Evaluating Strategies to Reduce Mother-to-Child Transmission of HIV Infection in Resource-Limited Countries
NCT ID: NCT01061151
Last Updated: 2022-02-11
Study Results
Results available
Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.
View full resultsBasic Information
Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.
Recruitment Status
COMPLETED
Clinical Phase
PHASE3
Total Enrollment
3747 participants
Study Classification
INTERVENTIONAL
Study Start Date
2011-03-01
Study Completion Date
2016-09-30
Brief Summary
Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.
The purpose of this study was to examine, in an integrated and comprehensive fashion, three critical questions currently facing HIV-infected pregnant and postpartum women and their infants:
1. What is the optimal intervention for the prevention of antepartum and intrapartum transmission of HIV?
2. What is the optimal intervention for the prevention of postpartum transmission in breastfeeding (BF) infants?
3. What is the optimal intervention for the preservation of maternal health after the risk period for prevention of mother-to-child-transmission ends (either at delivery or cessation of BF)?
The overall PROMISE protocol had three separate interventional components to address each of these three questions and was conducted at locations in Africa and other parts of the world. Due to variations in the standard of care for HIV-infected pregnant and postpartum women and their infants at different sites, not all of these questions were relevant. Therefore, two separate versions of the PROMISE protocol were developed, each containing only the relevant components. The 1077BF protocol was used at sites where the standard method of infant feeding was breastfeeding, whereas the 1077FF protocol was used at sites where the standard method of infant feeding was formula feeding. The analyses were collapsed across the two protocol versions, and therefore the summaries contain the results of the 1077BF and/or the 1077FF protocols.
1. What is the optimal intervention for the prevention of antepartum and intrapartum transmission of HIV?
2. What is the optimal intervention for the prevention of postpartum transmission in breastfeeding (BF) infants?
3. What is the optimal intervention for the preservation of maternal health after the risk period for prevention of mother-to-child-transmission ends (either at delivery or cessation of BF)?
The overall PROMISE protocol had three separate interventional components to address each of these three questions and was conducted at locations in Africa and other parts of the world. Due to variations in the standard of care for HIV-infected pregnant and postpartum women and their infants at different sites, not all of these questions were relevant. Therefore, two separate versions of the PROMISE protocol were developed, each containing only the relevant components. The 1077BF protocol was used at sites where the standard method of infant feeding was breastfeeding, whereas the 1077FF protocol was used at sites where the standard method of infant feeding was formula feeding. The analyses were collapsed across the two protocol versions, and therefore the summaries contain the results of the 1077BF and/or the 1077FF protocols.
Related Clinical Trials
Explore similar clinical trials based on study characteristics and research focus.
Extended Infant Post-exposure Prophylaxis With Antiretrovirals to Reduce Postnatal HIV Transmission
NCT00115648
HIV Infections
COMPLETED
PHASE3
Prenatal and Postnatal Studies of Interventions for Prevention of Mother-To-Child Transmission
NCT00028145
HIV Infections
Pregnancy Complications, Infectious
COMPLETED
Immediate or Deferred Pre-exposure Prophylaxis for HIV Prevention: Safe Options for Pregnant and Lactating Women
NCT03227731
HIV-1-infection
COMPLETED
PHASE2/PHASE3
Infant Peri-Exposure Prophylaxis to Prevent HIV-1 Transmission by Breastfeeding: Mechanisms & Safety
NCT03519503
Growth and Development
COMPLETED
Universal Use of EFV-TDF-FTC and AZT-3TC-LPV/r Combinations for HIV-1 PMTCT in Pregnant and Breastfeeding Women : a Phase 3 Trial
NCT00936195
HIV Infection
Pregnancy
Breastfeeding
+1 more
WITHDRAWN
PHASE3
Detailed Description
Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.
The incidence of mother-to-child transmission (MTCT) of HIV has decreased in recent years in the United States, Europe, and other resource-advantaged countries. Several factors have contributed to this decrease, including the administration of HAART during pregnancy, caesarean section delivery methods, and the use of formula instead of breastfeeding to feed infants. However, in resource-limited countries, the incidence of pediatric HIV infection remains high. Many pregnant women in these countries do not receive an adequate course of HAART, and the majority breastfeed their children.
This study was divided into three components (Antepartum, Postpartum, and Maternal Health Components). The following is a description of each of the three open label sequential randomization components, each designed to address one of the following three main objectives:
1. Antepartum Component: This PROMISE component compared the safety and efficacy of different HAART regimens for preventing the transmission of HIV during pregnancy, labor, and delivery.
* Participants were randomly assigned to one of the following three arms:
* Maternal Regimens:
* Arm A : 1) Zidovudine (ZDV) from study entry through delivery, 2) single dose nevirapine (sdNVP) and emtricitabine-tenofovir disoproxil (TRV ) intrapartum, and 3) TRV postpartum for up to 14 days post-partum. Arm A is also labeled as ZDV+sdNVP+TRV tail.
* Arm B: Lamivudine (3TC)-zidovudine (ZDV) + lopinavir (LPV)-ritonavir (RTV) from study entry up to 14 days postpartum. Arm B is also labeled as 3TC-ZDV/LPV-RTV.
* Arm C: TRV/LPV-RTV from study entry up to 14 days postpartum. Arm C is also labeled as FTC-TDF/LPV-RTV.
* All infants born to women enrolled in this study were to receive NVP once a day as soon as possible after birth through 42 days of age or until the Week 6 study visit, whichever was later. Women switched or initiated HAART if it was needed for their own health.
* During pregnancy, participants attended study visits at study entry, 2 and 4 weeks after entry, and then every 4 weeks until labor and delivery. Women and infants were monitored during labor and delivery and attended a study visit 6 to 14 days after delivery. After delivery, eligibility criteria were assessed for subsequent randomizations (either Postpartum or Maternal Health). If they failed the entry criteria for the subsequent randomization, the mothers remained in follow-up for safety assessments and the infants were followed until the 104 week visit; otherwise they were followed under the subsequent component.
