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      • SCISCIESCOPUS

        First-in-Human Evaluation of the Safety and Immunogenicity of an Intranasally Administered Replication-Competent Sendai Virus–Vectored HIV Type 1 Gag Vaccine: Induction of Potent T-Cell or Antibody Responses in Prime-Boost Regimens

        Nyombayire, Julien,Anzala, Omu,Gazzard, Brian,Karita, Etienne,Bergin, Philip,Hayes, Peter,Kopycinski, Jakub,Omosa-Manyonyi, Gloria,Jackson, Akil,Bizimana, Jean,Farah, Bashir,Sayeed, Eddy,Parks, Christ Oxford University Press 2017 The Journal of Infectious Diseases Vol. No.

        <P><B><I>Background.</I></B> We report the first-in-human safety and immunogenicity assessment of a prototype intranasally administered, replication-competent Sendai virus (SeV)–vectored, human immunodeficiency virus type 1 (HIV-1) vaccine.</P><P><B><I>Methods.</I></B> Sixty-five HIV-1–uninfected adults in Kenya, Rwanda, and the United Kingdom were assigned to receive 1 of 4 prime-boost regimens (administered at 0 and 4 months, respectively; ratio of vaccine to placebo recipients, 12:4): priming with a lower-dose SeV-Gag given intranasally, followed by boosting with an adenovirus 35–vectored vaccine encoding HIV-1 Gag, reverse transcriptase, integrase, and Nef (Ad35-GRIN) given intramuscularly (S<SUB>L</SUB>A); priming with a higher-dose SeV-Gag given intranasally, followed by boosting with Ad35-GRIN given intramuscularly (S<SUB>H</SUB>A); priming with Ad35-GRIN given intramuscularly, followed by boosting with a higher-dose SeV-Gag given intranasally (AS<SUB>H</SUB>); and priming and boosting with a higher-dose SeV-Gag given intranasally (S<SUB>H</SUB>S<SUB>H</SUB>).</P><P><B><I>Results.</I></B> All vaccine regimens were well tolerated. Gag-specific IFN-γ enzyme-linked immunospot–determined response rates and geometric mean responses were higher (96% and 248 spot-forming units, respectively) in groups primed with SeV-Gag and boosted with Ad35-GRIN (S<SUB>L</SUB>A and S<SUB>H</SUB>A) than those after a single dose of Ad35-GRIN (56% and 54 spot-forming units, respectively) or SeV-Gag (55% and 59 spot-forming units, respectively); responses persisted for ≥8 months after completion of the prime-boost regimen. Functional CD8<SUP>+</SUP> T-cell responses with greater breadth, magnitude, and frequency in a viral inhibition assay were also seen in the S<SUB>L</SUB>A and S<SUB>H</SUB>A groups after Ad35-GRIN boost, compared with those who received either vaccine alone. SeV-Gag did not boost T-cell counts in the AS<SUB>H</SUB> group. In contrast, the highest Gag-specific antibody titers were seen in the AS<SUB>H</SUB> group. Mucosal antibody responses were sporadic.</P><P><B><I>Conclusions.</I></B> SeV-Gag primed functional, durable HIV-specific T-cell responses and boosted antibody responses. The prime-boost sequence appears to determine which arm of the immune response is stimulated.</P><P><B><I>Clinical Trials Registration.</I></B> NCT01705990.</P>

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