Protocol 0107—488
PI: R.R. MacGregor
Title: A Phase 1a, randomized study of escalating single doses of VRX496 in subjects with AIDS
1. The advantages of using HIV vectors instead of MLV vectors in this trial include (1) co-localization of the vector RNA with wt-RNA may be more effective to inhibit the wt-RNA function; (2) competition between the vector and the wt HIV for transactivators important for replication; (3) HIV vectors are more efficient to transduce human T cells. The investigators have already indicated in the application that the current vector, just by itself without the antisense env gene, did not seem to interfere with wt HIV replication. This is consistent with observations reported by others (for example, Evans & Garcia, Hum Gene Ther 11:2331-2339, An et al., J Virol. 73: 7671-7677). The advantage of RNA co-localization remains hypothetical at this point since MLV vectors containing the antisense env gene has also been shown to effectively block wt HIV replication in culture (Veres et al. J. Virol. 72: 1894-1901). While close to 100% transduction efficiency of CD4+ lymphocytes with HIV vectors is stunning, can the similar transduction efficiency be obtained consistently with the lymphocytes from HIV patients? Has the same protocol for lymphocytes stimulation and vector transduction been tested with MLV vectors? If MLV can achieve similar levels of transduction, the risks of using HIV vectors may not justify this application.