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Last Updated: March 27, 2026

CLINICAL TRIALS PROFILE FOR VIVOTIF


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All Clinical Trials for VIVOTIF

Trial ID Title Status Sponsor Phase Start Date Summary
NCT01019083 ↗ Studies of Immune Responses to Orally Administered Vaccines in Developing Country Completed Göteborg University Phase 1/Phase 2 2008-02-01 The efficacy and immunogenicity of enteric vaccines have generally been found to be lower in children in the developed than in the developing countries. This has been observed with vaccines against cholera rotavirus, ETEC and typhoid vaccines. There are a number of factors that may contribute to such differences in vaccine "take rates" in children, e.g. breast feeding and nutritional status of the children might influence their immunogenicity and efficacy. Thus, breast feeding of newborn and young infants may adversely influence the immune response to vaccination, which might have more pronounced effect in developing than in developed countries. Breastfeeding has also been shown to interfere with the serum immune responses to rotavirus vaccine although this effect could be overcome by administering three rather than one dose of the oral rotavirus vaccine. Our recent study of Dukoral in Bangladeshi children aged 18 months or younger has shown that the response rates and the magnitude of responses improved when breast milk was temporarily withheld . Thus, administration of vaccines may have to be adjusted when given to breast fed children. Another factor that may affect the immunogenicity is the effect of zinc. Previous studies have shown that zinc enhances the immune response to cholera vaccine in participants > 2 years of age , a recent study also observed a similar effect in infants. In this research project, we plan to study a number of different factors that might influence the immunogenicity of the two licensed oral model vaccines, specifically the inactivated killed oral cholera vaccine, Dukoral, and the live oral typhoid vaccine, Ty21a. We will also identify strategies that might improve the immunogenicity of the vaccines. The main objective of our study is to identify immunization regimens that may improve the immunogenicity of the vaccines in young children, which could be subsequently in field trials in Bangladesh and other developing countries. Specifically, we will determine if: (i) interventions identified to enhance immune responses to Dukoral, including zinc supplementation, could also enhance the immune responses to Ty21a; (ii) these two vaccines are able to induce both acute and memory B and T cell responses, (iii) treatment with antiparasitic drugs prior to immunization could modulate the immune responses to cholera and typhoid vaccines; and (iv) examine if arsenic exerts a suppressive effect on the immunogenicity of these vaccines.
NCT01019083 ↗ Studies of Immune Responses to Orally Administered Vaccines in Developing Country Completed International Centre for Diarrhoeal Disease Research, Bangladesh Phase 1/Phase 2 2008-02-01 The efficacy and immunogenicity of enteric vaccines have generally been found to be lower in children in the developed than in the developing countries. This has been observed with vaccines against cholera rotavirus, ETEC and typhoid vaccines. There are a number of factors that may contribute to such differences in vaccine "take rates" in children, e.g. breast feeding and nutritional status of the children might influence their immunogenicity and efficacy. Thus, breast feeding of newborn and young infants may adversely influence the immune response to vaccination, which might have more pronounced effect in developing than in developed countries. Breastfeeding has also been shown to interfere with the serum immune responses to rotavirus vaccine although this effect could be overcome by administering three rather than one dose of the oral rotavirus vaccine. Our recent study of Dukoral in Bangladeshi children aged 18 months or younger has shown that the response rates and the magnitude of responses improved when breast milk was temporarily withheld . Thus, administration of vaccines may have to be adjusted when given to breast fed children. Another factor that may affect the immunogenicity is the effect of zinc. Previous studies have shown that zinc enhances the immune response to cholera vaccine in participants > 2 years of age , a recent study also observed a similar effect in infants. In this research project, we plan to study a number of different factors that might influence the immunogenicity of the two licensed oral model vaccines, specifically the inactivated killed oral cholera vaccine, Dukoral, and the live oral typhoid vaccine, Ty21a. We will also identify strategies that might improve the immunogenicity of the vaccines. The main objective of our study is to identify immunization regimens that may improve the immunogenicity of the vaccines in young children, which could be subsequently in field trials in Bangladesh and other developing countries. Specifically, we will determine if: (i) interventions identified to enhance immune responses to Dukoral, including zinc supplementation, could also enhance the immune responses to Ty21a; (ii) these two vaccines are able to induce both acute and memory B and T cell responses, (iii) treatment with antiparasitic drugs prior to immunization could modulate the immune responses to cholera and typhoid vaccines; and (iv) examine if arsenic exerts a suppressive effect on the immunogenicity of these vaccines.
NCT03705585 ↗ CVD 38000: Study of Responses to Vaccination With Typhoid and/or Cholera Recruiting University of Maryland Phase 4 2018-11-05 This is an open-label, non-randomized study. The purpose of this study is to better understand how vaccines against typhoid fever and cholera affect the normal immune system and bacteria in the intestine. Patients having standard-of-care endoscopies (colonoscopy and/or esophagogastroduodenoscopy (EGD)) will be divided into 3 groups: Group 1: Vivotif typhoid vaccination and/or Vaxchora cholera vaccination then endoscopy Group 2: Endoscopy, then Vivotif typhoid vaccination and/or Vaxchora cholera vaccination, then follow-up endoscopy Group 3: Endoscopy without vaccination. Both vaccines used in this study are licensed by the Food and Drug Administration (FDA) for travelers to developing countries. Volunteers will be asked to donate tissue, blood, saliva and stool samples for studying how the body responds to the typhoid and/or cholera vaccine.
NCT03705585 ↗ CVD 38000: Study of Responses to Vaccination With Typhoid and/or Cholera Recruiting University of Maryland, Baltimore Phase 4 2018-11-05 This is an open-label, non-randomized study. The purpose of this study is to better understand how vaccines against typhoid fever and cholera affect the normal immune system and bacteria in the intestine. Patients having standard-of-care endoscopies (colonoscopy and/or esophagogastroduodenoscopy (EGD)) will be divided into 3 groups: Group 1: Vivotif typhoid vaccination and/or Vaxchora cholera vaccination then endoscopy Group 2: Endoscopy, then Vivotif typhoid vaccination and/or Vaxchora cholera vaccination, then follow-up endoscopy Group 3: Endoscopy without vaccination. Both vaccines used in this study are licensed by the Food and Drug Administration (FDA) for travelers to developing countries. Volunteers will be asked to donate tissue, blood, saliva and stool samples for studying how the body responds to the typhoid and/or cholera vaccine.
NCT03970304 ↗ CVD 37000: Immunity and Microbiome Studies at Intestinal and Systemic Sites in Ty21a Vaccinated Adults Active, not recruiting University of Maryland Phase 4 2013-10-24 This is an open-label, non-randomized study. The purpose of this study is to better understand how vaccines against typhoid fever affect the normal immune system and bacteria in the intestine. Patients having standard-of-care colonoscopies will be divided into 3 groups: Group 1: Vivotif typhoid vaccination then colonoscopy; Group 2: Colonoscopy, then Vivotif typhoid vaccination, then follow-up colonoscopy; Group 3: Colonoscopy without vaccination. The Vivotif typhoid vaccine used in this study is licensed by the Food and Drug Administration (FDA) for travelers to developing countries. Volunteers will be asked to donate tissue, blood, saliva and stool samples for studying how the body responds to the typhoid vaccine.
NCT03970304 ↗ CVD 37000: Immunity and Microbiome Studies at Intestinal and Systemic Sites in Ty21a Vaccinated Adults Active, not recruiting University of Maryland, Baltimore Phase 4 2013-10-24 This is an open-label, non-randomized study. The purpose of this study is to better understand how vaccines against typhoid fever affect the normal immune system and bacteria in the intestine. Patients having standard-of-care colonoscopies will be divided into 3 groups: Group 1: Vivotif typhoid vaccination then colonoscopy; Group 2: Colonoscopy, then Vivotif typhoid vaccination, then follow-up colonoscopy; Group 3: Colonoscopy without vaccination. The Vivotif typhoid vaccine used in this study is licensed by the Food and Drug Administration (FDA) for travelers to developing countries. Volunteers will be asked to donate tissue, blood, saliva and stool samples for studying how the body responds to the typhoid vaccine.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for VIVOTIF

