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VH4524184 Proof-of-Concept in Treatment-Naïve Adults Living With HIV-1

Phase 2
Recruiting
Conditions
HIV Infections
Interventions
Drug: Placebo
Registration Number
NCT06214052
Lead Sponsor
ViiV Healthcare
Brief Summary

The purpose of this study is to evaluate the safety, tolerability, ability of VH4524184 when given alone to reduce the amount of HIV (viral load) in people with HIV-1 infection who have never received antiretroviral therapy (treatment-naïve). Data from this study will be used to decide how VH4524184 can be best included in a full-treatment regimen for HIV-1 in the future.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
28
Inclusion Criteria
  • Participant must be 18 to 65 years of age inclusive at the time of signing the informed consent.
  • Participants who are overtly healthy (other than HIV infection) as determined by the Investigator or medically qualified designee based on a medical evaluation including medical history, physical examination, laboratory tests, and cardiac monitoring.
  • Positive HIV antibody test
  • Documented HIV infection and Screening plasma HIV-1 RNA ≥ 3,000 copies/mL. A single repeat of this test is allowed within a single Screening period to determine eligibility.
  • Screening CD4+ T-cell count ≥200 cells/mm3
  • Treatment-naïve: No antiretrovirals (ARVs, in combination or monotherapy) received after the diagnosis of HIV-1 infection.
  • HIV Pre-exposure or post-exposure prophylaxis: No prior use of any INSTI (including cabotegravir) for HIV pre-exposure or post-exposure prophylaxis.
  • Body weight ≥50.0 kg (110 lbs.) for men and ≥45.0 kg (99 lbs) for women and BMI within the range 18.5-31.0 kg/m2 (inclusive - applies to males and females).
  • A participant of childbearing potential must have a negative serum hCG test at screening, and negative urine hCG test at Day 1, before the first dose of study intervention.
  • If a urine test cannot be confirmed as negative (e.g. ambiguous result), a serum pregnancy test is required. In such cases, the participant must be excluded from participation if the serum pregnancy result is positive.
  • The Investigator is responsible for review of medical history, menstrual history, and recent sexual activity to decrease risk for inclusion of a female with an early undetected pregnancy.
  • Capable of giving signed informed consent
  • Participant must be willing and able to start standard-of-care ART as selected with the investigator on Study Day 10.
Exclusion Criteria
  • Participants with primary HIV infection. Any evidence of an active CDC Stage 3 disease, except cutaneous Kaposi's sarcoma not requiring systemic therapy during the study. Untreated syphilis infection [positive RPR at screen] without documentation of treatment. Ongoing malignancy other than cutaneous Kaposi's sarcoma, basal cell carcinoma, or resected, non-invasive cutaneous squamous cell carcinoma, or cervical, anal or penile intraepithelial neoplasia; or other localized malignancies
  • Any pre-existing physical or mental condition which, in the opinion of the Investigator, may interfere with the participant's ability to comply with the dosing schedule and/or protocol evaluations or which may compromise the safety of the participant.
  • Any history of significant underlying psychiatric disorder, or a clinical assessment of suicidality based on the responses on the eCSSRS.
  • Any history of major depressive disorder with or without suicidal features, or anxiety disorders, that required medical intervention (pharmacologic or not) such as hospitalization or other inpatient treatment and/or chronic (>6 months) outpatient treatment.
  • Current or chronic history of liver disease or known hepatic or biliary abnormalities (with the exception of Gilbert's syndrome or asymptomatic gallstones).
  • Medical history of cardiac arrhythmias or cardiac disease or a family or personal history of long QT syndrome or sudden cardiac death. Treatment with immunomodulating agents (such as systemic corticosteroids, interleukins, interferons) or any agent with known anti-HIV activity (such as hydroxyurea or foscarnet) within 30 days of study drug administration.
  • Past or intended use of over-the-counter or prescription medication including herbal medications within 7 days (or 14 days if the drug is a potential enzyme inducer) or 5 half-lives (whichever is longer) prior to dosing. Specific medications listed in Section 6.9.1 may be allowed.
  • Participants who require concomitant medications known to be associated with a prolonged QTc.
  • Participants receiving any protocol-prohibited medication(s) and who are unwilling or unable to switch to an alternate medication).
  • The participant has ever received an investigational HIV vaccine (immunotherapeutic or immunomodulatory).
  • Exposure to an experimental drug or experimental vaccine within either 30 days, 5 half-lives of the test agent, or twice the duration of the biological effect of the test agent, whichever is longer, prior to the first dose of study intervention.
  • Participation in the study would result in donation of blood in excess of 500 mL within 56 days.
  • Exposure to more than four new investigational drugs or vaccines within 12 months prior to the first dosing day.
  • Current enrollment or past participation within the last 30 days, 5 half-lives or twice the duration of the biological effect of the investigational product (whichever is longer) before signing of consent in any other clinical study involving an investigational study intervention or any other type of medical research.