* All three antepartum arms were not available to all women throughout the PROMISE study. When the trial began, there were limited safety data on tenofovir in pregnancy, and randomization to tenofovir-based ART was limited to women coinfected with HIV and HBV, because benefit was felt to outweigh risk in that group. During period 1 (PROMISE protocol version 2.0 - April 2011 through September 2012), women without HBV coinfection were randomized to either Arm A or Arm B; and Hepatitis B (HBV) co-infected women were randomized to either Arm A, Arm B, or Arm C. However, in October 2012, with increased data on tenofovir in pregnancy, the protocol was modified to allow women regardless of HBV status to be assigned to any of the three regimens during period 2 (PROMISE protocol version 3.0 - October 2012 through the end of antepartum enrollment on October 1, 2014). By arm comparisons were restricted to times in which there were contemporaneous randomizations.
* Late Presenters: In addition the Antepartum Component, participants could enter PROMISE through the Late Presenters Registration (LP). Late presenters were identified in early or active labor or in the immediate postpartum period (up to 5 days postpartum). The Late Presenters Registration facilitated a structure to screen women and infants for randomization in the Postpartum Component. Women and infants not randomized in the Postpartum Component of PROMISE were followed through the Week 6 visit.
* There were 3543 mothers and 3407 live born infants enrolled in the Antepartum Component. There were 204 mothers and 204 live born infants in the Late Presenters Registration.
2. Postpartum Component: This PROMISE component compared the safety and efficacy of maternal triple ARV prophylaxis versus daily infant NVP prophylaxis for the prevention of mother-to-child transmission (PMTCT) through breastfeeding. The Postpartum Component consisted of mothers and infants from the Antepartum Component and the Late Presenters Registration who passed the Postpartum Component entry criteria.
* Participants were randomly assigned to one of two arms:
* Arm A: Women received LPV-RTV plus TRV from the Week 1 postpartum visit through the end of maternal follow-up (2 to 5 years). Infants received NVP once a day through 42 days of age or until the Week 6 study visit, whichever was later.
* Arm B: Infants received NVP once a day from the Week 1 postpartum visit until the end of risk for MTCT or until 18 months postpartum (104 weeks). Women did not receive antiretroviral drugs for MTCT prophylaxis.
* The maternal study visits were at entry, at postpartum weeks 6, 14, 26, and every 12 weeks thereafter. Infant study visits were at entry, every 4 weeks between postpartum weeks 6-26, every 12 weeks between postpartum week 38-98, and at postpartum week 104. At the end of risk for MTCT or 18 months postpartum, the mothers' eligibility criteria were assessed for a subsequent randomization in the Maternal Health Component. If they did not meet entry criteria for the Maternal Health randomization, they remained in follow-up for safety assessments; otherwise they were followed under the Maternal Health Component. Infants were followed until the 104 week visit.
* Women switched or initiated HAART if it was needed for their own health. If a woman in Arm B initiated HAART then her infant discontinued NVP after 12 weeks of HAART or after her viral load was suppressed, whichever came first.
* There were 2431 mothers and 2444 infants randomized as part of the Postpartum Component.
3. Maternal Health Component: This PROMISE component randomized women to continue or discontinue HAART after the end of risk for MTCT, either after delivery or after breastfeeding. Participants included women who were receiving the triple ARV regimen in the Postpartum Component; or receiving the triple ARV regimen in the Antepartum Component and were ineligible for the Postpartum Component.
* Participants were randomly assigned to one of two study arms:
* Arm A: Participants continued to receive the triple ARV regimen (preferred regimen was LPV-RTV plus TRV).
* Arm B: Participants discontinued the triple ARV regimen.
* Study visits occurred at Weeks 4 and 12 and then every 3 months thereafter. Study visits included a medical history review, questionnaires, physical exam, and blood collection. Women switched or initiated a triple ARV regimen if it was needed for their own health.
* There were 875 mothers randomized as part of the Maternal Health Component.
* The analyses for the Maternal Health Component we not solely based on the Maternal Health Randomization. Instead there were four prespecified comparison groups for the Maternal Health Component. The four comparison groups used the three randomizations as appropriate to answer the following questions:
* Question 1: What is the effect on women of using a maternal triple ARV regimen to prevent MTCT during pregnancy, relative to using ZDV + sdNVP + TRV tail to prevent MTCT during pregnancy?
* Question 2: What is the effect on women of using a maternal triple ARV regimen to prevent MTCT during breastfeeding, relative to using infant NVP to prevent MTCT during breastfeeding?
* Question 3: What is the effect on women of extending versus discontinuing the antepartum/intrapartum maternal triple ARV regimen at the time of birth?
* Question 4: What is the effect on women of extending versus discontinuing the postpartum maternal triple ARV regimen after the cessation of risk for MTCT during breastfeeding?
* There were 1602 mothers included in the analyses for Question 2.
PROMISE mothers were followed for 2 to 5 years, depending on when they enrolled. Infants were followed up to 104 weeks of age. Infant and maternal follow-up ended in September 2016. PROMISE randomizations were halted in the summer of 2014 due to slow accrual to the Later Presenters Registration and the Formula Feeding protocol. Due to the results of an external study, on July 7th 2015 the PROMISE interventions were halted and ART was offered to all participants. Per recommendation from the Data and Safety and Monitoring Board on November 4th 2014, the primary analyses for the Antepartum Component include follow-up through September 10th, 2014. Per recommendation from the Data and Safety and Monitoring Board on November 12th 2015, the primary analyses for the Postpartum Component include follow-up through July 7th, 2015. The Adverse Events in the Reported Adverse Event section include all study follow-up.
