Phase 2 Trial of LACTIN-V in Women at High Risk of HIV Acquisition

  • STATUS
    Recruiting
  • End date
    Mar 31, 2023
  • participants needed
    60
  • sponsor
    Osel, Inc.
Updated on 3 September 2021
metronidazole
HIV Vaccine
vaginal product

Summary

The purpose of this study is to assess the impact of LACTIN-V, a vaginally administered live biotherapeutic product (LBP) that contains the human L. crispatus CTV-05 strain, on the vaginal microbiome of Lactobacillus-deficient young women in the South African FRESH study who are at high risk for HIV acquisition.

Description

We will conduct a randomized, placebo-controlled trial of the vaginal live biotherapeutic product LACTIN-V in 60 young South African women.

After being informed about the study and potential risks, all participants giving written informed consent will be enrolled if they meet eligibility criteria. At enrollment on Day 1, they will start a 7-day course of standard oral metronidazole treatment for bacterial vaginosis. Women who completed their metronidazole treatment will be randomized 2:1 to LACTIN-V vs. placebo. Within 8-48 hours of the final metronidazole dose, women will receive the study product for five consecutive days, followed by twice weekly for three additional weeks. Women will be followed during the dosing (4 weeks) and post-dosing phase (4 weeks) for a total of 64 days.

Details
Condition Immunodeficiency, hiv disease, Vaginitis, Primary Immunodeficiency Disorders, HIV infection, Bacterial Vaginosis, HIV Infections, human immunodeficiency virus, Bacterial Infection, Bacterial Infections
Treatment Placebo, LACTIN-V
Clinical Study IdentifierNCT05022212
SponsorOsel, Inc.
Last Modified on3 September 2021

Eligibility

Yes No Not Sure

Inclusion Criteria

FRESH study participant
Capable of reading and writing English or isiZulu and voluntarily provide written informed consent to participate in the study and comply with all study procedures
HIV-negative
Nugent score 4-10 on vaginal Gram stain
Otherwise healthy women, 18-23 years of age on the day of enrolment
Regular predictable menstrual cycles or amenorrhoeic for at least 3 months due to use of a long-acting progestin
Willing to complete 7-day course of oral metronidazole
Willing to be asked questions about personal medical health and sexual history
Willing to apply study agent vaginally and comply with study examinations
Willing to self-administer Study Product on dosing days that do not coincide with regular FRESH study visits
Agree to try to abstain from sexual intercourse 12 hours prior to study visits that include a gynaecological exam (Randomization Visit 3, Follow-up Visit 11, Final Visit 19)
Agree to try to abstain from sexual intercourse for 12 hours after study product administration to ensure that the product will remain inside the vagina
Agree to abstain from the use of any other vaginal product throughout the trial period from the time of enrolment through the end of the study
Note: Intravaginal products include contraceptive creams such as Gynol II
gels, foams, sponges, lubricants not approved by the study investigators
tampons and douches
\. Must be stable on a reliable method of long-acting birth control and
agree to remain on, for the duration of the study (if of childbearing
potential) or, of non-childbearing potential (permanently sterile)

Exclusion Criteria

Urogenital infection (as tested during the FRESH Week 5 Study Visit, reported within 30 days of detection at the LACTIN-V Enrolment Visit)
Note: Urogenital infection includes urinary tract infection, Trichomonas (T.)
vaginalis, Neisseria (N.) gonorrhoeae, Chlamydia (C.) trachomatis, Mycoplasma
genitalium
\. Diagnosis of two or more outbreaks of N. gonorrhoeae, C. trachomatis, T
vaginalis, Mycoplasma genitalium, or herpes simplex virus (herpes genitalis)
within 6 months prior to enrolment
\. Subject is ineligible if menstrual cycle length is less than 21 days
\. Subject is ineligible if deep epithelial disruption is observed on genital
examination noted on or before the Randomization Visit
\. Positive for HIV (as tested during the FRESH Week 5 Study Visit, within 30
days of the LACTIN-V Enrolment Visit)
\. Current pregnancy or within 2 months of last pregnancy
\. Vaginal or systemic antibiotic or antifungal therapy within 21 days of
enrolment
\. Use of disulfiram within past 2 weeks or other contraindication to use of
metronidazole
\. Any condition requiring regular periodic use of systemic antibiotics
during participation in the trial
\. Investigational drug use other than LACTIN-V within 30 days or 10 half-
lives of the drug, whichever is longer, of Enrolment Visit
\. Other planned participation in an investigational drug study while
participating in this study
\. Intrauterine device (IUD) insertion or removal, pelvic surgery, cervical
cryotherapy or cervical laser treatment within the last 2 months prior to
enrolment
\. Use of vaginal ring (e.g, NuvaRing) within 3 days of enrolment or during
the course of the study
\. Hysterectomy
\. Unwilling to complete 7 days of oral metronidazole (twice daily) with the
last dose taken no later than 48 hours prior to randomization (minimum of 12
of 14 doses required)
\. Use of new long-acting hormonal treatments. Participant may be enrolled
if stable (>1 month) on existing therapy as determined by the principal
investigator (PI)
\. Known allergy to any component of LACTIN-V/placebo or metronidazole or to
nitroimidazole derivatives or latex (condoms)
\. Any social, medical, or psychiatric condition including history of drug
or alcohol abuse that in the opinion of the investigator would make it
difficult for the participant to comply with study procedures
\. Any serious or chronic illness, deemed incompatible with study
participation by the study doctor, including immunosuppression due to cancer
chemotherapy, systemic corticosteroids
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