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Prenatal and Postnatal Studies of Interventions for Prevention of Mother-To-Child Transmission

Completed
Conditions
Pregnancy Complications, Infectious
HIV Infections
Interventions
Behavioral: Adherence assessment
Registration Number
NCT00028145
Lead Sponsor
International Maternal Pediatric Adolescent AIDS Clinical Trials Group
Brief Summary

The purpose of this study is to collect and study clinical and laboratory information about a pregnant or new mother and her medical care that will increase our knowledge of the best care for HIV-infected pregnant women and their children.

The rate of transmission of HIV from mothers to their infants has gone down. Specific U.S. Public Health Service guidelines recommend that HIV-infected pregnant women be treated with anti-HIV therapies; but the effectiveness of treatment and safety for the mother and her infant have not been fully examined. This study will monitor the health of women and their infants while they receive anti-HIV therapy. Also, this study will provide information that may be used for future studies.

Detailed Description

The current low rate of vertical transmission of HIV in the U.S. limits the number and types of questions concerning transmission risk and pathogenesis that can be addressed by a single clinical trial. Specific U.S. Public Health Service guidelines recommend antiretroviral therapy (ART) during pregnancy to maximize health of women. However, data regarding the effectiveness and safety of and adherence to ART during pregnancy are limited. It is both appropriate and necessary for theInternational Maternal Pediatric Adolescent AIDS Clinical Trials Group (IMPAACT) to recruit pregnant women into a non-interventional, analytic, epidemiologic study to methodically collect clinical and laboratory data from them and their infants. This way, the IMPAACT can achieve the aims of evaluating management of HIV-infected women during pregnancy and determining the safety and effectiveness of ART and other interventions intended to prevent vertical transmission and/or improve maternal health. In addition, longitudinally collected core protocol data and repository specimens will enable future substudies.

Participants receive no protocol specific treatment or other intervention as part of this study. The study involves the follow-up of HIV-infected women enrolled during pregnancy or at the time of delivery for 6 months postpartum and their infants for the first 6 months of life. There will be 8 study visits for enrolled participants and 6 study visits for infants. Data concerning ART use, adherence to medications, and review of symptoms relevant to side effects and toxicities are collected through administration of questionnaires at all maternal visits. Phlebotomy is conducted to obtain specimens for a repository and for required laboratory tests. During labor and delivery, maternal blood is obtained for lymphocyte subset and viral load assays and for repository storage. Collection of amniotic fluid at the time of cesarean section is encouraged. These collections are submitted to a central repository. Data for the core protocol are abstracted from the infant's medical record at the time of birth and at each postnatal visit.

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
3090
Inclusion Criteria
  • HIV infected
  • At least 14 weeks pregnant OR have delivered a liveborn or stillborn infant and are within 14 days of the delivery
  • Currently receiving care at an IMPAACT or other participating site
  • Have a parent or guardian willing to provide signed informed consent, if applicable
  • Mentally capable of giving informed consent to have the infant and self followed at an IMPAACT site
Exclusion Criteria
  • Intend to end the pregnancy
  • Unable to come for a study visit within 14 days after delivery (if known to be HIV infected prior to delivery) OR within 28 days after delivery (if found to be HIV infected at the time of labor and delivery or within 14 days after delivery)

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
1Adherence assessmentPregnant, HIV-infected women
Primary Outcome Measures
NameTimeMethod
Maternal and infant response to prescribed interventionsThroughout study
Immune and viral parameters of participants taking prescribed interventionsThroughout study
Secondary Outcome Measures
NameTimeMethod
Occurrences of genotypic and phenotypic resistance in HIV-infected mothersThroughout study
Clinical, immunological, and virological responses in HIV-infected womenThroughout study
Mother-to-child transmission rates of resistance mutationsThroughout study
Adherence to ART among HIV-infected pregnant women during pregnancy and postpartumThroughout study

Trial Locations

Locations (77)

UCLA Med Ctr / Pediatric

🇺🇸

Los Angeles, California, United States

University of Connecticut, Farmington

🇺🇸

Farmington, Connecticut, United States

The Children's Hospital of Philadelphia (6701)

🇺🇸

Philadelphia, Pennsylvania, United States

Univ of Illinois

🇺🇸

Chicago, Illinois, United States

Chicago Childrens Memorial Hosp (Pediatric)

🇺🇸

Chicago, Illinois, United States

Univ of Chicago Children's Hosp (4001)

🇺🇸

Chicago, Illinois, United States

Brigham and Women's Hosp

🇺🇸

Boston, Massachusetts, United States

Texas Children's Hosp / Baylor Univ (3801)

🇺🇸

Houston, Texas, United States

Univ of Washington Children's Hospital Seattle (5017)

🇺🇸

Seattle, Washington, United States

Harborview Medical Center NICHD CRS (5027)

🇺🇸

Seattle, Washington, United States

University of Washington NICHD CRS (5029)

🇺🇸

Seattle, Washington, United States

Univ of California, San Diego (4601)

🇺🇸

San Diego, California, United States

Los Angeles County Medical Center/USC

🇺🇸

Los Angeles, California, United States

Long Beach Memorial (Pediatric)

🇺🇸

Long Beach, California, United States

Miller Children's Hospital Long Beach (5093)

🇺🇸

Long Beach, California, United States

University of South Alabama

🇺🇸

Mobile, Alabama, United States

Usc La Nichd Crs (5048)

🇺🇸

Los Angeles, California, United States

UCLA-Los Angeles/Brazil AIDS Consortium (LABAC) CR (3601)

🇺🇸

Los Angeles, California, United States

Harbor-UCLA Med Ctr (5045)

🇺🇸

Torrance, California, United States

Connecticut Childrens Medical Center (Pediatric)

