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Multi Interventional Study Exploring HIV-1 Residual Replication: a Step Towards HIV-1 Eradication and Sterilizing Cure

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ClinicalTrials.gov Identifier: NCT02961829
Recruitment Status : Completed
First Posted : November 11, 2016
Last Update Posted : July 28, 2020
Sponsor:
Collaborators:
Fundação de Amparo à Pesquisa do Estado de São Paulo
Conselho Nacional de Desenvolvimento Científico e Tecnológico
ViiV Healthcare
Information provided by (Responsible Party):
Ricardo Sobhie Diaz, MD, PHD, Federal University of São Paulo

Study Description
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Brief Summary:
It is becoming clear that a combination of interventions will be desirable to achieve HIV cure. Therefore the investigators propose a pilot proof of concept study, using combination of a number of different interventions for eradicating residual plasma viremia and decreasing HIV reservoirs. The investigators hypothesize that, (i) antiretroviral intensification using Maraviroc, and/or dolutegravir with (ii) Dendritic Cell vaccination using autologous HIV, and (iii) purging intervention using the Class III HDACs, Sirtuin-1, and (iv) decreasing the ratio of long-lived central memory (TCM)/transitional memory (TTM) CD4+ T-cells using Auranofin will provide a synergistic impact leading to a sterilizing cure of HIV infection. Results of this study may provide insightful evidence for planning the next steps using the more efficacious combination of intervention strategies towards HIV sterilizing cure.

Condition or disease Intervention/treatment Phase
Chronic Infection HIV Drug: Maraviroc Drug: Dolutegravir Biological: Dendritic Cell Vaccine Drug: Auranofin Drug: Sirtuin Histone deacetylase inhibitor Not Applicable

Study Design
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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 30 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Multi Interventional Study Exploring HIV-1 Residual Replication: a Step Towards HIV-1 Eradication and Sterilizing Cure
Actual Study Start Date : July 2015
Actual Primary Completion Date : March 2019
Actual Study Completion Date : March 2020

Resource links provided by the National Library of Medicine

MedlinePlus related topics: HIV/AIDS Vaccines

Arms and Interventions
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Arm Intervention/treatment
No Intervention: Antiretroviral Treated (ART) Group
Five patients will receive no further intervention this group (control group)
Experimental: ART Intensification Group
Five patients will receive antiretroviral intensification with maraviroc and dolutegravir for 48 weeks
 Drug: Maraviroc
antiretroviral intensification
Other Names:
  • Selzentry
  • Celsentri

Drug: Dolutegravir
antiretroviral intensification
Other Name: Tivicay
Experimental: ART Intensification + Nicotinamide Group
Five patients will receive antiretroviral intensification with maraviroc and dolutegravir and the Sirtuin Histone deacetylase inhibitor nicotinamide for 48 weeks.
 Drug: Maraviroc
antiretroviral intensification
Other Names:
  • Selzentry
  • Celsentri

Drug: Dolutegravir
antiretroviral intensification
Other Name: Tivicay

Drug: Sirtuin Histone deacetylase inhibitor
latency disruption
Other Name: Nicotinamide
Experimental: ART Intensification + Auranofin Group
Five patients will receive antiretroviral intensification with maraviroc and dolutegravir for 48 weeks and the gold salt auranofin for 24 weeks.
 Drug: Maraviroc
antiretroviral intensification
Other Names:
  • Selzentry
  • Celsentri

Drug: Dolutegravir
antiretroviral intensification
Other Name: Tivicay

Drug: Auranofin
purging
Other Name: Gold Salt
Experimental: ART Intensification + DC vaccine Group
Five patients will receive antiretroviral intensification with dolutegravir and for 48 weeks, and dendritic cell vaccine.
 Drug: Dolutegravir
antiretroviral intensification
Other Name: Tivicay

Biological: Dendritic Cell Vaccine
Therapeutic vaccination
Other Name: DC Vaccine
Experimental: Multi Interventional Group
Five patients will receive antiretroviral intensification with dolutegravir and the Sirtuin Histone deacetylase inhibitor nicotinamide for 48 weeks, and gold salt for 24 weeks and dendritic cell vaccine.
 Drug: Dolutegravir
antiretroviral intensification
Other Name: Tivicay

Biological: Dendritic Cell Vaccine
Therapeutic vaccination
Other Name: DC Vaccine

Drug: Auranofin
purging
Other Name: Gold Salt

Drug: Sirtuin Histone deacetylase inhibitor
latency disruption
Other Name: Nicotinamide


