MedPath

Safety of and Immune Response to an H1N1 Influenza Virus Vaccine in HIV Infected Children and Youth

Phase 2
Completed
Conditions
HIV Infections
H1N1 Influenza Virus
Interventions
Biological: Influenza A (H1N1) 2009 monovalent vaccine
Registration Number
NCT00992836
Lead Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)
Brief Summary

Children and people infected with HIV are particularly susceptible to influenza infections. This study testED the safety and effectiveness of a vaccine for the new H1N1 influenza virus in children and youth infected with HIV.

Detailed Description

The new H1N1 influenza virus seen in 2009 has been designated a pandemic by the World Health Organization, due to the sustained community outbreaks seen in the United States and Mexico. Based on preliminary data, it appears children and young adults were particularly at risk of the H1N1 virus. People infected with HIV were also more susceptible to severe influenza infections than those who are uninfected. Children with HIV infection, then, have a compounded risk of H1N1 infection. Higher doses of influenza vaccines are associated with the development of higher levels of serum antibodies, which are needed to resist infection. Higher vaccine doses can be used to improve vaccine effectiveness in at-risk populations. This study tested the safety and immune response of HIV infected children and youth to a high dose of a vaccine for the new H1N1 influenza virus.

Participation in this study lasted 7 months and had two steps. The first step involved receiving the first dose of H1N1 virus vaccine, and the second step, occurring 21 days later, involved receiving the second dose of vaccine. Each dose of vaccine was delivered via two intramuscular shots (four total injections). After receiving each dose of the vaccine, participants were given a diary to record any symptoms or reactions. Participants were stratified into three groups by age, including 4 to 9 years, 9 to 18 years, and 18 to 25 years.

Participants completed five scheduled visits, taking place at screening, study entry, Days 21 and 31, and after 7 months. Measurements taken on these visits included a medical history, physical and neurological exams, a blood draw, and, when applicable, a pregnancy test. In addition to these visits, participants received up to three additional phone calls or visits occurring 2 and 10 days after the first dose of vaccine and 2 days after the second dose of vaccine to check for reactions to the vaccine.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
155
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Influenza A (H1N1) 2009 monovalent vaccineInfluenza A (H1N1) 2009 monovalent vaccineAll participants received two doses of the H1N1 influenza virus vaccine, administered 21 days apart.
Primary Outcome Measures
NameTimeMethod
The Number of Participants Who Had at Least One Adverse Event (AE)Measured up to 7 months after vaccination

Shows the number of participants who had at least one adverse event (AE) in each category. The AEs include: abnormal laboratory values, signs and symptoms, or diagnoses; solicited local AEs; and solicited systemic AEs.

Adverse Events were graded using the DAIDS Grading Severity of AEs (see Link under More Information), as follows: grade 1=mild, 2=moderate, 3=severe, 4=life threatening/disabling, 5=death.

Percent of Participants With a Hemagglutinin Inhibition (HAI) Titer of >=40Measured at 21 days after first dose and 10 days after second dose

Antibodies to Influenza A (H1N1) 2009 were measured using an HAI assay. The potential titer read-outs from the assay used were \<10 (considered undetectable), 10, 20, 40, 60, 80, 160, 320, 640 and \>=1280. Seroprotection was defined as having a titer of \>=40 following vaccination.

The Number of Participants Who Had at Least One AE Attributed to the Study VaccineMeasured up to 7 months after vaccination

Shows the number of participants who experienced any events that were thought to be at least possibly related to study treatment. Adverse Events were graded using the DAIDS Grading Severity of AEs (see Link under More Information), as follows: grade 1=mild, 2=moderate, 3=severe, 4=life threatening/disabling, 5=death.

Withholding of Second Vaccine Dose Due to Adverse Reactions Attributed to First DoseMeasured at Day 21
Secondary Outcome Measures
NameTimeMethod
Cell-mediated Immune Responses, Measured by B-cell and T-cell Enzyme-linked Immunosorbent Spot (ELISPOT) Assay ValuesMeasured at entry, 21 days after first dose, and 10 days after second dose

The median and interquartile range (IQR) of B-Cell ELISPOT-measured IgG antibody-secreting cells (ASC)/10\^6 peripheral blood mononucleated cell (PBMC) and the median and interquartile range (IQR) of T-Cell ELISPOT-measured pH1N1 IFNgamma spot-forming cells (SFC)/10\^6 PBMC.

HAI Titers Against Seasonal Influenza Viruses Containing Trivalent Influenza Vaccine (TIV)Measured at entry, 21 days after first dose, and 10 days and 6 months after second dose

Presents the value of the median titer as well as the interquartile range at study entry. Antibodies to seasonal Influenza vaccine were measured using an HAI assay. The potential titer read-outs from the assay used were \<10 (considered undetectable), 10, 20, 40, 60, 80, 160, 320, 640, and \>=1280.