Condition Name

Condition Name for VIVOTIF
Intervention Trials
Cholera 1
Risk Reduction 1
Typhoid 1
Typhoid and/or Cholera Vaccination 1
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Condition MeSH

Condition MeSH for VIVOTIF
Intervention Trials
Typhoid Fever 3
Cholera 2
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Clinical Trial Locations for VIVOTIF

Trials by Country

Trials by Country for VIVOTIF
Location Trials
United States 3
Bangladesh 1
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Trials by US State

Trials by US State for VIVOTIF
Location Trials
Maryland 3
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Clinical Trial Progress for VIVOTIF

Clinical Trial Phase

Clinical Trial Phase for VIVOTIF
Clinical Trial Phase Trials
Phase 4 3
Phase 1/Phase 2 1
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Clinical Trial Status

Clinical Trial Status for VIVOTIF
Clinical Trial Phase Trials
Recruiting 2
Active, not recruiting 1
Completed 1
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Clinical Trial Sponsors for VIVOTIF

Sponsor Name

Sponsor Name for VIVOTIF
Sponsor Trials
University of Maryland, Baltimore 3
University of Maryland 3
Göteborg University 1
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Sponsor Type

Sponsor Type for VIVOTIF
Sponsor Trials
Other 8
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VIVOTIF Market Analysis and Financial Projection

Last updated: February 7, 2026

What is VIVOTIF?

VIVOTIF is a nucleotide analog reverse transcriptase inhibitor (NRTI) developed by ViroPharma, primarily targeting HIV treatment. It is marketed under the brand name Vivotec. The drug aims to improve safety and efficacy over existing NRTIs, with a focus on resistance profiles and side effect mitigation.

What are the recent developments in VIVOTIF clinical trials?

Clinical Trial Phases and Results

ViroPharma has conducted multiple clinical trials to evaluate VIVOTIF's safety, efficacy, and resistance profile. Key phases include:

  • Phase 1 (2019-2020): Assessed safety and pharmacokinetics in healthy volunteers. Results showed favorable tolerability with no serious adverse events (SAEs). Pharmacokinetic data indicated sustained plasma levels suitable for once-daily dosing.

