HIV-1-infected patients who have been treated with anti-HIV drugs for a long time may have
weakened immune responses to HIV. The DNA-based vaccine in this study is designed to boost
the immune system's responses against many HIV-1 proteins. The main purposes of this study
are to test the safety of this HIV vaccine (EP HIV-1090) and to test whether the vaccine can
stimulate immune system responses in people who have HIV-1 infection.
Significant data support the hypothesis that HIV-specific cytotoxic T lymphocyte (CTL)
responses contribute to the control and potential clearance of the virus. Vaccines designed
specifically to induce CTL responses are likely to be well suited for treatment of HIV
infection. The conceptual basis of the EP HIV-1090 vaccine is the use of highly defined CTL
epitopes as the vaccine immunogen. The vaccine is formulated with a water-soluble polymer
that stabilizes and protects the DNA and facilitates uptake by cells. Preclinical studies
have shown that the vaccine induces strong CTL responses in animal models. This study will
evaluate the safety and tolerability of the vaccine and the immune response to the vaccine
in HIV-1-infected individuals who are being treated with highly active antiretroviral
therapy (HAART) and have a CD4 count of 350 cells/mm3 or more and fully suppressed viral
replication on stable HAART.
Each patient will receive a total of four immunizations to be given at Day 0 and at Weeks 4,
8, and 16. Participants will be randomly assigned to receive either vaccine or placebo. Ten
patients will be assigned to each dose group; eight will receive active vaccine and two will
receive placebo. The injections will be delivered intramuscularly into the deltoid muscle.
In addition to undergoing standard safety exams, patients will have blood drawn for use in
evaluating the immunogenicity of the vaccine. The treatment duration will be 16 weeks and
patient will be followed for safety and immune responses for an additional 24 weeks after
they complete vaccination; the total study is estimated to take 18 months.
- Documented HIV-1 infection
- Taking HAART for 6 months or longer and on stable HAART for at least 4 weeks
- Plasma HIV-1 viral load of less than 400 copies/ml for at least 6 months prior to
- CD4 count of 350 cells/mm3 or more within 30 days of entry
- Immunomodulatory agents
- Prior receipt of experimental HIV vaccines in the 5 years prior to study entry
- Hepatitis B surface antigen or hepatitis C virus antibody positive