Redirected MazF‐CD4 Autologous T Cells for HIV Gene Therapy

Inclusion Criteria:

1. HIV-1 infection, as documented by a rapid HIV test or any FDA-approved HIV-1 enzyme
or chemiluminescence immunoassay (E/CIA) test kit and confirmed by Western blot at
any time prior to study entry. Alternatively, if a rapid HIV test or any FDA-approved
HIV-1 enzyme or chemiluminescence immunoassay (E/CIA) test kit is not available, two
HIV-1 RNA values >2000 copies/mL at least 24 hours apart performed by any laboratory
that has CLIA certification, or its equivalent, may be used to document infection.

2. Antiretroviral medication

- Cohort 1: Subjects on HAART (no changes to treatment within 4 weeks of study
entry) for at least 3 months.

- Subjects on HAART (no changes to treatment within 4 weeks of study entry) for at
least 3 months.

3. Plasma HIV viremia

- Cohort 1: HIV‐1‐positive men and women >18 years of age with HIV‐1‐RNA levels
undetectable by ultrasensitive HIV PCR Abbott assay at screening. Also eligible
are subjects with HIV‐1 RNA < 400 copies/mL; however, the HIV‐1 RNA must be < 50
copies/mL within 60 days prior to study entry based on the Abbott assay.
Subjects with intermittent isolated episodes of detectable low level viremia (>
50 but <1,000 copies RNA/mL; blips) will be eligible. There should be at least 2
documented HIV‐1 RNA assays, one drawn >3 months before study entry, one drawn
<3 months before study entry.

- Cohort 2: HIV-1-positive men and women >18 years of age with HIV-1-RNA levels
undetectable by ultrasensitive HIV PCR assay at screening. Note: Due to
sensitivity issues using the Roche Assay and the fact that we cannot control the
HIV testing technique prior to enrollment, we decided to consider subjects with
HIV-1 RNA < 400 copies/mL; however, the HIV-1 RNA must be undetectable within 60
days prior to study entry based on the ultrasensitive HIV PCR assay. Subjects
with intermittent isolated episodes of detectable low level viremia (> 50 but
<1,000 copies RNA/mL; blips) will be eligible. There should be at least 2
documented HIV-1 RNA assays: one drawn >3 months before study entry, one drawn
<3 months before study entry.

4. CD4 counts

- Cohort 1: Subjects with CD4 counts >350 cells/mm3.

- Cohort 2: Subjects with CD4 counts of at least 450 cells/mm3 at screening. Note:
CD4 nadir in Cohort 2 must be above 200 cells/mm3.

5. Adequate venous access and no other contraindications for leukapheresis.

6. Laboratory values obtained within 60 days prior to entry.

- Hemoglobin: ≥ 10.0 (males); ≥ 9.5 (females) g/dL

- Absolute neutrophil count (ANC): ≥ 1000/mm3

- Platelet count: ≥ 75,000/mm3

- Serum creatinine: ≤ 1.5 mg/dL (133μ mol/L)

- Aspartate aminotransferase (AST) or alanine aminotransferase (ALT): ≤ 2.5 times
the upper limit of normal (ULN).

7. Subjects must be willing to comply with study‐mandated evaluations. Rectal biopsy
procedures are optional.

8. Be male or female, 18 years of age and older.

9. Ability and willingness of subject to provide informed consent.

10. Have a Karnofsky Performance Score of 70 or higher.

Exclusion Criteria:

1. No history of opportunistic infections or neoplasm.

2. Concomitant acute or chronic hepatitis B (surface antigen positive) or hepatitis C
infection. If HCV antibody test is positive, an HCV RNA test will be performed. If
both HCV tests (antibody and RNA) are positive, the subjects will be excluded from
study. If HCV antibody test is positive, but HCV RNA test is negative, subject can
enroll. Results should be obtained no more than 30 days prior to screening.

3. History of cancer or malignancy, with the exception of successfully treated basal
cell or squamous cell carcinoma of the skin.

4. 4.2.4 History or any features on physical examination indicative of active or
unstable cardiac disease or hemodynamic instability.

5. History or any features on physical examination indicative of a bleeding diathesis.

6. Have been previously treated with any HIV experimental vaccine within 6 months prior
to screening, or any previous gene therapy using an integrating vector.

7. Use of chronic corticosteroids, hydroxyurea, or immunomodulating agents (e.g.,
interleukin‐2, interferon‐alpha or ‐gamma, granulocyte colony stimulating factors,
etc.) within 30 days prior to study entry.

8. Breast-feeding, pregnant, or unwilling to use acceptable methods of birth control.

9. Use of aspirin, dipyrdamole, warfarin or any other medication that is likely to
affect platelet function or other aspects of blood coagulation during the 2-week
period prior to leukapheresis.

10. Active drug or alcohol use or dependence that, in the opinion of the site
investigator, would interfere with adherence to study requirements.

11. Serious illness requiring systemic treatment and/or hospitalization within 30 days
prior to study entry.

12. Asymptomatic abnormal baseline serum chemistry elevations. Note: Asymptomatic
baseline serum chemistry elevations in total or indirect bilirubin in subjects
receiving atazanavir or indinavir is not exclusionary. Asymptomatic baseline serum
chemistry elevations in LFTs, lipase and creatinine due to HAART medication are not
exclusionary, when in the opinion of the investigator, the abnormalities are not
attributable to intrinsic hepatorenal disease. Such elevations must be due to HAART.

13. Receipt of a vaccination within 30 days prior to study entry.

14. Have an allergy or hypersensitivity to study product excipients (human serum albumin,
DMSO and Dextran 40).

15. For Cohort 2: CD4 nadir below 200 cells/mm3.