Percent of Participants With an HAI Titer >=40 at Long-term Follow-upMeasured at 6 months after second dose
Geometric Mean Antibody Titers (GMT) HAIMeasured after first and second doses and 6 months after second dose

Presents the value of the geometric mean titer at each time point.

Cell-mediated Immune Responses to Influenza Viruses Contained in TIV and Other AntigensMeasured at entry, 21 days after first dose, and 10 days after second dose

The TIV assay was not performed due to lack of available cells after completion of other planned assays.

The median and interquartile range (IQR) of T-Cell ELISPOT-measured pH1N1 Granzyme B spot-forming cells (SFC)/10\^6 peripheral blood mononucleated cell (PBMC).

The median and interquartile range (IQR) of T-Cell ELISPOT-measured PHA INFgamma spot-forming cells (SFC)/10\^6 PBMC.

The median and interquartile range (IQR) of T-Cell ELISPOT-measured PHA Granzyme B spot-forming cells (SFC)/10\^6 PBMC.

Trial Locations

Locations (37)

Rush Univ. Cook County Hosp. Chicago NICHD CRS

🇺🇸

Chicago, Illinois, United States

Ann & Robert H. Lurie Children's Hospital of Chicago (LCH) CRS

🇺🇸

Chicago, Illinois, United States

Rutgers - New Jersey Medical School CRS

🇺🇸

Newark, New Jersey, United States

The Children's Hosp. of Philadelphia IMPAACT CRS

🇺🇸

Philadelphia, Pennsylvania, United States

Children's Hosp. of Boston NICHD CRS

🇺🇸

Boston, Massachusetts, United States

Boston Medical Center Ped. HIV Program NICHD CRS

🇺🇸

Boston, Massachusetts, United States

Seattle Children's Research Institute CRS

🇺🇸

Seattle, Washington, United States

Pediatric Perinatal HIV Clinical Trials Unit CRS

🇺🇸

Miami, Florida, United States

Texas Children's Hospital CRS

🇺🇸

Houston, Texas, United States

Univ. of California San Francisco NICHD CRS

🇺🇸

San Francisco, California, United States

UAB Pediatric Infectious Diseases CRS

🇺🇸

Birmingham, Alabama, United States

Usc La Nichd Crs

🇺🇸

Alhambra, California, United States

University of California, UC San Diego CRS

🇺🇸

La Jolla, California, United States

Miller Children's Hosp. Long Beach CA NICHD CRS

🇺🇸

Long Beach, California, United States

UCLA-Los Angeles/Brazil AIDS Consortium (LABAC) CRS

🇺🇸

Los Angeles, California, United States

Univ. of Colorado Denver NICHD CRS

🇺🇸

Aurora, Colorado, United States

Harbor UCLA Medical Ctr. NICHD CRS

🇺🇸

Torrance, California, United States

Children's National Med. Ctr. Washington DC NICHD CRS

🇺🇸

Washington, District of Columbia, United States

Howard Univ. Washington DC NICHD CRS

🇺🇸

Washington, District of Columbia, United States

USF - Tampa NICHD CRS

🇺🇸

Tampa, Florida, United States

Univ. of Florida Jacksonville NICHD CRS

🇺🇸

Jacksonville, Florida, United States

Univ. of Maryland Baltimore NICHD CRS

🇺🇸

Baltimore, Maryland, United States

Johns Hopkins Univ. Baltimore NICHD CRS

🇺🇸

Baltimore, Maryland, United States

WNE Maternal Pediatric Adolescent AIDS CRS

🇺🇸

Worcester, Massachusetts, United States

Bronx-Lebanon CRS

🇺🇸

Bronx, New York, United States

Children's Hospital of Michigan NICHD CRS

🇺🇸

Detroit, Michigan, United States

Jacobi Med. Ctr. Bronx NICHD CRS

🇺🇸

Bronx, New York, United States

Nyu Ny Nichd Crs

🇺🇸

New York, New York, United States

Metropolitan Hosp. NICHD CRS

🇺🇸

New York, New York, United States

SUNY Stony Brook NICHD CRS

🇺🇸

Stony Brook, New York, United States

Strong Memorial Hospital Rochester NY NICHD CRS

🇺🇸

Rochester, New York, United States

St. Jude Children's Research Hospital CRS

🇺🇸

Memphis, Tennessee, United States

Columbia IMPAACT CRS

🇺🇸

New York, New York, United States

DUMC Ped. CRS

🇺🇸

Durham, North Carolina, United States

University of Puerto Rico Pediatric HIV/AIDS Research Program CRS

🇵🇷

San Juan, Puerto Rico

South Florida CDTC Ft Lauderdale NICHD CRS

🇺🇸

Fort Lauderdale, Florida, United States

San Juan City Hosp. PR NICHD CRS

🇵🇷

San Juan, Puerto Rico

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