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A Study of Nevirapine for the Prevention of HIV Transmission From Mothers to Their Babies

Phase 3
Completed
Conditions
HIV Infections
Pregnancy
Registration Number
NCT00000869
Lead Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)
Brief Summary

The purpose of this study is to see if giving the anti-HIV drug nevirapine (NVP) to HIV-positive pregnant women and their babies can help reduce the chance that a mother will give HIV to her baby during delivery. This study will also test the safety of the drug and see how well it is tolerated by the mother and her baby.

Previous studies suggest that NVP is a promising medication for blocking HIV transmission from HIV-positive mothers to their babies.

Detailed Description

Nevirapine has several properties that make it an attractive candidate for antiretroviral therapy to interrupt HIV-1 transmission in the intrapartum and early postpartum period. The pharmacokinetic profile suggested that nevirapine would be rapidly absorbed and transferred to the infant in utero when given during labor and delivery. In addition, nevirapine has been shown to penetrate cell-free virions and inactivate virion-associated reverse transcriptase (RT) in situ. This property would be potentially useful in inactivating cell-free virions in the genital tract as well as in breast milk. These characteristics of nevirapine suggest that treatment of an HIV-infected pregnant woman in labor with an oral dose of nevirapine may provide a prophylactic level of nevirapine in the infant during the time of exposure to virus in the birth canal and/or maternal blood. In addition, nevirapine may inactivate the virion-associated RT present in cell-free virions in the genital tract or breast milk.

Women are randomized to receive either NVP or the corresponding placebo in active labor. Women are randomized at any time after their 32nd week gestation \[AS PER AMENDMENT 1/13/98: 28th week gestation\] \[AS PER AMENDMENT 2/23/00: 20th week gestation\]. The randomization is stratified using two factors: (1) use of \[AS PER AMENDMENT 2/23/00: current or anticipated\] antiretroviral therapy during the current pregnancy (no therapy at all; monotherapy for any duration; multi-agent therapy for any duration), and (2) CD4 cell count at the time of randomization (less than 200 cells; 200 - 399 cells; 400 cells or greater). Mothers are followed on study for 4 to 6 weeks postpartum. Mothers are also encouraged to follow the regimen of zidovudine (ZDV) outlined in the Office of Public Health and Science (PHS) treatment guidelines for both themselves and their infants. Infants are administered either NVP or placebo between 48 and 72 hours of life. The infant's study drug is the same as the mother's randomized treatment assignment. Infants are dosed with the study drug according to their randomization group regardless of whether the mother received the study drug. Infants are followed for 4 to 6 weeks, and are tested for HIV at 4 to 6 weeks, 3 months, and 6 months.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
2009
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

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

Trial Locations

Locations (72)

Univ of South Alabama

🇺🇸

Mobile, Alabama, United States

UCSD Med Ctr / Pediatrics / Clinical Sciences

🇺🇸

La Jolla, California, United States

UCLA Med Ctr / Pediatric

🇺🇸

Los Angeles, California, United States

Long Beach Memorial (Pediatric)

