MedPath

Daily Nevirapine to Prevent Mother to Infant Transmission of HIV

Phase 3
Completed
Conditions
HIV Infections
Interventions
Registration Number
NCT00061321
Lead Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)
Brief Summary

Infants who are breast-fed by HIV infected mothers have an increased risk of becoming infected with HIV. Standard therapy for the prevention of HIV infections in infants included zidovudine (ZDV) prior to the onset of labor, a single dose of nevirapine (NVP) for women during labor, and a single dose of NVP for newborns given 72 hours after birth. This study will determine if giving low dose daily NVP to breastfed infants of HIV infected mothers, in addition to standard therapy, will be more effective than standard therapy alone at preventing HIV infections in these infants.

Detailed Description

This study will evaluate the safety and effectiveness of adding daily infant NVP to standard prevention measures to decrease vertical transmission of HIV.

According to current statistics from the study site, approximately 70% of the pregnant HIV infected women in this study will have begun antenatal ZDV prior to the initiation of NVP at labor. The remaining 30% of the HIV infected women enrolled in this trial will have been previously undiagnosed. These women will be diagnosed with HIV infection either at the time they present to the delivery room in stage 1 of labor or immediately postpartum if they present for delivery late in labor and cannot provide informed consent for HIV screening prior to delivery.

All infants will receive the standard does of NVP at 72 hours postpartum. Infants will then be randomized to receive either daily NVP and a daily multivitamin (MVI) or a daily MVI alone. Infants will take NVP/MVI or MVI alone during Weeks 2 to 6 postpartum. The primary outcome measure is infant HIV infection rates at 6 months.

Two additional related cohorts of women will be followed for comparison: 1) an equal number of HIV uninfected women and their children will be enrolled for comparison of postpartum morbidity and mortality; and 2) consenting HIV infected women and their children who choose not to enroll in the clinical trial or are ineligible because they are not breastfeeding will be enrolled in an ancillary cohort.

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
770
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
CROSSOVER
Arm && Interventions
GroupInterventionDescription
2Nevirapine and mulitvitaminsMothers: One dose of intrapartum nevirapine by mouth (200mg) at onset of labor Infants: One dose of liquid nevirapine by mouth within 72 hours of birth (2mg/kg) Infants: Liquid multivitamins (1ml/day)by mouth, from week 1 through week 6 post-partum Infants: Liquid nevirapine (5 mg/day) by mouth, from week 1 through week 6 post-partum
1Nevirapine and mulitvitaminsMothers: One dose of intrapartum nevirapine by mouth (200mg) at onset of labor Infants: One dose of liquid nevirapine by mouth within 72 hours of birth (2mg/kg) Infants: Liquid multivitamins (1ml/day) week 1 through week 6 post-partum
Primary Outcome Measures
NameTimeMethod
HIV infection rate of infants6 months of age
Safety of the regimens for HIV-infected mothers and their breast-fed infantsThrough 12 months post-partum
Secondary Outcome Measures
NameTimeMethod
Acceptability and compliance of intervention regimensUntil 6 weeks of age
Time to HIV infection by treatment regimenover 12 months of age
Time to infection by infant feeding practice and time to weaningUntil 12 months post-partum
Maternal ZDV and NVP resistanceBaseline and post-partum
Infant morbidity and mortality by treatment armUntil 12 months post partum
Infant NVP resistance by treatment armUp to 12 months post partum
Maternal NVP pharmacokineticsUp to 12 months post-partum
Infant NVP pharmacokineticsUp to 12 months post-partum

Trial Locations

Locations (1)

BJ Medical College

🇮🇳

Pune, India

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