Extended Infant Post-exposure Prophylaxis With Antiretrovirals to Reduce Postnatal HIV Transmission

NCT ID: NCT00115648

Last Updated: 2014-03-07

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

3300 participants

Study Classification

INTERVENTIONAL

Study Start Date

2004-04-30

Study Completion Date

2009-10-31

Brief Summary

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The purpose of this study is to determine if extended antiretroviral regimens given to the infant during the first 14 weeks of age would decrease breast milk transmission of HIV.

Detailed Description

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This is a three-arm randomized, open label, clinical trial to evaluate the effectiveness of two extended regimens of antiretrovirals compared to infant single dose nevirapine plus AZT given twice daily for 1 week (comparison regimen). All infants receive the comparison regimen at birth and then randomized at birth to start either one of the two extended regimens after the first week. The extended regimens are nevirapine daily and nevirapine plus AZT daily - both regimens are given up to age 14 weeks.

Conditions

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HIV Infections

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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A

Single dose NVP + ZDV daily for the first week.

Group Type ACTIVE_COMPARATOR

Nevirapine

Intervention Type DRUG

Oral NVP daily dosage

AZT

Intervention Type DRUG

Oral AZT daily

NVP and AZT

Intervention Type DRUG

Oral single dose NVP plus oral daily AZT during the first weeks

C

Arm A plus NVP + ZDV daily to age 14 weeks.

Group Type EXPERIMENTAL

Nevirapine

Intervention Type DRUG

Oral NVP daily dosage

AZT

Intervention Type DRUG

Oral AZT daily

NVP+AZT

Intervention Type DRUG

Oral NVP daily plus oral AZT daly to age 14 weeks

B

Arm A plus oral NVP daily to age 14 weeks.

Group Type EXPERIMENTAL

Nevirapine

Intervention Type DRUG

Oral NVP daily dosage

NVP

Intervention Type DRUG

Oral NVP daily to age 14 weeks

Interventions

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Nevirapine

Oral NVP daily dosage

Intervention Type DRUG

AZT

Oral AZT daily

Intervention Type DRUG

NVP and AZT

Oral single dose NVP plus oral daily AZT during the first weeks

Intervention Type DRUG

NVP

Oral NVP daily to age 14 weeks

Intervention Type DRUG

NVP+AZT

Oral NVP daily plus oral AZT daly to age 14 weeks

Intervention Type DRUG

Other Intervention Names

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Zidovuidne (ZDV) Nevirapine and zidovudine Nevirapine Nevirapine plus zidovudine

Eligibility Criteria

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Inclusion Criteria

* Had given birth within the last 24 hours
* Ability and willingness to give informed consent for HIV testing and enrollment into the study
* Willing to receive HIV results
* HIV infected
* Planning to deliver or had given birth at the study clinics
* Willing to come back for follow-up visits for 2 years postnatally
* Resident of Blantyre city or its suburbs

Exclusion Criteria

* HIV negative
* Women with discordant HIV results
* Women who indicate that they will not breastfeed at time of delivery
* Inability or unwillingness to follow any of the inclusion requirements
* Newborn with life-threatening condition
* Women who previously enrolled in this study and have a second pregnancy cannot reenroll
Minimum Eligible Age

18 Years

Maximum Eligible Age

54 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Centers for Disease Control and Prevention

FED

Sponsor Role collaborator

Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

NIH

Sponsor Role collaborator

Johns Hopkins Bloomberg School of Public Health

OTHER

Sponsor Role lead

Responsible Party

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Centers for Disease Control and Prevention

Principal Investigators

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Taha E Taha, MD PhD

Role: PRINCIPAL_INVESTIGATOR

Johns Hopkins Bloomberg School of Public Health

Locations

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College of Medicine

Blantyre, , Malawi

Site Status

Countries

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Malawi

References

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Schwartz SR, Kumwenda N, Kumwenda J, Chen S, Mofenson LM, Taylor AW, Fowler MG, Taha TE. Maternal Highly Active Antiretroviral Therapy and Child HIV-Free Survival in Malawi, 2004-2009. Matern Child Health J. 2016 Mar;20(3):542-9. doi: 10.1007/s10995-015-1852-5.

Reference Type DERIVED
PMID: 26525557 (View on PubMed)

Redd AD, Wendel SK, Longosz AF, Fogel JM, Dadabhai S, Kumwenda N, Sun J, Walker MP, Bruno D, Martens C, Eshleman SH, Porcella SF, Quinn TC, Taha TE. Evaluation of postpartum HIV superinfection and mother-to-child transmission. AIDS. 2015 Jul 31;29(12):1567-73. doi: 10.1097/QAD.0000000000000740.

Reference Type DERIVED
PMID: 26244396 (View on PubMed)

Taha TE, Li Q, Hoover DR, Mipando L, Nkanaunena K, Thigpen MC, Taylor A, Kumwenda J, Fowler MG, Mofenson LM, Kumwenda NI. Postexposure prophylaxis of breastfeeding HIV-exposed infants with antiretroviral drugs to age 14 weeks: updated efficacy results of the PEPI-Malawi trial. J Acquir Immune Defic Syndr. 2011 Aug 1;57(4):319-25. doi: 10.1097/QAI.0b013e318217877a.

Reference Type DERIVED
PMID: 21423025 (View on PubMed)

Kumwenda NI, Hoover DR, Mofenson LM, Thigpen MC, Kafulafula G, Li Q, Mipando L, Nkanaunena K, Mebrahtu T, Bulterys M, Fowler MG, Taha TE. Extended antiretroviral prophylaxis to reduce breast-milk HIV-1 transmission. N Engl J Med. 2008 Jul 10;359(2):119-29. doi: 10.1056/NEJMoa0801941. Epub 2008 Jun 4.

Reference Type DERIVED
PMID: 18525035 (View on PubMed)

Other Identifiers

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PEPI-Malawi

Identifier Type: -

Identifier Source: org_study_id

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