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Problems Associated With the Use of Anti-HIV Drugs in HIV-Infected Pregnant Women

Completed
Conditions
HIV Infections
Pregnancy
Registration Number
NCT00017797
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 who take protease inhibitors (PIs) are more likely to have blood sugar problems than those who do not take PIs.

HIV-infected people generally are treated with a combination of different types of anti-HIV drugs, 1 of which is usually a PI. The same holds true for pregnant women, but not much is known about the use of these drugs in pregnancy. Blood sugar and liver problems caused by anti-HIV drugs in nonpregnant patients are well known but their effects in pregnancy are not. Also, certain physical changes brought about by pregnancy may affect the way drugs are handled in the body. There remains a need for further study into the use of anti-HIV drugs during pregnancy and their effect on the safety of the mother and baby.

Detailed Description

The dramatic impact of potent combination antiretroviral therapies on the course of HIV disease has made the use of PIs routine in the care of HIV-1-infected individuals. Combination therapy likewise has become the standard of care in pregnant individuals, even though information on use of these drugs during human pregnancy is limited. There are no published prospective evaluations of toxicities experienced by pregnant women on PI-containing antiretroviral regimens, despite findings of metabolic disturbances of glucose, fatty acids, and cholesterol, as well as lactic acidosis/hepatic steatosis in nonpregnant individuals treated with antiretrovirals. Gastrointestinal (GI) side effects also are well documented in nonpregnant individuals treated with PIs, but have not been systematically evaluated in pregnancy. In addition, the physiologic changes brought about by pregnancy may influence the pharmacokinetics, safety, and side effects of antiretroviral drugs. There remains a need for further evaluation of the use of antiretrovirals during pregnancy and their impact on maternal, fetal, and infant safety.

Patients are stratified according to whether or not they are on a PI-containing antiretroviral regimen and the number of weeks of gestation (26 weeks or less versus greater than 26 weeks). Patients are followed at 8-week intervals from the time of entry until delivery or pregnancy termination, with an additional visit at 12 weeks after delivery or pregnancy termination. All infants born to study participants are evaluated at the time of delivery (anthropometrics and HIV DNA PCR) and are seen again at the mothers' 12-week post-delivery visit. Glucose tolerance testing and other metabolic studies are performed serially during pregnancy and again postpartum. This is an observational study and drugs are not supplied. Patients receiving antiretroviral therapy must obtain their own medications.

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
160
Inclusion Criteria

Not provided

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Exclusion Criteria

Not provided

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Study & Design

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

Trial Locations

Locations (40)

The CORE Ctr

🇺🇸

Chicago, Illinois, United States

Univ of Pittsburgh

🇺🇸

Pittsburgh, Pennsylvania, United States

Univ of Miami (Pediatric)

🇺🇸

Miami, Florida, United States

Univ of Minnesota

🇺🇸

Minneapolis, Minnesota, United States

Indiana Univ Hosp

🇺🇸

Indianapolis, Indiana, United States

Duke Univ Med Ctr

🇺🇸

Durham, North Carolina, United States

Univ of Cincinnati

🇺🇸

Cincinnati, Ohio, United States

Vanderbilt Univ Med Ctr

🇺🇸

Nashville, Tennessee, United States

Univ of Washington

🇺🇸

Seattle, Washington, United States

Hennepin County Med Ctr

🇺🇸

Minneapolis, Minnesota, United States

Methodist Hosp of Indiana / Life Care Clinic

🇺🇸

Indianapolis, Indiana, United States

Case Western Reserve Univ

🇺🇸

Cleveland, Ohio, United States

Univ of Hawaii

🇺🇸

Honolulu, Hawaii, United States

Los Angeles County - USC Med Ctr

🇺🇸

Los Angeles, California, United States

Mt Sinai Hosp Med Ctr / Dept of Pediatrics

🇺🇸

Chicago, Illinois, United States

Rush Presbyterian - Saint Luke's Med Ctr

🇺🇸

Chicago, Illinois, United States

Metropolitan Hosp Ctr

🇺🇸

New York, New York, United States

Washington Univ (St.Louis)

🇺🇸

St.Louis, Missouri, United States

Brigham and Womens Hosp

🇺🇸

Boston, Massachusetts, United States

MetroHealth Med Ctr

🇺🇸

Cleveland, Ohio, United States

Univ of Rochester Medical Center

🇺🇸

Rochester, New York, United States

Bellevue Hosp / New York Univ Med Ctr

🇺🇸

New York, New York, United States

Univ of Marlyand (Pediatric)

🇺🇸

Baltimore, Maryland, United States

Univ of Massachusetts Med School

🇺🇸

Worcester, Massachusetts, United States

St Peter's Med Ctr

🇺🇸

New Brunswick, New Jersey, United States

Children's Hosp of Michigan

🇺🇸

Detroit, Michigan, United States

Jacobi Med Ctr

🇺🇸

Bronx, New York, United States

Univ of North Carolina

🇺🇸

Chapel Hill, North Carolina, United States

Wishard Hosp

🇺🇸

Indianapolis, Indiana, United States

San Juan City Hosp

🇵🇷

San Juan, Puerto Rico

Hutzel Hospital

🇺🇸

Detroit, Michigan, United States

Univ of Alabama at Birmingham - Pediatric

🇺🇸

Birmingham, Alabama, United States

Yale University School of Medicine

🇺🇸

New Haven, Connecticut, United States

Univ of Florida Health Science Ctr / Pediatrics

🇺🇸

Jacksonville, Florida, United States

The Med Ctr Inc

🇺🇸

Columbus, Georgia, United States

Baystate Med Ctr of Springfield

🇺🇸

Springfield, Massachusetts, United States

Saint Jude Children's Research Hosp of Memphis

🇺🇸

Memphis, Tennessee, United States

Children's Hospital & Medical Center / Seattle ACTU

🇺🇸

Seattle, Washington, United States

Howard Univ Hosp

🇺🇸

Washington, District of Columbia, United States

Univ of Medicine & Dentistry of New Jersey / Univ Hosp

🇺🇸

Newark, New Jersey, United States

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