This study was divided into three components (Antepartum, Postpartum, and Maternal Health Components). The following is a description of each of the three open label sequential randomization components, each designed to address one of the following three main objectives:
1. Antepartum Component: This PROMISE component compared the safety and efficacy of different HAART regimens for preventing the transmission of HIV during pregnancy, labor, and delivery.
* Participants were randomly assigned to one of the following three arms:
* Maternal Regimens:
* Arm A : 1) Zidovudine (ZDV) from study entry through delivery, 2) single dose nevirapine (sdNVP) and emtricitabine-tenofovir disoproxil (TRV ) intrapartum, and 3) TRV postpartum for up to 14 days post-partum. Arm A is also labeled as ZDV+sdNVP+TRV tail.
* Arm B: Lamivudine (3TC)-zidovudine (ZDV) + lopinavir (LPV)-ritonavir (RTV) from study entry up to 14 days postpartum. Arm B is also labeled as 3TC-ZDV/LPV-RTV.
* Arm C: TRV/LPV-RTV from study entry up to 14 days postpartum. Arm C is also labeled as FTC-TDF/LPV-RTV.
* All infants born to women enrolled in this study were to receive NVP once a day as soon as possible after birth through 42 days of age or until the Week 6 study visit, whichever was later. Women switched or initiated HAART if it was needed for their own health.
* During pregnancy, participants attended study visits at study entry, 2 and 4 weeks after entry, and then every 4 weeks until labor and delivery. Women and infants were monitored during labor and delivery and attended a study visit 6 to 14 days after delivery. After delivery, eligibility criteria were assessed for subsequent randomizations (either Postpartum or Maternal Health). If they failed the entry criteria for the subsequent randomization, the mothers remained in follow-up for safety assessments and the infants were followed until the 104 week visit; otherwise they were followed under the subsequent component.
* All three antepartum arms were not available to all women throughout the PROMISE study. When the trial began, there were limited safety data on tenofovir in pregnancy, and randomization to tenofovir-based ART was limited to women coinfected with HIV and HBV, because benefit was felt to outweigh risk in that group. During period 1 (PROMISE protocol version 2.0 - April 2011 through September 2012), women without HBV coinfection were randomized to either Arm A or Arm B; and Hepatitis B (HBV) co-infected women were randomized to either Arm A, Arm B, or Arm C. However, in October 2012, with increased data on tenofovir in pregnancy, the protocol was modified to allow women regardless of HBV status to be assigned to any of the three regimens during period 2 (PROMISE protocol version 3.0 - October 2012 through the end of antepartum enrollment on October 1, 2014). By arm comparisons were restricted to times in which there were contemporaneous randomizations.
* Late Presenters: In addition the Antepartum Component, participants could enter PROMISE through the Late Presenters Registration (LP). Late presenters were identified in early or active labor or in the immediate postpartum period (up to 5 days postpartum). The Late Presenters Registration facilitated a structure to screen women and infants for randomization in the Postpartum Component. Women and infants not randomized in the Postpartum Component of PROMISE were followed through the Week 6 visit.
* There were 3543 mothers and 3407 live born infants enrolled in the Antepartum Component. There were 204 mothers and 204 live born infants in the Late Presenters Registration.
2. Postpartum Component: This PROMISE component compared the safety and efficacy of maternal triple ARV prophylaxis versus daily infant NVP prophylaxis for the prevention of mother-to-child transmission (PMTCT) through breastfeeding. The Postpartum Component consisted of mothers and infants from the Antepartum Component and the Late Presenters Registration who passed the Postpartum Component entry criteria.
* Participants were randomly assigned to one of two arms:
* Arm A: Women received LPV-RTV plus TRV from the Week 1 postpartum visit through the end of maternal follow-up (2 to 5 years). Infants received NVP once a day through 42 days of age or until the Week 6 study visit, whichever was later.
* Arm B: Infants received NVP once a day from the Week 1 postpartum visit until the end of risk for MTCT or until 18 months postpartum (104 weeks). Women did not receive antiretroviral drugs for MTCT prophylaxis.
* The maternal study visits were at entry, at postpartum weeks 6, 14, 26, and every 12 weeks thereafter. Infant study visits were at entry, every 4 weeks between postpartum weeks 6-26, every 12 weeks between postpartum week 38-98, and at postpartum week 104. At the end of risk for MTCT or 18 months postpartum, the mothers' eligibility criteria were assessed for a subsequent randomization in the Maternal Health Component. If they did not meet entry criteria for the Maternal Health randomization, they remained in follow-up for safety assessments; otherwise they were followed under the Maternal Health Component. Infants were followed until the 104 week visit.
* Women switched or initiated HAART if it was needed for their own health. If a woman in Arm B initiated HAART then her infant discontinued NVP after 12 weeks of HAART or after her viral load was suppressed, whichever came first.
* There were 2431 mothers and 2444 infants randomized as part of the Postpartum Component.
3. Maternal Health Component: This PROMISE component randomized women to continue or discontinue HAART after the end of risk for MTCT, either after delivery or after breastfeeding. Participants included women who were receiving the triple ARV regimen in the Postpartum Component; or receiving the triple ARV regimen in the Antepartum Component and were ineligible for the Postpartum Component.
* Participants were randomly assigned to one of two study arms:
* Arm A: Participants continued to receive the triple ARV regimen (preferred regimen was LPV-RTV plus TRV).
* Arm B: Participants discontinued the triple ARV regimen.
* Study visits occurred at Weeks 4 and 12 and then every 3 months thereafter. Study visits included a medical history review, questionnaires, physical exam, and blood collection. Women switched or initiated a triple ARV regimen if it was needed for their own health.
* There were 875 mothers randomized as part of the Maternal Health Component.
