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Neutralizing Antibodies to HIV-1 in Seronegative Volunteers Immunized With Recombinant gp 120 From the MN Strain of HIV-1
Robert B. Belshe, MD;
Barney S. Graham, MD, PhD;
Michael C. Keefer, MD;
Geoffrey J. Gorse, MD;
Peter Wright, MD;
Raphael Dolin, MD;
Thomas Matthews, PhD;
Kent Weinhold, PhD;
Dani P. Bolognesi, PhD;
Richard Sposto, PhD;
Donald M. Stablein, PhD;
Tom Twaddell, MD;
Phillip W. Berman, PhD;
Tim Gregory, PhD;
Allen E. Izu, MS;
Mary Clare Walker, PhD;
Patricia Fast, MD, PhD;
the NIAID AIDS Vaccine Clinical Trials Network
JAMA. 1994;272(6):475-480.
Abstract
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Objective.
—To evaluate the safety and immunogenicity of the MN strain of recombinant gp 120 (MN rgp 120) as a vaccine prototype to prevent human immunodeficiency virus (HIV).
Design.
—Double-blind, randomized, placebo-controlled study with subjects vaccinated at 0, 4, 24, and 48 weeks and followed up through 64 weeks.
Setting.
—The AIDS Vaccine Evaluation Units in St Louis, Mo, Nashville, Tenn, and Rochester, NY, conducted the clinical study. Laboratory studies were conducted at Duke University, Raleigh, NC; data analysis was done by the Data Coordinating and Analysis Center at the EMMES Corporation, Potomac, Md.
Participants.
—Fifty-seven persons seronegative for HIV, at low risk for acquiring HIV infection, and 18 to 60 years of age.
Interventions.
—The MN rgp 120 vaccine was administered to 12 volunteers each in doses of 100 µg, 300 µg, or 600 µg, and 12 volunteers received a combination of 300 µg of MN rgp 120 vaccine and 300 µg of vaccine from rgp 120 of strain IIIB. Nine volunteers received alum adjuvant alone (control).
Main Outcome Measures.
—Safety was assessed by monitoring lymphocyte subsets, serum creatinine, and liver enzymes. Immunogenicity was measured by enzyme-linked immunosorbent assay using the immunogen and synthetic peptide corresponding to the variable region 3 domain of gp 120. Functional antibody assays included CD4 binding blocking; antibody-dependent, cell-mediated cytotoxicity; and neutralization of homologous and heterologous HIV strains.
Results.
—No severe adverse reactions occurred. In 33 of 48 volunteers, tw doses of vaccine induced antibodies that neutralized the homologous strain HIV-1/MN. Three doses of vaccine induced antibodies that neutralized MN (in 46 of 48 volunteers), SF-2 (in 45 of 48 volunteers), or IIIB strains of HIV-1 (in 30 of 48 volunteers).
Conclusion.
—The vaccines were safe and immunogenic. Multiple injections of vaccine broadened and increased the neutralizing antibody response.
(JAMA. 1994;272:475-480)
Author Affiliations
From the Department of Medicine, St Louis (Mo) University School of Medicine (Drs Belshe and Gorse); the Departments of Medicine and Pediatrics, Vanderbilt University School of Medicine, Nashville, Tenn (Drs Graham and Wright); the Department of Medicine, University of Rochester (NY) School of Medicine and Dentistry (Drs Keefer and Dolin); the Department of Surgery, Duke University School of Medicine, Raleigh, NC (Drs Matthews, Weinhold, and Bolognesi); EMMES Corporation, Potomac, Md (Drs Sposto and Stablein); Genentech Inc, South San Francisco, Calif (Drs Twaddell, Berman, and Gregory and Mr Izu); and the Division of AIDS, National Institute of Allergy and Infectious Diseases, Bethesda, Md (Drs Walker and Fast).
Footnotes
Reprint requests to Division of Infectious Diseases, Department of Medicine, St Louis University, 1402 S Grand Blvd, St Louis, MO 63104 (Dr Belshe).
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