A Multi-site, Open-label Non-inferiority Trial to Assess Immunogenicity of Two Doses of the Nonavalent Human Papillomavirus (HPV) Vaccine Among Children, Adolescents and Young Adults (9-26 Years) Living With HIV vs Three Doses of Nonavalent HPV Vaccine Among HIV Uninfected Young Women (15-26 Years) in Eswatini
试验速览
- 阶段
- 4 期
- 状态
- 已完成
- 入组人数
- 1,403
- 试验地点
- 5
- 主要终点
- Number of seroconversions
研究概览
简要总结
This is a multi-site, open-label non-inferiority study of the 9vHPV vaccine among a population of children, adolescents and young women living with HIV in Eswatini. This protocol seeks to assess immunogenicity of a two-dose 9vHPV vaccine regimen among girls and boys (9-14 years) and young women (15-26 years) living with HIV on antiretroviral therapy versus a three-dose 9vHPV vaccine regimen among HIV uninfected young women (15-26 years) in Eswatini. The secondary objectives include examining the safety profiles of the two-dose 9vHPV regimen in those living with HIV and the three-dose 9vHPV regimen in HIV-uninfected young women, as well as measuring the completion of the vaccination series among those living with HIV and those who are not infected with HIV.
详细描述
Cervical cancer remains a significant threat to public health worldwide and remains the leading cause of cancer-associated mortality in women in Sub Saharan Africa. Cervical cancer-associated morbidity and mortality is preventable through HPV vaccination, and screening and treatment of pre-cancerous lesions. To date, there is no nationwide HPV vaccination program in Eswatini and the country is not eligible for Global Alliance for Vaccines and Immunization (GAVI) procurement of HPV vaccines, and yet the triad of HIV, sexually transmitted infections (STI) and cervical cancer generates a severe disease burden warranting immediate introduction of this intervention. Given the global limitations in vaccine supply and the high cost for procurement, country programs, including in Eswatini, must optimize vaccine resources in order to maximize HPV vaccine coverage.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Parallel
- 主要目的
- Prevention
- 盲法
- None
入排标准
- 年龄范围
- 9 Years 至 26 Years（Child, Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •For people living with HIV receiving two-dose regimen:
- •Females 9-26 years and males 9-14 years,
- •Documented HIV infection,
- •Aware of HIV+ status,
- •Currently receiving antiretroviral treatment (ART) for HIV infection for at least six months,
- •Living in Eswatini,
- •For individuals 18+ years: able to provide informed consent,
- •For individuals 15-17 years: able to provide informed assent,
- •For individuals 9-14 years of age: able to provide informed assent AND accompanied by an adult caregiver who is able to give informed consent,
- •Intending to remain in the vicinity of the study sites for the study period
- •For reference group of HIV-uninfected women receiving three-dose regimen:
- •Females 15-26 years,
- •Documented negative HIV test at baseline
- •Living in Eswatini,
- •Able to provide informed assent (15-17 years) or informed consent (18-26 years)
- •Intending to remain in the vicinity of the study sites for the study period
排除标准
- •For all participants:
- •Diagnosis of other immunosuppressive diseases or receipt of immunosuppressive medications,
- •Diagnosis of other acute or chronic illness,
- •Receipt of other vaccinations within 2-3 weeks before or after study vaccination,
- •Receipt of blood-derived products within 6 months before or during the study,
- •Previous receipt of an HPV vaccine,
- •Currently pregnant,
- •Known allergies to a vaccine component
研究组 & 干预措施
2-dose regimen group
Boys and girls (aged 9-14 years) and young women (aged 15-26 years) living with HIV will receive a two-dose regimen of the HPV vaccine at baseline (Month 0) and Month 6.
干预措施: Gardasil ® 9 (Biological)
3-dose regimen group (SOC)
HIV-uninfected young women (aged 15-26 years) will receive the standard of care three-dose regimen of the HPV vaccine at baseline (Month 0), Month 2 and Month 6.
干预措施: Gardasil ® 9 (Biological)
结局指标
主要结局
Number of seroconversions
时间窗: Month 7 (4 weeks post Month 6 vaccine dose)
Number of participants who seroconvert, defined as having no HPV antibodies pre-vaccination, but detectable HPV antibodies at 4 weeks post month 6 vaccine dose
Anti-HPV geometric mean antibody titers
时间窗: Month 7 (4 weeks post Month 6 vaccine dose)
Serum antibodies against HPV antigens (IgG, IFNg, TNF, IL2, CXCL10, granzyme, perforin, PTX3). Geometric mean titers will be summarized by treatment group, and the ratios of mean GMTs between treatment and control and their 95% confidence intervals calculated around point estimates.
次要结局
- Number of participants with serious adverse events (SAE)(Up to 6 months)
- Number of participants completing vaccination series(Up to 6 months)
研究者
Elaine J. Abrams, MD
Professor of Pediatrics and Epidemiology
Columbia University