title: Reasons for ineligibility in phase 1 and 2A HIV vaccine clinical trials at Kenya AIDS vaccine initiative (KAVI), Kenya.
abstract: BACKGROUND
  With the persistent challenges towards controlling the HIV epidemic, there is an ongoing need for research into HIV vaccines and drugs. Sub-Saharan African countries--worst affected by the HIV pandemic--have participated in the conduct of clinical trials for HIV vaccines. In Kenya, the Kenya AIDS Vaccine Initiative (KAVI) at the University of Nairobi has conducted HIV vaccine clinical trials since 2001.
  
  
  METHODS
  Participants were recruited after an extensive informed consent process followed by screening to determine eligibility. Screening included an assessment of risk behavior, medical history and physical examination, and if clinically healthy, laboratory testing. In the absence of locally derived laboratory reference ranges, the ranges used in these trials were derived from populations in the West.
  
  
  RESULTS
  Two hundred eighty-one participants were screened between 2003 and 2006 for two clinical trials. Of these, 167 (59.4%) met the inclusion/exclusion criteria. Overall, laboratory abnormalities based on the non-indigenous laboratory references used were the most frequent reasons (61.4%) for ineligibility. Medical abnormalities contributed 30.7% of the total reasons for ineligibility. Based on the laboratory reference intervals now developed from East and Southern Africa, those ineligible due to laboratory abnormalities would have been 46.3%. Of the eligible participants, 18.6% declined enrollment.
  
  
  CONCLUSIONS
  Participant recruitment for HIV vaccine clinical trials is a rigorous and time-consuming exercise. Over 61% of the screening exclusions in clinically healthy people were due to laboratory abnormalities. It is essential that laboratory reference ranges generated from local populations for laboratory values be used in the conduct of clinical trials to avoid unnecessary exclusion of willing participants and to avoid over-reporting of adverse events for enrolled participants.
  
  
  BACKGROUND
  Protocol IAVI VRC V001 [1]. ClinicalTrials.gov NCT00124007 Protocol IAVI 010 [2](registration with ClincalTrials.gov is in progress) Protocols IAVI 002 and IAVI 004 are Phase 1 trials only mentioned in introductory paragraphs; details will not be reported. Registration was not required when they were conducted.
authors.affiliation: Kenya AIDS Vaccine Initiative, University of Nairobi, Nairobi, Kenya. gomosa@kaviuon.org
authors.forename: Gloria S
authors.initials: GS
authors.lastname: Omosa-Manyonyi
authors.forename: Walter
authors.initials: W
authors.lastname: Jaoko
authors.forename: Omu
authors.initials: O
authors.lastname: Anzala
authors.forename: Hilda
authors.initials: H
authors.lastname: Ogutu
authors.forename: Sabina
authors.initials: S
authors.lastname: Wakasiaka
authors.forename: Roselyn
authors.initials: R
authors.lastname: Malogo
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Nyange
authors.forename: Pamela
authors.initials: P
authors.lastname: Njuguna
authors.forename: Jeckoniah
authors.initials: J
authors.lastname: Ndinya-Achola
authors.forename: Kirana
authors.initials: K
authors.lastname: Bhatt
authors.forename: Bashir
authors.initials: B
authors.lastname: Farah
authors.forename: Micah
authors.initials: M
authors.lastname: Oyaro
authors.forename: Claudia
authors.initials: C
authors.lastname: Schmidt
authors.forename: Frances
authors.initials: F
authors.lastname: Priddy
authors.forename: Patricia
authors.initials: P
authors.lastname: Fast
mesh_terms: D016915:AIDS Vaccines / Q000627:therapeutic use*; D019411:Clinical Laboratory Techniques; D006801:Humans; D007630:Kenya; D018579:Patient Selection; D012015:Reference Standards
chemical_list: D016915:AIDS Vaccines