Diagnostic Assessments

  • Presence of HBsAg or HBcAb at screening
  • Positive Hepatitis C antibody test result at Screening
  • Positive Hepatitis C RNA test result at Screening.
  • Creatinine clearance (eGFR) of < 60 mL/min/1.73 m2 using CKD-EPI equation (2021).

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PlaceboPlaceboParticipants will receive Placebo matching VH4524184.
VH4524184VH4524184Participants will receive VH4524184.
Primary Outcome Measures
NameTimeMethod
Maximum Change from Baseline in logarithm in 10 base (log10) Plasma HIV-1 Ribonucleic Acid (RNA) Through Day 10Baseline (Day 1) and up to Day 10

The antiviral activity of VH4524184 in treatment-naïve (TN) participants with HIV-1 during 10 days of monotherapy will be evaluated.

Secondary Outcome Measures
NameTimeMethod
Change from Baseline for Liver Panel Laboratory Parameters: Total bilirubin, Direct bilirubin (Micromoles per liter [umol/L])Baseline (Day 1) and up to Day 38
Time to Maximum Observed Plasma Drugs Concentration (tmax) of VH4524184Up to Day 10

Blood samples will be collected at indicated time points for PK analysis of VH4524184.

Number of Participants with AEs by severityUp to Day 38
Change from Baseline for Liver Panel Laboratory Parameters: Alanine Aminotransferase (ALT), Aspartate Aminotransferase (AST), Alkaline Phosphatase (ASP) (International units per liter)Baseline (Day 1) and up to Day 38
Number of Participants with Adverse Events (AEs)Up to Day 38

An AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of a study intervention, whether or not considered related to the study intervention. An AE can be any unfavourable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of a study intervention.

Number of Participants with AEs Leading to Study Treatment DiscontinuationUp to Day 38
Change from Baseline for Liver Panel Laboratory Parameters: Albumin and Total Protein (Grams per liter [g/L])Baseline (Day 1) and up to Day 38
Maximum Observed Plasma Drug Concentration (Cmax) of VH4524184Up to Day 10

Blood samples will be collected at indicated time points for Pharmacokinetic (PK) analysis of VH4524184.

Plasma Concentration of VH4524184 on Day 10Day 10

Blood samples will be collected at indicated time points for PK analysis of VH4524184.

Percentage of Participants with Maximum Toxicity Grade Increase Relative to Baseline in liver panel laboratory parameters: ALT, AST, total bilirubin, direct bilirubin, alkaline phosphatase, albumin and total proteinUp to Day 38
Number of Participants with Treatment-emergent Phenotypic ResistanceBaseline (Day 1), Day 10

Phenotypic data from baseline (Day 1) and Day 10 will be compared to identify amino acid substitutions and assess the fold change in the half maximal inhibitory concentration (IC50) for VH4524184.

Correlation of VH4524184 PK Parameters with Maximum Plasma HIV-1 RNA change from baseline through Day 10Baseline (Day 1) and up to Day 10

Any relationship between VH4524184 exposure and change in plasma HIV-1 RNA will be evaluated.

Change From Baseline in Cluster of Differentiation 4 (CD4+) T-cell Counts at Day 10Baseline (Day 1), Day 10

Immune response to VH452418 will be evaluated over 10 days in participants living with HIV. Blood samples will be collected for assessment of lymphocyte subsets (CD4+ lymphocyte count) by flow cytometry at Baseline and Day 10.

Number of Participants with Treatment-emergent Genotypic ResistanceBaseline (Day 1), Day 10

Genotypic data from baseline (Day 1) and Day 10 will be compared to identify amino acid substitutions and assess the fold change in the half maximal inhibitory concentration (IC50) for VH4524184.

Trial Locations

Locations (1)

GSK Investigational Site

🇪🇸

Valencia, Spain

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