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A Study of HIV Levels During Pregnancy and After Childbirth

Completed
Conditions
HIV Infections
Pregnancy
Registration Number
NCT00041964
Lead Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)
Brief Summary

The purpose of this study is to find out if HIV-infected pregnant women taking anti-HIV drugs have an increased amount of HIV in their blood (viral load) after having the baby.

The purpose of A5153s, a substudy of A5150, is to characterize two anti-HIV drugs (nelfinavir \[NFV\] and lopinavir/ritonavir \[LPV/r\]) in HIV-infected women during pregnancy and after childbirth.

Sometimes pregnant women have an increase in their HIV viral load after their baby is born. This study will try to find out how often this happens. It will also examine possible reasons why the increase in viral load occurs.

Detailed Description

Limited data suggest that HIV-infected pregnant women develop postpartum viral rebound. However, viral load changes in the postpartum period have not been adequately characterized. Changes in adherence to antiretroviral therapy, pregnancy-related changes in pharmacokinetics of antiretroviral medications, and decline in immune competence are mechanisms by which postpartum viral load rebound may occur. This study is designed to characterize the incidence and magnitude of postpartum viral rebound during the initial 24 weeks postpartum and to explore the mechanisms and consequences of viral rebound.

Eligible patients are evaluated at gestational weeks 34 and 36, at delivery, and at regular visits for 96 weeks postpartum. Most evaluations include a medical history, physical exam, laboratory tests, and adherence and quality-of-life questionnaires. Viral load and CD4/CD8 cell counts are measured frequently.

Patients are expected to receive at least 8 weeks of stable HAART before delivery, and to continue HAART throughout the remainder of the study. The choice of HAART is left to the primary provider. No antiretroviral drugs are provided by this study.

Patients participating in the A5153s substudy receive either NFV or LPV/r as part of their HAART. Pharmacokinetic blood sampling takes place at 36 weeks gestation, 6 weeks postpartum, and 24 weeks postpartum. Patients record the administration times and doses of their NFV or LPV/r for 48 hours prior to each substudy visit, and hold their regularly scheduled doses of antiretroviral medications on substudy days. Patients arrive at the clinic fasting (no food or drink for the previous 8 hours) and are given a standardized breakfast prior to supervised administration of their NFV or LPV/r dose. An intravenous catheter is placed in an arm vein for blood collection at pre-dose and 1, 2, 4, and 6 hours post-dose.

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
129
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (32)

Univ of Alabama at Birmingham

πŸ‡ΊπŸ‡Έ

Birmingham, Alabama, United States

Los Angeles County Medical Center/USC

πŸ‡ΊπŸ‡Έ

Los Angeles, California, United States

UCLA School of Medicine

πŸ‡ΊπŸ‡Έ

Los Angeles, California, United States

UCSD Mother, Child & Adolescent HIV Program

πŸ‡ΊπŸ‡Έ

San Diego, California, United States

San Francisco General Hosp

πŸ‡ΊπŸ‡Έ

San Francisco, California, United States

Univ of Florida- Health Science Ctr

πŸ‡ΊπŸ‡Έ

Jacksonville, Florida, United States

Emory Univ

πŸ‡ΊπŸ‡Έ

Atlanta, Georgia, United States

University of Hawaii

πŸ‡ΊπŸ‡Έ

Honolulu, Hawaii, United States

Northwestern University

πŸ‡ΊπŸ‡Έ

Chicago, Illinois, United States

Cook County Hosp Core Ctr

πŸ‡ΊπŸ‡Έ

Chicago, Illinois, United States

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Univ of Alabama at Birmingham
πŸ‡ΊπŸ‡ΈBirmingham, Alabama, United States

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