* The analyses for the Maternal Health Component we not solely based on the Maternal Health Randomization. Instead there were four prespecified comparison groups for the Maternal Health Component. The four comparison groups used the three randomizations as appropriate to answer the following questions:
* Question 1: What is the effect on women of using a maternal triple ARV regimen to prevent MTCT during pregnancy, relative to using ZDV + sdNVP + TRV tail to prevent MTCT during pregnancy?
* Question 2: What is the effect on women of using a maternal triple ARV regimen to prevent MTCT during breastfeeding, relative to using infant NVP to prevent MTCT during breastfeeding?
* Question 3: What is the effect on women of extending versus discontinuing the antepartum/intrapartum maternal triple ARV regimen at the time of birth?
* Question 4: What is the effect on women of extending versus discontinuing the postpartum maternal triple ARV regimen after the cessation of risk for MTCT during breastfeeding?
* There were 1602 mothers included in the analyses for Question 2.
PROMISE mothers were followed for 2 to 5 years, depending on when they enrolled. Infants were followed up to 104 weeks of age. Infant and maternal follow-up ended in September 2016. PROMISE randomizations were halted in the summer of 2014 due to slow accrual to the Later Presenters Registration and the Formula Feeding protocol. Due to the results of an external study, on July 7th 2015 the PROMISE interventions were halted and ART was offered to all participants. Per recommendation from the Data and Safety and Monitoring Board on November 4th 2014, the primary analyses for the Antepartum Component include follow-up through September 10th, 2014. Per recommendation from the Data and Safety and Monitoring Board on November 12th 2015, the primary analyses for the Postpartum Component include follow-up through July 7th, 2015. The Adverse Events in the Reported Adverse Event section include all study follow-up.
Conditions
See the medical conditions and disease areas that this research is targeting or investigating.
HIV Infections
Study Design
Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.
Allocation Method
RANDOMIZED
Intervention Model
PARALLEL
Primary Study Purpose
PREVENTION
Blinding Strategy
DOUBLE
Investigators
Outcome Assessors
The investigators and outcomes assessor did not receive by-arm tabulations while the study was ongoing.
Study Groups
Review each arm or cohort in the study, along with the interventions and objectives associated with them.
Antepartum Arm A
Mothers received ZDV + sdNVP + TRV Tail
Group Type
ACTIVE_COMPARATOR
Zidovudine (ZDV)
Intervention Type
DRUG
300 mg twice daily
Nevirapine (NVP): Antepartum Mothers
Intervention Type
DRUG
200 mg at onset of labor
Emtricitabine-tenofovir disoproxil fumarate (Truvada [TRV]) tail
Intervention Type
DRUG
200 mg/300 mg x 2 tablets at onset of labor or as soon as possible thereafter; 200 mg/300 mg orally each day after delivery for 7 days or the date of the Week 1 visit (up to 14 days), whichever is later.
Nevirapine (NVP): Infant short-course
Intervention Type
DRUG
Oral suspension (dosing according to birth weight) once a day through 42 days of age or through the week 6 visit, whichever is later.
Antepartum Arm B
Mothers received Triple ARV (3TC-ZDV + LPV-RTV)
Group Type
EXPERIMENTAL
Lamivudine-Zidovudine (3TC-ZDV)
Intervention Type
DRUG
150 mg/300 mg twice daily
Lopinavir-ritonavir (LPV-RTV)
Intervention Type
DRUG
400 mg/100 mg twice daily beginning at \>= 14 weeks gestation; 600 mg/150 mg twice daily beginning at \>= 28 weeks gestation or at next visit (during third trimester) through delivery; 400 mg/100 mg twice daily after delivery up to 14 days postpartum.
Nevirapine (NVP): Infant short-course
Intervention Type
DRUG
Oral suspension (dosing according to birth weight) once a day through 42 days of age or through the week 6 visit, whichever is later.
Antepartum Arm C
Mothers received Triple ARV (TRV + LPV-RTV)
Group Type
EXPERIMENTAL
Lopinavir-ritonavir (LPV-RTV)
Intervention Type
DRUG
400 mg/100 mg twice daily beginning at \>= 14 weeks gestation; 600 mg/150 mg twice daily beginning at \>= 28 weeks gestation or at next visit (during third trimester) through delivery; 400 mg/100 mg twice daily after delivery up to 14 days postpartum.
Emtricitabine-tenofovir disoproxil fumarate (Truvada [TRV])
Intervention Type
DRUG
200 mg/300 mg
Nevirapine (NVP): Infant short-course
Intervention Type
DRUG
Oral suspension (dosing according to birth weight) once a day through 42 days of age or through the week 6 visit, whichever is later.
Late Presenters
Registration to facilitate a structure to screen women and infants for randomization in the Postpartum Component.
Group Type
OTHER
No Intervention
Intervention Type
OTHER
Women registered before/during labor received the full Antepartum Arm A regimen.
Women registered after labor, and who received nevirapine outside of the study, received the Emtricitabine-tenofovir disoproxil fumarate (Truvada \[TRV\]) tail.
Postpartum Arm A (Maternal Prophylaxis)
Mothers received prophylaxis \[preferred regimen: TRV + LPV-RTV\]. Infants received short-course NVP.
Group Type
EXPERIMENTAL
Lopinavir-ritonavir (LPV-RTV)
Intervention Type
DRUG
400 mg/100 mg twice daily beginning at \>= 14 weeks gestation; 600 mg/150 mg twice daily beginning at \>= 28 weeks gestation or at next visit (during third trimester) through delivery; 400 mg/100 mg twice daily after delivery up to 14 days postpartum.
Emtricitabine-tenofovir disoproxil fumarate (Truvada [TRV])
Intervention Type
DRUG
200 mg/300 mg
Nevirapine (NVP): Infant short-course
Intervention Type
DRUG
Oral suspension (dosing according to birth weight) once a day through 42 days of age or through the week 6 visit, whichever is later.
Postpartum Arm B (Infant Prophylaxis)
Infants received extended NVP.