🇺🇸

Long Beach, California, United States

Los Angeles County - USC Med Ctr

🇺🇸

Los Angeles, California, United States

Harbor - UCLA Med Ctr / UCLA School of Medicine

🇺🇸

Los Angeles, California, United States

Connecticut Children's Med Ctr

🇺🇸

Farmington, Connecticut, United States

Howard Univ Hosp

🇺🇸

Washington, District of Columbia, United States

North Broward Hosp District

🇺🇸

Fort Lauderdale, Florida, United States

Univ of Florida Gainesville

🇺🇸

Gainesville, Florida, United States

Univ of Florida Health Science Ctr / Pediatrics

🇺🇸

Jacksonville, Florida, United States

Med College of Georgia

🇺🇸

Augusta, Georgia, United States

The Med Ctr Inc

🇺🇸

Columbus, Georgia, United States

Cook County Hosp

🇺🇸

Chicago, Illinois, United States

Univ of Illinois College of Medicine / Pediatrics

🇺🇸

Chicago, Illinois, United States

Chicago Children's Memorial Hosp

🇺🇸

Chicago, Illinois, United States

Univ of Chicago Children's Hosp

🇺🇸

Chicago, Illinois, United States

Tulane Univ / Charity Hosp of New Orleans

🇺🇸

New Orleans, Louisiana, United States

Tulane Univ Hosp of New Orleans

🇺🇸

New Orleans, Louisiana, United States

Univ Hosp

🇺🇸

New Orleans, Louisiana, United States

Univ of Maryland at Baltimore / Univ Med Ctr

🇺🇸

Baltimore, Maryland, United States

Johns Hopkins Hosp - Pediatric

🇺🇸

Baltimore, Maryland, United States

Univ of Massachusetts Med School

🇺🇸

Worcester, Massachusetts, United States

Baystate Med Ctr of Springfield

🇺🇸

Springfield, Massachusetts, United States

Univ of Mississippi Med Ctr

🇺🇸

Jackson, Mississippi, United States

Cooper Hosp - Univ Med Ctr / UMDNJ - New Jersey Med Schl

🇺🇸

Camden, New Jersey, United States

UMDNJ - Robert Wood Johnson Med School / Pediatrics

🇺🇸

New Brunswick, New Jersey, United States

Univ of Medicine & Dentistry of New Jersey / Univ Hosp

🇺🇸

Newark, New Jersey, United States

Saint Joseph's Hosp and Med Ctr/UMDNJ - New Jersey Med Schl

🇺🇸

Newark, New Jersey, United States

St Peter's Med Ctr

🇺🇸

New Brunswick, New Jersey, United States

Children's Hosp at Albany Med Ctr

🇺🇸

Albany, New York, United States

Bronx Municipal Hosp Ctr/Jacobi Med Ctr

🇺🇸

Bronx, New York, United States

Bronx Lebanon Hosp Ctr

🇺🇸

Bronx, New York, United States

Bellevue Hosp / New York Univ Med Ctr

🇺🇸

New York, New York, United States

North Shore Univ Hosp

🇺🇸

Great Neck, New York, United States

Metropolitan Hosp Ctr

🇺🇸

New York, New York, United States

SUNY Health Sciences Ctr at Syracuse / Pediatrics

🇺🇸

Syracuse, New York, United States

Univ of Rochester Med Ctr

🇺🇸

Rochester, New York, United States

Columbia Presbyterian Med Ctr

🇺🇸

New York, New York, United States

Children's Hosp of Philadelphia

🇺🇸

Philadelphia, Pennsylvania, United States

Saint Christopher's Hosp for Children

🇺🇸

Philadelphia, Pennsylvania, United States

Hosp of the Univ of Pennsylvania

🇺🇸

Philadelphia, Pennsylvania, United States

Med Univ of South Carolina

🇺🇸

Charleston, South Carolina, United States

Temple Univ School of Medicine

🇺🇸

Philadelphia, Pennsylvania, United States

Methodist Hosp Central

🇺🇸

Memphis, Tennessee, United States

Children's Med Ctr of Dallas

🇺🇸

Dallas, Texas, United States

Senetara Norfolk Gen Hosp

🇺🇸

Norfolk, Virginia, United States

Children's Hosp of the King's Daughters

🇺🇸

Norfolk, Virginia, United States

Med College of Virginia

🇺🇸

Richmond, Virginia, United States

Tacoma Gen Hosp

🇺🇸

Tacoma, Washington, United States

Ramon Ruiz Arnau Univ Hosp / Pediatrics

🇵🇷

Bayamon, Puerto Rico

Children's Hosp of Boston

🇺🇸

Boston, Massachusetts, United States

Brigham and Women's Hosp

🇺🇸

Boston, Massachusetts, United States

Boston City Hosp / Pediatrics

🇺🇸

Boston, Massachusetts, United States

Texas Children's Hosp / Baylor Univ

🇺🇸

Houston, Texas, United States

Children's Hospital & Medical Center / Seattle ACTU

🇺🇸

Seattle, Washington, United States

Univ of Miami / Jackson Memorial Hosp

🇺🇸

Miami, Florida, United States

Univ of Miami (Pediatric)

🇺🇸

Miami, Florida, United States

San Francisco Gen Hosp

🇺🇸

San Francisco, California, United States

UCSF / Moffitt Hosp - Pediatric

🇺🇸

San Francisco, California, United States

Duke Univ Med Ctr

🇺🇸

Durham, North Carolina, United States

Univ of North Carolina at Chapel Hill / Duke Univ Med Ctr

🇺🇸

Durham, North Carolina, United States

Saint Jude Children's Research Hosp of Memphis

🇺🇸

Memphis, Tennessee, United States

Washington Hosp Ctr

🇺🇸

Washington, District of Columbia, United States

Univ of Connecticut / Farmington

🇺🇸

Farmington, Connecticut, United States

Univ of Puerto Rico / Univ Children's Hosp AIDS

🇵🇷

San Juan, Puerto Rico

Vanderbilt Univ Med Ctr

🇺🇸

Nashville, Tennessee, United States

Regional Med Ctr at Memphis

🇺🇸

Memphis, Tennessee, United States

San Juan City Hosp

🇵🇷

San Juan, Puerto Rico

Univ of Alabama at Birmingham - Pediatric

🇺🇸

Birmingham, Alabama, United States

Children's Hosp of Denver

🇺🇸

Denver, Colorado, United States

Children's Hosp of Michigan

🇺🇸

Detroit, Michigan, United States

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