Table 2.
HIV-antigen specific therapeutic vaccinations
| a) Non dendritic cell-based | |||||||
|---|---|---|---|---|---|---|---|
|
Name Trial |
Species |
Baseline patients characteristics |
Type of immune therapy |
Route and frequency of administration |
Number of patients |
Outcome |
References |
| Uncontrolled clinical trial |
Human |
Therapy naïve |
Remune® |
iv |
2527 |
Increased HIV-specific T cell responses. Positive impact on controlling the virus. |
[78] |
| P2101B (thai open label trial) |
Human |
Therapy naïve |
Remune® |
iv every 12 weeks for 132 weeks |
223 |
Increasing CD4 and CD8 T cell counts and stable viral load. |
[79] |
| Randomized double blind placebo controlled trial |
Human |
HAART |
ALVAC, ALVAC + Remune, placebo |
iv injections Alvac @w 8, 12, 16, 20. Remune@w 0, 4, 12, 20 |
79 |
Safe and immunogenic. No difference between the three groups after STI on viral rebound. |
[80] |
| Placebo controlled |
Indian rhesus macaque |
Chronic SIV HAART |
SIV mac239 gag and env DNA vaccine |
im 3 injections |
23 |
Increase in HIV specific cellular responses and lower viral rebound in vaccinated animals. |
[81] |
| |
Indian rhesus macaque |
Chronic SIV HAART |
SIV mac239 gag and env DNA vaccine + IL-15 |
In vivo electroporation |
3 |
Sustained polyfunctional T cells. One log decrease in VL. |
[82] |
| |
Human |
HAART |
DNA vaccine consisting of CTL epitopes |
im injections w 0, 4, 8, 16 |
41 |
Safe and tolerable. In some persons weak responses. Overall no differences with placebo group. |
[83] |
| VRC HIV DNA 009-00-VP double blind placebo controlled |
Human |
HAART |
plasmid DNA encoding subtype B Gag-Pol-Nef and multiclade env |
im injections w 0, 4, 8, 24 |
20 |
Poorly immunogenic. No effect on viral rebound after ATI. |
[84] |
| |
Human |
HAART |
Plasmid DNA multiclade |
Patch |
12 |
Broader and higher HIV specific T-cell responses. No effect on viral rebound after ATI. |
[85] |
| ANRS 094 single arm open |
Human |
|
ALVAC vCP1433 |
im injections w 0, 4, 8, 12 |
50 |
Safe and immunogenic. Delay in treatment resumption of ATI. |
[86] |
| ANRS 093 |
human |
HAART |
ALVAC + lipo 6T 4 injections followed by 3 cycles sc IL2 |
im injections of ALVAC w 0, 4, 8, 12. IL-2@w 16, 24, 32 |
71 |
Lower viral set point after ATI, correlated with HIV specific CD4 T cell responses. |
[87] |
| ACTG (A5024) randomized partially blinded phase II |
Human |
HAART |
ALVAC ALVAC + sc IL2 sc IL2 alone placebo |
im injections of ALVAC w 0, 4, 8, 12. IL-2 sc for5 days in 8 week cycles |
19 |
Lower viral rebound after ATI in ALVAC vaccines. IL-2 + vaccine boosted CD4 T cell count but had no influence on VL. |
[88] |
| Double blind placebo controlled |
Human |
HAART (acute phase) |
ALVAC ALVAC + Remune |
iv injection of ALVAC w8, 12, 16, 20. remune w 0, 4, 12, 20 |
79 |
No influence on VL after ATI. Increased CD4 and CD8 T cell responses |
[80] |
| CTN173 randomized controlled |
Human |
HAART |
ALVAC, ALVAC + remune, placebo |
im injections of ALVAC w8, 12, 16, 20. Remune w0, 12, 20. ATI w24 |
52 |
No lower viral setpoint. Tendency towards delay of rebound |
[89] |
| ORVACS |
Human |
HAART |
ALVAC vcp1420 placebo |
im injections w 0, 4, 8, 20 |
65 |
Higher viral rebound in vaccines |
[90] |
| |
Human |
HAART |
Fowlpox gag/pol (PC) |
3 im injections (w 0,4, 12). ATI w20 |
35 |
Lower man viral rebound in FC group and this is associated with IgG2 antibodies to HIVp24 |
[91][92] |
| Fowlpox gag/pol IFN-y (FC | |||||||
| placebo | |||||||
| |
Indian rhesus macaque |
Chronic SIV HAART |
MVA gag pol and MVA env |
im injections w10, 16. STI w20 |
18 |
Tendency lower viral rebound after ATI but not significant. |
[93] |
| |
Rhesus macaque |
Chronic SIV HAART |
MVA + Ad5 gag and env |
im injection of Ad5/35 on day 74 and MVA-SIV on day 134 |
|
