genes that are significantly associated with the immune response. False discovery rate (FDR) will be used as selection criterion. The tentative selection criterion is FDR ≤ 0.1.

  • Characterization of the gut microbiota to determine compositional differences between HIV-uninfected adults versus HIV-infected adults on HAART versus HIV-infected long-term non-progressors [ Time Frame: From baseline (Day 0) to Day 28 post vaccination ] [ Designated as safety issue: No ]
    Gut mircobiota will be characterized to determine what compositional differences exist between HIV-uninfected adults versus HIV-infected adults on HAARt versus HIV-infected long-term non-progressors at baseline (Day 0), Day 7 and Day 28 post vaccination

  • Correlation between microbiata status and the quality of immune response elicited in vaccinated individuals [ Time Frame: From baseline (Day 0) to Day 28 post vaccination ] [ Designated as safety issue: No ]
    Determine whether the status of the microbita correlates with the quality of immune responses elicited in vaccinated individuals


Enrollment: 63
Study Start Date: June 2013
Study Completion Date: March 2014
Primary Completion Date: December 2013 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
HIV uninfected adults
25 HIV uninfected adults enrolled at the Mulago National Referral Hospital complex in Kampala, Uganda will receive seasonal trivalent inactivated influenza vaccine (Vaxigrip®).
Drug: Seasonal trivalent inactivated influenza vaccine (Vaxigrip®)
Administer seasonal trivalent inactivated influenza vaccine (Vaxigrip®) and collect blood specimens at 0, 1, 3, 7, 14, 28 and 100 days following vaccination.
HIV infected adults on HAART
25 HIV infected adults enrolled at the Mulago National Referral Hospital complex in Kampala, Uganda will receive seasonal trivalent inactivated influenza vaccine (Vaxigrip®).
Drug: Seasonal trivalent inactivated influenza vaccine (Vaxigrip®)
Administer seasonal trivalent inactivated influenza vaccine (Vaxigrip®) and collect blood specimens at 0, 1, 3, 7, 14, 28 and 100 days following vaccination.
HIV-infected long-term non-progressors
10 HIV-infected long-term non-progressor adults enrolled at the Mulago National Referral Hospital complex in Kampala, Uganda will receive seasonal trivalent inactivated influenza vaccine (Vaxigrip®).
Drug: Seasonal trivalent inactivated influenza vaccine (Vaxigrip®)
Administer seasonal trivalent inactivated influenza vaccine (Vaxigrip®) and collect blood specimens at 0, 1, 3, 7, 14, 28 and 100 days following vaccination.

Detailed Description:

This longitudinal, observational cohort study will be conducted at the Makerere University- Johns Hopkins University Research Collaboration, at the Mulago National Referral Hospital complex in Kampala Uganda. The study will consist of 2 groups. One group will consist of 25 healthy HIV uninfected adults and the other arm will consist of 35 HIV infected adults. Within the HIV infected arm there will be two groups, 25 HIV infected adults and 10 long term non-progressors. Vaccinees will receive a primary immunization at day 0, and blood samples will be obtained at days 0, 1, 3, 7, 14, 28 and 100 after immunization.

We will analyze the early molecular signatures (identified by microarray analyses, as well as by FACS analyses of innate immune cells and luminex analyses of cytokines and chemokines) that correlate and predict the later immune responses.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  1. For HIV uninfected group

    • Confirmation of HIV-1 infection from medical records
  2. For HIV infected on HAART group

    • Confirmation of HIV-1 infection from medical records
    • Participants must be on HAART for at least 6 months prior to enrollment
    • A CD4 T-cell count available in the last 6 months
    • CD4 T-cell count >350 cells/μL on the eligibility blood specimen
  3. Long-term non-progressor group

    • HIV infected for more than 7 years
    • No evidence of opportunistic infections in the medical records
    • Never received antiretroviral therapy (except anti-retrovirals for prevention of mother-to-infant transmission of HIV)
    • A CD4 T-cell count available in the last 6 months
    • CD4+ T-cell count slop of ≥0 cells/µl blood from entry into the MU-JHU cohort until the most recent available CD4+ T-cell count.

Exclusion Criteria:

  1. Current moderate or severe acute illness, history of fever or temperature ≥37.5oC within 48 hours prior to vaccination (participants can be re-evaluated at a subsequent visit)
  2. History of systemic disease, including: Guillain-Barré Syndrome; known hepatitis B, or hepatitis C infection; cardiac disease; uncontrolled diabetes mellitus (including gestational diabetes); chronic liver condition; clinically significant renal impairment; clinically significant neurological disorders; active TB within the last year; Cancer. This information will be based on self-reporting and (where possible) will be confirmed by hospital medical records
  3. Received immunoglobulin or other blood product within the preceding 3 months or expected receipt of blood products during the 3 months of follow-up
  4. History of anaphylactic hypersensitivity reactions to egg proteins (eggs or egg products), or any other component of the vaccine including traces (formaldehyde, octoxinol 9 (Triton X-100) and neomycin)
  5. History of severe reaction (including hypersensitivity) after receiving any vaccine
  6. Currently pregnant
  7. In the opinion of the study team it would be unsuitable for the study subjects to receive the vaccine or participate in the study.
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01916759

Locations
Uganda
Makere University- Johns Hopkins University Research Collaboration, at the Mulago National Referral Hospital
Kampala, Uganda
Sponsors and Collaborators
Emory University
Makerere University
Investigators
Principal Investigator: Saad B Omer, MBBS,MPH,PhD Emory Unversity
  More Information

Publications:

Responsible Party: Saad B. Omer, PhD, Associate Professor, Emory University
ClinicalTrials.gov Identifier: NCT01916759     History of Changes
Other Study ID Numbers: IRB00058919, 1U19AI090023-02
Study First Received: February 25, 2013
Last Updated: April 22, 2014
Health Authority: United States: Institutional Review Board

Keywords provided by Emory University:
immunization

Additional relevant MeSH terms:
Acquired Immunodeficiency Syndrome
HIV Infections
Immunologic Deficiency Syndromes
Influenza, Human
Lentivirus Infections
Retroviridae Infections
RNA Virus Infections
Virus Diseases
Sexually Transmitted Diseases, Viral
Sexually Transmitted Diseases
Slow Virus Diseases
Immune System Diseases
Orthomyxoviridae Infections
Respiratory Tract Infections
Respiratory Tract Diseases

ClinicalTrials.gov processed this record on July 22, 2014