Group Type
EXPERIMENTAL
Nevirapine (NVP): Infant extended
Intervention Type
DRUG
Oral suspension (dosing according to birth weight) once a day from 6 (up to 14) days of age until there was no longer any risk of MTCT or until the end of follow-up (104 weeks), whichever came first.
Maternal Health Arm A (Continue triple ARVs)
Mothers continued receiving triple ARV regimen \[preferred regimen: TRV + LPV-RTV\].
Group Type
EXPERIMENTAL
Continue triple ARVs
Intervention Type
OTHER
Mothers could be prescribed any licensed antiretroviral medication, as long as the treatment met the definition of HAART (three ARV drugs from two or more drug classes).
Maternal Health Arm B (Discontinue triple ARVs)
Mothers discontinued triple ARV regimen.
Group Type
ACTIVE_COMPARATOR
Discontinue triple ARVs
Intervention Type
OTHER
ARVs were discontinued. When protocol specified criteria were met, mothers could be prescribed any licensed antiretroviral medication, as long as the treatment met the definition of HAART (three ARV drugs from two or more drug classes).
Interventions
Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.
Zidovudine (ZDV)
300 mg twice daily
Intervention Type
DRUG
Nevirapine (NVP): Antepartum Mothers
200 mg at onset of labor
Intervention Type
DRUG
Emtricitabine-tenofovir disoproxil fumarate (Truvada [TRV]) tail
200 mg/300 mg x 2 tablets at onset of labor or as soon as possible thereafter; 200 mg/300 mg orally each day after delivery for 7 days or the date of the Week 1 visit (up to 14 days), whichever is later.
Intervention Type
DRUG
Lamivudine-Zidovudine (3TC-ZDV)
150 mg/300 mg twice daily
Intervention Type
DRUG
Lopinavir-ritonavir (LPV-RTV)
400 mg/100 mg twice daily beginning at \>= 14 weeks gestation; 600 mg/150 mg twice daily beginning at \>= 28 weeks gestation or at next visit (during third trimester) through delivery; 400 mg/100 mg twice daily after delivery up to 14 days postpartum.
Intervention Type
DRUG
Emtricitabine-tenofovir disoproxil fumarate (Truvada [TRV])
200 mg/300 mg
Intervention Type
DRUG
Nevirapine (NVP): Infant short-course
Oral suspension (dosing according to birth weight) once a day through 42 days of age or through the week 6 visit, whichever is later.
Intervention Type
DRUG
Nevirapine (NVP): Infant extended
Oral suspension (dosing according to birth weight) once a day from 6 (up to 14) days of age until there was no longer any risk of MTCT or until the end of follow-up (104 weeks), whichever came first.
Intervention Type
DRUG
No Intervention
Women registered before/during labor received the full Antepartum Arm A regimen.
Women registered after labor, and who received nevirapine outside of the study, received the Emtricitabine-tenofovir disoproxil fumarate (Truvada \[TRV\]) tail.
Intervention Type
OTHER
Discontinue triple ARVs
ARVs were discontinued. When protocol specified criteria were met, mothers could be prescribed any licensed antiretroviral medication, as long as the treatment met the definition of HAART (three ARV drugs from two or more drug classes).
Intervention Type
OTHER
Continue triple ARVs
Mothers could be prescribed any licensed antiretroviral medication, as long as the treatment met the definition of HAART (three ARV drugs from two or more drug classes).
Intervention Type
OTHER
Eligibility Criteria
Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.
Inclusion Criteria
* Confirmed HIV-1 infection, defined as documented positive results from two samples collected at different time points prior to study entry. More information on this criterion can be found in the protocol.
* Currently pregnant and greater than or equal to 14 weeks gestation based on clinical or other obstetrical measurements
* CD4 count greater than or equal to 350 cells/mm\^3, or greater than or equal to the country-specific threshold for initiation of treatment (if that threshold is greater than 350 cells/mm\^3), on a specimen obtained within 30 days prior to study entry
* Results of HBV screening (HBsAg testing) available from specimen obtained within 30 days prior to study entry
* The following laboratory values from a specimen obtained within 30 days prior to study entry:
1. Hemoglobin greater than or equal to 7.5 g/dL
2. White blood cell count (WBC) greater than or equal to 1,500 cells/mm\^3
3. Absolute neutrophil count (ANC) greater than or equal to 750 cells/mm\^3
4. Platelets greater than or equal to 50,000 cells/mm\^3
5. Alanine aminotransferase (ALT) less than or equal to 2.5 times the upper limit of normal (ULN)
6. Estimated creatinine clearance of greater than or equal to 60 mL/min using the Cockroft-Gault equation for women
* Plans to deliver in the study-affiliated clinic or hospital
* Has no plans to move outside of the study site area during the 24 months following delivery
* Age of legal majority for the respective country and willing and able to provide written informed consent
* Age of legal majority for the respective country
* HIV-1 infection, defined as documented positive results from tests performed on one sample at any time prior to Late Presenter Registration
* In labor (from onset/early labor or beyond) or within 5 days after delivery (with day of delivery considered day 0)
* Has provided written informed consent
* Has no plans to move outside of the study site area during the 24 months following delivery
* If delivered, infant alive and healthy (In the case of a multiple birth, a mother-infant pair will be included in the Late Presenter registration only if both/all infants and the mother meet the eligibility criteria. If only one infant of a multiple birth is alive, the M-I pair may be registered if the infant and the mother otherwise meet all of the eligibility criteria.)
* Participation in the Antepartum Component or registered as a Late Presenter
* Provided written informed consent
* Has no plans to move outside of the study site area during the 24 months following delivery
* Maternal CD4 count greater than or equal to 350 cells/mm\^3, or greater than or equal to the country-specific threshold for initiation of treatment (if that threshold is greater than 350 cells/mm\^3), from a specimen obtained within 30 days prior to study entry. More information on this criterion can be found in the protocol.