Vaccinated animals had higher CD4 T cell counts, SIV-specific cell-mediated immunity and anti-SIV-neutralizing antibodies. After ATI there was a sustained reduction in VL and increased CD4 T cell responses. |
[94] |
| |
Human |
HAART |
MVA nef |
sc injections w 0, 4, 16. ATI w 18 |
14 |
Well tolerated. Induction HIV specific responses. Lower viral rebound. |
[95] |
| |
Human |
HAART |
MVA clade A p24/17 + CD8 T cell epitopes |
id 4 week interval |
18 |
Amplification and broadening of CD8 and CD4 T cell responses. Induction of CD8 T cell responses with capacity to inhibit viral replication in vitro |
[96][97] |
| |
Indian rhesus macaque |
Chronic SIV HAART |
Ad5 and Ad35 SIV gag, env, nef + IL15 |
im injections |
15 |
Increased T cell responses no effect on viral rebound. |
[98] |
| w 16, 22, 36, 42 | |||||||
| |
Human |
HAART |
rAd5 gag |
im injections |
114 |
Safe and well tolerated. 0.5 log lower VL 16 weeks after A-STI |
[99] |
| w 0, 4, 26. | |||||||
| ATI w 38 to 54 | |||||||
|
b) Dendritic cell-based | |||||||
|
Species |
Number and baseline characteristics |
Loading strategy |
Antigen |
Results |
References |
||
| Human |
6 therapy- naïeve |
Pulsing |
Recombinant HIV-1 MN gp160 or synthetic peptides corresponding to HLA-A2- restricted cytotoxic epitopes of envelope, Gag, and Pol proteins |
Well tolerated and no effect on viral load. HIV specific responses were enhanced. |
[100] |
||
| Human |
4 HAART |
Pulsing |
Seven CTL peptides with HLA-A*2402 restriction |
Well tolerated, discontinuation of HAART after vaccination failed to lower viral set points. CD8 T cell responses induced in 2 out of 4 patients. |
[101] |
||
| Pigtail macaque |
36 HAART |
Pulsing of whole blood |
Gag proteins or peptides spanning all 9 SIV proteins |
SIV-specific CD4 and CD8T cell responses during antiretroviral cover and off treatment. Virus levels were 10-fold lower in immunized animals for 1 year. |
[102] |
||
| Chinese rhesus macaques |
HAART |
Pulsing |
AT-2 inactivated virus |
Effective and durable SIV-specific cellular and humoral immunity is elicited. At week 34 of the study: 50-fold decrease of SIV DNA and a 1,000-fold decrease of SIV RNA. |
[103] |
||
| Human |
18 therapy naieve |
Pulsing |
AT-2-inactivated virus |
Plasma viral load levels were decreased by 80% (median) over the first 112 days following immunization. The suppression of viral load was positively correlated with HIV-1-specific interleukin-2 or IFN-γ expressing CD4 T cells and with HIV-1 gag-specific perforin-expressing CD8 effector cells. |
[104] |
||
| Human |
12 HAART |
Pulsing |
Heat-inactivated virus |
Safe and well tolerated. Partial viral control 24 weeks after ATI . |
[105] |
||
| Human |
24 therapy- naïeve |
Pulsing |
Heat-inactivated virus |
Feasible, safe and well tolerated. Modest decrease in viral load 24 weeks after first vaccination compared to controls. |
[106] |
||
| Human |
29 HAART |
Live virus |
ALVACvcp1452 |
Viral load rebounded in both groups no differences in HIV-specific immune responses. |
[107] |
||
| |
|
|
ALVACvcp1452 + KLH |
|
|
|
|
| |
|
|
KLH |
|
|
|
|
| Human |
9 HAART |
Electroporation |
Autologous mRNA encoding Gag, Vpr, Rev and Nef |
Mild adverse events. Full or partial HIV-specific immune responses in 7/9 subjects. |
[108] |
||
| Human |
9 HAART |
Electroporation |
Autologous mRNA encoding Gag, Vpr, Rev and Nef |
Partial viral control . |
[109] |
||
| Human |
17 HAART |
Electroporation |
mRNA encoding tat rev nef |
Vaccine was safe, 69 weeks after STI 6/17 patients remains off therapy. |
[110] |
||
| Human | 6 HAART | Electroporation | mRNA encoding gag and mRNA encoding tat rev nef | Vaccine was safe. HIV-specific responses against Gag were broader, higher and polyfunctional after vaccination. CD8 T-cells could inhibit superinfection of CD4 T-cells. | [111] | ||