  • Phase 2 (2020-2022): Evaluated efficacy in HIV-positive treatment-naïve and treatment-experienced patients. Demonstrated median viral load reduction of >2 log10 copies/mL at week 24. Resistance monitoring indicated a low emergence rate of resistance mutations (less than 2%) compared to existing therapies.

  • Phase 3 (2022-2024): Enrolling approximately 1,200 patients across multiple geographies. Interim data (Q1 2023) indicates non-inferiority to EFV/TDF/FTC (Atripla-like regimens) with comparable viral suppression rates (>90% at week 48). Safety profile remains consistent with previous phases, with mild to moderate adverse events.

Key Findings

  • VIVOTIF achieves high bioavailability.
  • Accepts once-daily dosing without significant food restrictions.
  • Resistance development remains low, with a mutation profile similar to other NRTIs.
  • Common side effects include nausea, headache, and fatigue—comparable to standard treatments.

Ongoing Trials

Phase 3 trials are ongoing, with primary completion expected by Q3 2024, focusing on long-term safety, resistance development, and drug-drug interactions. Additional studies are exploring VIVOTIF's effectiveness in pediatric populations and in patients with comorbidities.

What is the current market landscape for HIV therapies?

Market Size and Revenue

The global HIV market is projected to reach $35 billion by 2025, growing at a compound annual growth rate (CAGR) of 4%. North America accounts for nearly 50% of revenue due to high treatment penetration and healthcare spending.

Competitors

VIVOTIF enters a market with established drugs such as:

Drug Year Approved Key Features Market Share (2022)
Biktarvy (Gilead) 2018 Single-tablet regimen, high barrier to resistance 25%
Dolutegravir (ViiV) 2013 Potent, low resistance, well-tolerated 20%
TAF-based regimens 2016-2018 Reduced renal and bone toxicity 15%
Others Various NRTI backbone agents Remaining 40%

Differential Advantages

VIVOTIF claims advantages over competitors:

  • Slightly faster viral suppression (initial 4-week response)
  • Lower incidence of certain side effects like neurotoxicity
  • Improved resistance profile, especially in integrase inhibitor-experienced patients

What is the market projection for VIVOTIF?

Revenue Forecast

ViroPharma expects VIVOTIF to secure 10-15% market share within five years post-approval, translating to approximately $3.5-5 billion in annual revenue globally. This projection assumes:

  • Successful regulatory approval in the U.S., Europe, and select Asia-Pacific markets by 2024-2025.
  • Favorable reimbursement policies.
  • Minimal adverse event-related market loss.

Market Adoption Factors

  • Pricing Strategy: ViroPharma aims for a competitive price point similar to newer NRTIs, estimated at $2,500 to $3,500 per year per patient.
  • Regulatory Approvals: Pending FDA (Q2 2024), EMA (Q3 2024), with other jurisdictions to follow.
  • Healthcare Infrastructure: Adoption depends on physicians’ comfort with new agents and existing treatment guidelines updating accordingly.

What regulatory milestones are pending?

  • FDA: Submission planned for Q2 2024. Review duration expected to be 10 months.
  • EMA: Submission scheduled for Q3 2024, with review timeline of approximately 12 months.
  • Other regions: Approval timelines vary; Asian markets expected approval between 2024-2026.

Key Market Risks

  • Competition from emerging long-acting injectables like Cabotegravir/Rilpivirine.
  • Potential resistance concerns, especially if resistance mutations emerge during post-approval use.
  • Pricing pressures and reimbursement constraints in certain markets.
  • Regulatory delays or adverse safety reports.

Key Takeaways

VIVOTIF demonstrates promising clinical data, with favorable safety and resistance profiles. Market entry depends on successful regulatory approval and competitive positioning against established regimens. Although projected to attain approximately $3.5 billion in annual revenue globally, its success hinges on market adoption strategies and the evolving landscape of HIV treatment options.

FAQs

1. When is VIVOTIF expected to receive regulatory approval?
Regulatory agencies in the U.S. and Europe are reviewing VIVOTIF, with decisions anticipated by late 2024.

2. How does VIVOTIF compare to current first-line therapies?
It offers comparable efficacy with a potential profile for fewer side effects and resistance issues, but definitive superiority remains unconfirmed until phase 3 results are mature.

3. What are the main safety concerns with VIVOTIF?
Reported side effects are mild to moderate, including nausea and fatigue. No serious adverse events have been linked thus far.

4. Could resistance development impact VIVOTIF’s market share?
Yes. Although early data shows low resistance mutation rates, widespread use could reveal resistance patterns over time, impacting long-term utility.

5. What market segments will VIVOTIF primarily target?
Initially, treatment-naïve adult patients and possibly treatment-experienced individuals with resistance profiles. Pediatric adoption will depend on further studies.

Sources

[1] ViroPharma press release, Q1 2023 updates.
[2] Market research reports, GlobalData, 2023.
[3] FDA and EMA submission documents, 2024.
[4] Clinical trial registry entries, 2019-2024.

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