* The following maternal laboratory values within 30 days prior to entry:
1. Hemoglobin greater than or equal to 7.0 g/dL
2. WBC greater than or equal to 1,500 cells/mm\^3
3. ANC greater than or equal to 750 cells/mm\^3
4. Platelets greater than or equal to 50,000 cells/mm\^3
5. ALT less than or equal to 2.5 times the upper limit of normal (ULN)
6. Estimated creatinine clearance of greater than or equal to 60 mL/min using the Cockroft-Gault equation for women
* Infant alive, healthy, less than or equal to 14 days of age, and uninfected (negative HIV NAT result on specimen drawn prior to study entry)
* The following infant lab values on specimen obtained prior to study entry (within 14 days of birth):
1. Hemoglobin greater than or equal to 10 g/dL
2. WBC greater than or equal to 1,500 cells/mm\^3
3. ANC greater than or equal to 750 cells/mm\^3
4. Platelets greater than or equal to 50,000 cells/mm\^3
5. ALT less than or equal to 2.5 times the ULN
* For Registered Late Presenters: Confirmed maternal HIV-1 infection, defined as documented positive results from two samples collected at different time points at any time prior to entry. More information on this criterion can be found in the protocol.
* Randomly assigned to triple ARV prophylaxis as part of the Postpartum Component and has continued triple ARV prophylaxis until the current randomization without treatment interruption (defined as more than 14 consecutive days of missed dosing) within the previous 30 days; OR randomly assigned to triple ARV prophylaxis in the Antepartum Component but ineligible for the Postpartum Component and has continued triple ARV prophylaxis until the current randomization without treatment interruption (defined as more than 7 consecutive days of missed dosing) within the previous 30 days
* Within two weeks after complete breastfeeding cessation is achieved (defined as completely stopping all exposure to breast milk for greater than or equal to 28 days); i.e., within 29 to 42 days of last breast milk exposure, or reached 18 months postpartum (whichever comes first). Women who reach 18 months postpartum while still breastfeeding will be eligible for entry within 2 weeks before and 4 weeks after the Week 74 visit (Week 72-78); OR if the woman was randomized to triple ARV prophylaxis in the Postpartum Component and her infant is infected and still breastfeeding, she will be eligible for the Maternal Health Component within 42 days of specimen collection for the confirmatory infant HIV NAT; OR if the woman was randomized to triple ARV prophylaxis in the Antepartum Component but mother-infant pair was ineligible for the Postpartum Component she will be eligible for the Maternal Health Component beginning at the Week 1 visit (6-14 days postpartum) through 28 days after delivery; these women should be randomized as soon as possible, ideally within 6-14 days after delivery; OR if the woman was randomized to triple ARV prophylaxis in the Postpartum Component and breastfeeding risk for MTCT ceases for other reasons (e.g., infant death or permanent removal from home through legal services or adoption) within 28 days of event. More information on this criterion can be found in the protocol.
* Provided written informed consent
* CD4 cell count greater than or equal to 350 cells/mm\^3, or greater than or equal to the country-specific threshold for initiation of treatment (if that threshold is greater than 350 cells/mm\^3), on a specimen obtained within 30 days prior to study entry
* The following laboratory values on a specimen obtained within 30 days prior to study entry:
1. ANC greater than or equal to 750 cells/mm\^3
2. Hemoglobin greater than or equal to 7.0 gm/dL
3. Platelet count greater than or equal to 50,000 cells/mm\^3
4. ALT (SGPT) less than or equal to 2.5 times the ULN
5. Estimated creatinine clearance of greater than or equal to 60 mL/min using the Cockroft-Gault equation for women
* Intend to remain in current geographical area of residence for the duration of study
* Currently pregnant and greater than or equal to 14 weeks gestation based on clinical or other obstetrical measurements
* CD4 count greater than or equal to 350 cells/mm\^3, or greater than or equal to the country-specific threshold for initiation of treatment (if that threshold is greater than 350 cells/mm\^3), on a specimen obtained within 30 days prior to study entry
* Results of HBV screening (HBsAg testing) available from specimen obtained within 30 days prior to study entry
* The following laboratory values from a specimen obtained within 30 days prior to study entry:
1. Hemoglobin greater than or equal to 7.5 g/dL
2. White blood cell count (WBC) greater than or equal to 1,500 cells/mm\^3
3. Absolute neutrophil count (ANC) greater than or equal to 750 cells/mm\^3
4. Platelets greater than or equal to 50,000 cells/mm\^3
5. Alanine aminotransferase (ALT) less than or equal to 2.5 times the upper limit of normal (ULN)
6. Estimated creatinine clearance of greater than or equal to 60 mL/min using the Cockroft-Gault equation for women
* Plans to deliver in the study-affiliated clinic or hospital
* Has no plans to move outside of the study site area during the 24 months following delivery
* Age of legal majority for the respective country and willing and able to provide written informed consent
* Age of legal majority for the respective country
* HIV-1 infection, defined as documented positive results from tests performed on one sample at any time prior to Late Presenter Registration
* In labor (from onset/early labor or beyond) or within 5 days after delivery (with day of delivery considered day 0)
* Has provided written informed consent
* Has no plans to move outside of the study site area during the 24 months following delivery
* If delivered, infant alive and healthy (In the case of a multiple birth, a mother-infant pair will be included in the Late Presenter registration only if both/all infants and the mother meet the eligibility criteria. If only one infant of a multiple birth is alive, the M-I pair may be registered if the infant and the mother otherwise meet all of the eligibility criteria.)
* Participation in the Antepartum Component or registered as a Late Presenter
* Provided written informed consent
* Has no plans to move outside of the study site area during the 24 months following delivery
* Maternal CD4 count greater than or equal to 350 cells/mm\^3, or greater than or equal to the country-specific threshold for initiation of treatment (if that threshold is greater than 350 cells/mm\^3), from a specimen obtained within 30 days prior to study entry. More information on this criterion can be found in the protocol.
