[HTML][HTML] Vaccine efficacy of ALVAC-HIV and bivalent subtype C gp120–MF59 in adults
GE Gray, LG Bekker, F Laher… - … England Journal of …, 2021 - Mass Medical Soc
New England Journal of Medicine, 2021•Mass Medical Soc
Background A safe, effective vaccine is essential to eradicating human immunodeficiency
virus (HIV) infection. A canarypox–protein HIV vaccine regimen (ALVAC-HIV plus AIDSVAX
B/E) showed modest efficacy in reducing infection in Thailand. An analogous regimen using
HIV-1 subtype C virus showed potent humoral and cellular responses in a phase 1–2a trial
in South Africa. Efficacy data and additional safety data were needed for this regimen in a
larger population in South Africa. Methods In this phase 2b–3 trial, we randomly assigned …
virus (HIV) infection. A canarypox–protein HIV vaccine regimen (ALVAC-HIV plus AIDSVAX
B/E) showed modest efficacy in reducing infection in Thailand. An analogous regimen using
HIV-1 subtype C virus showed potent humoral and cellular responses in a phase 1–2a trial
in South Africa. Efficacy data and additional safety data were needed for this regimen in a
larger population in South Africa. Methods In this phase 2b–3 trial, we randomly assigned …
Background
A safe, effective vaccine is essential to eradicating human immunodeficiency virus (HIV) infection. A canarypox–protein HIV vaccine regimen (ALVAC-HIV plus AIDSVAX B/E) showed modest efficacy in reducing infection in Thailand. An analogous regimen using HIV-1 subtype C virus showed potent humoral and cellular responses in a phase 1–2a trial in South Africa. Efficacy data and additional safety data were needed for this regimen in a larger population in South Africa.
Methods
In this phase 2b–3 trial, we randomly assigned 5404 adults without HIV-1 infection to receive the vaccine (2704 participants) or placebo (2700 participants). The vaccine regimen consisted of injections of ALVAC-HIV at months 0 and 1, followed by four booster injections of ALVAC-HIV plus bivalent subtype C gp120–MF59 adjuvant at months 3, 6, 12, and 18. The primary efficacy outcome was the occurrence of HIV-1 infection from randomization to 24 months.
Results
In January 2020, prespecified criteria for nonefficacy were met at an interim analysis; further vaccinations were subsequently halted. The median age of the trial participants was 24 years; 70% of the participants were women. The incidence of adverse events was similar in the vaccine and placebo groups. During the 24-month follow-up, HIV-1 infection was diagnosed in 138 participants in the vaccine group and in 133 in the placebo group (hazard ratio, 1.02; 95% confidence interval, 0.81 to 1.30; P=0.84).
Conclusions
The ALVAC–gp120 regimen did not prevent HIV-1 infection among participants in South Africa despite previous evidence of immunogenicity. (HVTN 702 ClinicalTrials.gov number, NCT02968849.)
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