Outcome Measures
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Primary Outcome Measures :
  1. Ultrasensitive RNA Viral load, [ Time Frame: from baseline and every 4 weeks up to 48 weeks. ]
  2. Cell-associated HIV RNA [ Time Frame: from baseline and every 4 weeks up to 48 weeks. ]
  3. Episomal DNA [ Time Frame: from baseline and every 4 weeks up to 48 weeks ]
  4. specific HIV antibodies [ Time Frame: from baseline and every 4 weeks up to 48 weeks ]
  5. CD38 and HLA-DR on CD4 and CD8+ cells [ Time Frame: from baseline and every 4 weeks up to 48 weeks ]
  6. PBMC for env sequence evolution [ Time Frame: from baseline and every 4 weeks up to 48 weeks ]

Eligibility Criteria
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Ages Eligible for Study:   18 Years to 60 Years   (Adult)
Sexes Eligible for Study:   Male
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • > 18 years old Documented HIV-1 infection.
  • Has voluntarily signed ICF.
  • On HAART ≥ 2 years, without changes in the 24 weeks immediately prior to screening.
  • HIV viral load <50 copies/mL, and never > 50 copies/mL on 2 consecutive occasions in the last 2 years. CD4 count nadir.
  • > 350 cells/ mm3 Current CD4 count > 500 cells/ mm3.
  • R5 HIV-1 at Screening as defined by proviral DNA genotropism.

Exclusion Criteria:

A subject will NOT be eligible for study participation if he/she meets ANY of the following criteria:

  • Any evidence of an active AIDS-defining condition.
  • Any significant acute medical illness in the past 8 weeks.
  • Women who are pregnant or breastfeeding.
  • Use of any of the following within 90 days prior to entry: systemic cytotoxic chemotherapy; investigational agents; immunomodulators (colony-stimulating factors, growth factors, systemic corticosteroids, HIV vaccines, immune globulin, interleukins, interferons); coumadin, warfarin, or other Coumadin derivative anticoagulants. Use of an agent definitely or possibly associated with effects on QT intervals: amiodarone, arsenic trioxide, astemizole, bepridil, chloroquine, chlorpromazine, cisapride, clarithromycin, disopyramide, dofetilide, domperidone, droperidol, erythromycin, halofantrine, haloperidol, ibutilide, levomethadyl, mesoridazine, methadone, pentamidine, pimozide, probucol, procainamide, quinidine, sotalol, sparfloxacin, terfenadine, thioridazine.
  • Receipt of compounds with HDAC inhibitor-like activity, such as valproic acid or nicotinamide within the last 30 days. Potential participants may enroll after a 30-day washout period.
  • Known hypersensitivity to the components of gold salt, nicotinamide or its analogs.
  • Hepatitis B (HBsAg +) or Hepatitis C (HCV RNA +) infection.
  • Known renal insufficiency defined as calculated creatinine clearance (Cockcroft Gault formula) <60 mL/min.
  • Subjects with a laboratory abnormality grade 3 or 4 with the following exceptions: pancreatic amylase, cholesterol, triglyceride, gamma glutamyl transpeptidase, bilirubin.
  • Any condition which, in the investigators opinion, could compromise the subject's safety or adherence to the trial protocol.
Contacts and Locations
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Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02961829


Locations
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Brazil
CCDI
Sao Paulo, SP, Brazil, 04040002
Sponsors and Collaborators
Federal University of São Paulo
Fundação de Amparo à Pesquisa do Estado de São Paulo
Conselho Nacional de Desenvolvimento Científico e Tecnológico
ViiV Healthcare
More Information
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Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

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Responsible Party: Ricardo Sobhie Diaz, MD, PHD, Associate Professor of Medicine, Federal University of São Paulo
ClinicalTrials.gov Identifier: NCT02961829    
Other Study ID Numbers: SPARC-7
First Posted: November 11, 2016    Key Record Dates
Last Update Posted: July 28, 2020
Last Verified: July 2020
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Undecided
Keywords provided by Ricardo Sobhie Diaz, MD, PHD, Federal University of São Paulo:
Dendritic Cell vaccination using
antiretroviral intensification
Auranofin
Histone Deacetylase Inhibitor
 residual viral replication
HIV sanctuaries
HIV latency
Additional relevant MeSH terms:
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Niacinamide
Maraviroc
Dolutegravir
Auranofin
Vaccines
Histone Deacetylase Inhibitors
Immunologic Factors
Physiological Effects of Drugs
HIV Fusion Inhibitors
Viral Fusion Protein Inhibitors
Molecular Mechanisms of Pharmacological Action
Anti-HIV Agents
 Anti-Retroviral Agents
Antiviral Agents
Anti-Infective Agents
CCR5 Receptor Antagonists
HIV Integrase Inhibitors
Integrase Inhibitors
Enzyme Inhibitors
Vitamin B Complex
Vitamins
Micronutrients
Antirheumatic Agents