* The following maternal laboratory values within 30 days prior to entry:
1. Hemoglobin greater than or equal to 7.0 g/dL
2. WBC greater than or equal to 1,500 cells/mm\^3
3. ANC greater than or equal to 750 cells/mm\^3
4. Platelets greater than or equal to 50,000 cells/mm\^3
5. ALT less than or equal to 2.5 times the upper limit of normal (ULN)
6. Estimated creatinine clearance of greater than or equal to 60 mL/min using the Cockroft-Gault equation for women
* Infant alive, healthy, less than or equal to 14 days of age, and uninfected (negative HIV NAT result on specimen drawn prior to study entry)
* The following infant lab values on specimen obtained prior to study entry (within 14 days of birth):
1. Hemoglobin greater than or equal to 10 g/dL
2. WBC greater than or equal to 1,500 cells/mm\^3
3. ANC greater than or equal to 750 cells/mm\^3
4. Platelets greater than or equal to 50,000 cells/mm\^3
5. ALT less than or equal to 2.5 times the ULN
* For Registered Late Presenters: Confirmed maternal HIV-1 infection, defined as documented positive results from two samples collected at different time points at any time prior to entry. More information on this criterion can be found in the protocol.
* Randomly assigned to triple ARV prophylaxis as part of the Postpartum Component and has continued triple ARV prophylaxis until the current randomization without treatment interruption (defined as more than 14 consecutive days of missed dosing) within the previous 30 days; OR randomly assigned to triple ARV prophylaxis in the Antepartum Component but ineligible for the Postpartum Component and has continued triple ARV prophylaxis until the current randomization without treatment interruption (defined as more than 7 consecutive days of missed dosing) within the previous 30 days
* Within two weeks after complete breastfeeding cessation is achieved (defined as completely stopping all exposure to breast milk for greater than or equal to 28 days); i.e., within 29 to 42 days of last breast milk exposure, or reached 18 months postpartum (whichever comes first). Women who reach 18 months postpartum while still breastfeeding will be eligible for entry within 2 weeks before and 4 weeks after the Week 74 visit (Week 72-78); OR if the woman was randomized to triple ARV prophylaxis in the Postpartum Component and her infant is infected and still breastfeeding, she will be eligible for the Maternal Health Component within 42 days of specimen collection for the confirmatory infant HIV NAT; OR if the woman was randomized to triple ARV prophylaxis in the Antepartum Component but mother-infant pair was ineligible for the Postpartum Component she will be eligible for the Maternal Health Component beginning at the Week 1 visit (6-14 days postpartum) through 28 days after delivery; these women should be randomized as soon as possible, ideally within 6-14 days after delivery; OR if the woman was randomized to triple ARV prophylaxis in the Postpartum Component and breastfeeding risk for MTCT ceases for other reasons (e.g., infant death or permanent removal from home through legal services or adoption) within 28 days of event. More information on this criterion can be found in the protocol.
* Provided written informed consent
* CD4 cell count greater than or equal to 350 cells/mm\^3, or greater than or equal to the country-specific threshold for initiation of treatment (if that threshold is greater than 350 cells/mm\^3), on a specimen obtained within 30 days prior to study entry
* The following laboratory values on a specimen obtained within 30 days prior to study entry:
1. ANC greater than or equal to 750 cells/mm\^3
2. Hemoglobin greater than or equal to 7.0 gm/dL
3. Platelet count greater than or equal to 50,000 cells/mm\^3
4. ALT (SGPT) less than or equal to 2.5 times the ULN
5. Estimated creatinine clearance of greater than or equal to 60 mL/min using the Cockroft-Gault equation for women
* Intend to remain in current geographical area of residence for the duration of study
Exclusion Criteria
* Participation in PROMISE for a prior pregnancy
* Ingestion of any antiretroviral (ARV) regimen with three or more drugs (regardless of duration) or more than 30 days of a single or dual ARV regimen during current pregnancy, according to self report or available medical records
* Requires triple ARV therapy (HAART) for own health based on local standard guidelines
* World Health Organization (WHO) stage 4 disease
* Prior receipt of HAART for maternal treatment indications (e.g., CD4 less than 350 cells/mm\^3 or clinical indications); however, could have received ARVs for the sole purpose of prevention of mother-to-child transmission (PMTCT) in previous pregnancies (prior PMTCT regimens could have included a triple ARV regimen, ZDV, 3TC-ZDV, and/or sdNVP for PMTCT, as well as use of a short dual nucleoside reverse transcriptase inhibitor \[NRTI\] "tail" to reduce risk of NVP resistance.)
* In labor - at onset or beyond (may be eligible for the Late Presenter registration)
* Clinically significant illness or condition requiring systemic treatment and/or hospitalization within 30 days prior to study entry
* Current or history of tuberculosis (TB) disease (positive PPD without TB disease is not exclusionary)
* Use of prohibited medications within 14 days prior to study entry (refer to the protocol for a list of prohibited medications)
* Fetus detected to have serious congenital malformation (ultrasound not required to rule out this condition)
* Current documented conduction heart defect (specialized assessments to rule out this condition are not required; a heart murmur alone and/or type 1 second-degree atrioventricular block \[also known as Mobitz I or Wenckebach\] is not considered exclusionary)
* Known to meet the local standard criteria for treatment of HBV (Note: HBV DNA testing or other specialized assessments are not expected to be performed as part of this study. A woman would be excluded only if this information is documented from other sources and she meets the local standard criteria for HBV treatment based on those assessments.)
* Social or other circumstances that would hinder long-term follow-up, in the opinion of the site investigator
* Currently incarcerated
* Participation in PROMISE in prior pregnancy
* Ingestion of any antiretroviral regimen during current pregnancy (including for solely for PMTCT), according to self report and available medical records (Note: Use of ARVs provided as standard of care for PMTCT during labor/delivery or postpartum prior to Late Presenter registration is not exclusionary.)
