VAC069: A Study of Blood-stage Controlled Human P. Vivax Infection

Inclusion Criteria

• Healthy adult aged 18 to 50 years.
• Red blood cells positive for the Duffy antigen/chemokine receptor (DARC).
• Normal serum levels of Glucose-6-phosphate dehydrogenase (G6PDH).
• Negative haemoglobinopathy screen
• Able and willing (in the Investigator's opinion) to comply with all study requirements.
• Willing to allow the Investigators to discuss the volunteer's medical history with their General Practitioner.
• Women only: Must practice continuous effective contraception for the duration of the clinic visits (first 3 months post-CHMI).
• Agreement to permanently refrain from blood donation
• Written informed consent to participate in the trial.
• Reachable (24/7) by mobile phone during the period between CHMI and completion of all antimalarial treatment.
• Willing to take a curative anti-malarial regimen following CHMI.
• Willing to reside in Oxford for the duration of the study, until antimalarials have been completed.
• Answer all questions on the informed consent quiz correctly.

Exclusion Criteria

• History of clinical malaria (any species).
• Travel to a clearly malaria endemic locality during the study period or within the preceding six months.
• Use of systemic antibiotics with known antimalarial activity within 30 days of CHMI (e.g.trimethoprim-sulfamethoxazole, doxycycline, tetracycline, clindamycin, erythromycin, fluoroquinolones and azithromycin).
• Haemoglobin <120 g/L for a female volunteer or <130 g/L for a male volunteer prior to primary CHMI. (However, for enrolment into secondary and tertiary CHMIs slightly lower haemoglobin values (≤0.5 g/L) will be permitted at the discretion of the Investigator, to account for the blood volume donated during the previous CHMI).
• Receipt of immunoglobulins within the three months prior to enrolment.
• Receipt of blood transfusion at any time in the past.
• Peripheral venous access unlikely to allow twice daily blood testing (as determined by the Investigator).
• Receipt of an investigational product in the 30 days preceding enrolment, or planned receipt during the study period.
• Prior receipt of an investigational vaccine likely to impact on interpretation of the trial data or the P. vivax parasite as assessed by the Investigator.
• Planned receipt of a COVID-19 vaccine between 2 weeks before the day of CHMI until completion of antimalarial treatment
• Any confirmed or suspected immunosuppressive or immunodeficient state, including HIV infection; asplenia; recurrent, severe infections and chronic (more than 14 days) immunosuppressant medication within the past 6 months (inhaled and topical steroids are allowed).
• History of allergic disease or reactions likely to be exacerbated by malaria infection.
• Pregnancy, lactation or intention to become pregnant during the study.
• Use of medications known to cause prolongation of the QT interval and existing contraindication to the use of Malarone.
• Use of medications known to have a potentially clinically significant interaction with Riamet and Malarone.
• Any clinical condition known to prolong the QT interval.
• History of cardiac arrhythmia, including clinically relevant bradycardia.
• Disturbances of electrolyte balance, e.g. hypokalaemia or hypomagnesaemia.
• Family history of congenital QT prolongation or sudden death.
• Contraindications to the use of both of the proposed anti-malarial medications Riamet and Malarone.
• History of cancer (except basal cell carcinoma of the skin and cervical carcinoma in situ).
• History of serious psychiatric condition that may affect participation in the study.
• Any other serious chronic illness requiring hospital specialist supervision.
• Suspected or known current alcohol abuse as defined by an alcohol intake of greater than 25 standard UK units every week.
• Suspected or known injecting drug abuse in the 5 years preceding enrolment.
• Hepatitis B surface antigen (HBsAg) detected in serum.
• Seropositive for hepatitis C virus (antibodies to HCV) at scree