🇺🇸

Farmington, Connecticut, United States

Yale Univ School of Med

🇺🇸

New Haven, Connecticut, United States

Children's National Medical Center Washington DC NICHD CRS (5015)

🇺🇸

Washington, District of Columbia, United States

Washington Hospital Center NICHD CRS (5023)

🇺🇸

Washington, District of Columbia, United States

North Broward Hosp District

🇺🇸

Fort Lauderdale, Florida, United States

South Florida CDC Ft Lauderdale NICHD CRS (5055)

🇺🇸

Ft Lauderdal, Florida, United States

Jackson Memorial Hosp

🇺🇸

Miami, Florida, United States

University of Florida Jacksonville (5051)

🇺🇸

Jacksonville, Florida, United States

University of Miami Pediatric/Perinatal HIV/AIDS (4201)

🇺🇸

Miami, Florida, United States

University of South Florida at Tampa (5018)

🇺🇸

St Petersburg, Florida, United States

Med College of Georgia

🇺🇸

Augusta, Georgia, United States

Womens & Childrens HIV Program

🇺🇸

Chicago, Illinois, United States

Mt Sinai Hosp Med Ctr / Dept of Pediatrics

🇺🇸

Chicago, Illinois, United States

The Medical Center

🇺🇸

Columbus, Georgia, United States

Cook County Hospital

🇺🇸

Chicago, Illinois, United States

Rush University Cook County Hospital NICHD CRS (5083)

🇺🇸

Chicago, Illinois, United States

Tulane University New Orleans (5095)

🇺🇸

New Orleans, Louisiana, United States

University of Maryland Baltimore NICHD CRS (5094)

🇺🇸

Baltimore, Maryland, United States

Tulane-Lakeside Hospital

🇺🇸

New Orleans, Louisiana, United States

Tulane University Charity Hosp of New Orleans (7201)

🇺🇸

New Orleans, Louisiana, United States

Johns Hopkins University NICHD CRS (5092)

🇺🇸

Baltimore, Maryland, United States

Children's Hospital of Boston NICHD CRS (5009)

🇺🇸

Boston, Massachusetts, United States

Boston Med Ctr (Pediatric) (5011)

🇺🇸

Boston, Massachusetts, United States

Baystate Med Ctr of Springfield

🇺🇸

Springfield, Massachusetts, United States

WNE Maternal Pediatric Adolescent AIDS CRS (7301)

🇺🇸

Worcester, Massachusetts, United States

Univ of Massachusetts Med School

🇺🇸

Worcester, Massachusetts, United States

St. Louis Children's Hosp

🇺🇸

St. Louis, Missouri, United States

Univ of Medicine & Dentistry of New Jersey / Univ Hosp (P2802)

🇺🇸

Newark, New Jersey, United States

New Jersey Medical School (2802)

🇺🇸

Newark, New Jersey, United States

Lincoln Medical & Mental Health Center

🇺🇸

Bronx, New York, United States

Univ of Med & Dentistry of New Jersey/Univ Hosp

🇺🇸

Newark, New Jersey, United States

Bronx-Lebanon Hospital IMPAACT (6901)

🇺🇸

Bronx, New York, United States

Jacobi Med. Ctr. Bronx NICHD CRS (5013)

🇺🇸

Bronx, New York, United States

Montefiore Medical / AECOM

🇺🇸

Bronx, New York, United States

New York University NY (5012)

🇺🇸

New York, New York, United States

NYU/Bellevue Hospital

🇺🇸

New York, New York, United States

Metropolitan Hosp Ctr (5003)

🇺🇸

New York, New York, United States

Columbia IMPAACT CRS (4101)

🇺🇸

New York, New York, United States

Univ of Rochester Med Ctr

🇺🇸

Rochester, New York, United States

Children's Hospital at Downstate

🇺🇸

Brooklyn, New York, United States

State Univ of New York at Stony Brook (5040)

🇺🇸

Stony Brook, New York, United States

SUNY Upstate Medical Univ

🇺🇸

Syracuse, New York, United States

Hahnemann University Hospital (6706)

🇺🇸

Philadelphia, Pennsylvania, United States

Hospital of the University of Pennsylvania

🇺🇸

Philadelphia, Pennsylvania, United States

The Regional Med Ctr, Memphis (6502)

🇺🇸

Memphis, Tennessee, United States

St. Jude Childrens Research Hosp, Memphis (6501)

🇺🇸

Memphis, Tennessee, United States

University of Puerto Rico Pediatric HIV/AIDS (6601)

🇵🇷

San Juan, Puerto Rico

San Juan City Hosp. PR NICHD CRS (5031)

🇵🇷

San Juan, Puerto Rico

Duke Univ (Pediatric) (DUMC) (4701)

🇺🇸

Durham, North Carolina, United States

Univ. of California San Francisco NICHD CRS (5091)

🇺🇸

San Francisco, California, United States

Vanderbilt Univ Med Ctr

🇺🇸

Nashville, Tennessee, United States

Univ. of Alabama Birmingham NICHD CRS (5096)

🇺🇸

Birmingham, Alabama, United States

Phoenix Childrens Hospital

🇺🇸

Phoenix, Arizona, United States

Hutzel Hospital (5089)

🇺🇸

Detroit, Michigan, United States

University of Colorado Denver NICHD CRS (5052)

🇺🇸

Denver, Colorado, United States

Wayne State University Detroit Children's Hosp of Michigan (5041)

🇺🇸

Detroit, Michigan, United States

Oregon Health and Science University

🇺🇸

Portland, Oregon, United States

Howard Univ Hosp (5044)

🇺🇸

Washington, District of Columbia, United States

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