* If known: CD4 count \< 350 cells/mm3 or below the country-specific threshold for initiation of treatment, if that threshold is \> 350 cells/mm3, on specimen obtained within 30 days prior to study entry (result not required prior to registration)
* Requires triple ARV therapy (HAART) for own health according to local standard guidelines
* WHO Stage 4 disease
* Prior receipt of HAART for maternal treatment indications (e.g., CD4 \< 350 cells/mm3 or clinical indications); however, could have received ARVs for the sole purpose of PMTCT in previous pregnancies. (Prior PMTCT regimens could have included a triple ARV regimen, ZDV, 3TCZDV and/or sdNVP for PMTCT, as well as use of a short dual NRTI "tail" to reduce risk of NVP resistance.)
* Current or history of TB disease (positive PPD without TB disease is not exclusionary)
* Known positive infant HIV nucleic acid test (NAT) result (result not required prior to registration)
* Fetal demise or early neonatal death (prior to enrollment/registration)
* Fetus detected with serious congenital malformation (ultrasound not required to rule out this condition)
* Life threatening infant illness or birth condition incompatible with life
* If delivered, infant birth weight \< 2.0 kg
* Social or other circumstances which would hinder long-term follow-up, in the opinion of the site investigator
* Current documented conduction heart defect (specialized assessments to rule out this condition are not required; a heart murmur alone and/or type 1 second-degree atrioventricular block (also known as Mobitz I or Wenckebach) is not considered exclusionary)
* Positive infant HIV NAT result on specimen drawn prior to entry or no infant HIV NAT result on specimen drawn prior to entry
* Life-threatening infant illness or birth condition incompatible with life
* Infant birth weight less than 2.0 kg
* Social or other circumstances that would hinder long-term follow-up, as judged by the site investigator
* Current or history of TB disease (positive PPD without TB disease is not exclusionary)
* Current documented conduction heart defect (specialized assessments to rule out this condition are not required; a heart murmur alone and/or type 1 second-degree atrioventricular block \[also known as Mobitz I or Wenckebach\] is not considered exclusionary)
* Requires triple ARV therapy (HAART) for own health
* WHO Stage 4 disease
* Clinically significant illness or condition requiring systemic treatment and/or hospitalization within 30 days prior to study entry
* Current or history of TB disease (positive PPD without TB disease is not exclusionary)
* Use of prohibited medications within 14 days prior to study entry
* Social or other circumstances that would hinder long term follow-up as judged by the site investigator
* Current documented conduction heart defect (specialized assessments to rule out this condition are not required; a heart murmur alone and/or type 1 second-degree atrioventricular block \[also known as Mobitz I or Wenckebach\] is not considered exclusionary)
* Requires a triple ARV regimen for own health
* Ingestion of any antiretroviral (ARV) regimen with three or more drugs (regardless of duration) or more than 30 days of a single or dual ARV regimen during current pregnancy, according to self report or available medical records
* Requires triple ARV therapy (HAART) for own health based on local standard guidelines
* World Health Organization (WHO) stage 4 disease
* Prior receipt of HAART for maternal treatment indications (e.g., CD4 less than 350 cells/mm\^3 or clinical indications); however, could have received ARVs for the sole purpose of prevention of mother-to-child transmission (PMTCT) in previous pregnancies (prior PMTCT regimens could have included a triple ARV regimen, ZDV, 3TC-ZDV, and/or sdNVP for PMTCT, as well as use of a short dual nucleoside reverse transcriptase inhibitor \[NRTI\] "tail" to reduce risk of NVP resistance.)
* In labor - at onset or beyond (may be eligible for the Late Presenter registration)
* Clinically significant illness or condition requiring systemic treatment and/or hospitalization within 30 days prior to study entry
* Current or history of tuberculosis (TB) disease (positive PPD without TB disease is not exclusionary)
* Use of prohibited medications within 14 days prior to study entry (refer to the protocol for a list of prohibited medications)
* Fetus detected to have serious congenital malformation (ultrasound not required to rule out this condition)
* Current documented conduction heart defect (specialized assessments to rule out this condition are not required; a heart murmur alone and/or type 1 second-degree atrioventricular block \[also known as Mobitz I or Wenckebach\] is not considered exclusionary)
* Known to meet the local standard criteria for treatment of HBV (Note: HBV DNA testing or other specialized assessments are not expected to be performed as part of this study. A woman would be excluded only if this information is documented from other sources and she meets the local standard criteria for HBV treatment based on those assessments.)
* Social or other circumstances that would hinder long-term follow-up, in the opinion of the site investigator
* Currently incarcerated
* Participation in PROMISE in prior pregnancy
* Ingestion of any antiretroviral regimen during current pregnancy (including for solely for PMTCT), according to self report and available medical records (Note: Use of ARVs provided as standard of care for PMTCT during labor/delivery or postpartum prior to Late Presenter registration is not exclusionary.)
* If known: CD4 count \< 350 cells/mm3 or below the country-specific threshold for initiation of treatment, if that threshold is \> 350 cells/mm3, on specimen obtained within 30 days prior to study entry (result not required prior to registration)
* Requires triple ARV therapy (HAART) for own health according to local standard guidelines
* WHO Stage 4 disease
* Prior receipt of HAART for maternal treatment indications (e.g., CD4 \< 350 cells/mm3 or clinical indications); however, could have received ARVs for the sole purpose of PMTCT in previous pregnancies. (Prior PMTCT regimens could have included a triple ARV regimen, ZDV, 3TCZDV and/or sdNVP for PMTCT, as well as use of a short dual NRTI "tail" to reduce risk of NVP resistance.)
* Current or history of TB disease (positive PPD without TB disease is not exclusionary)
* Known positive infant HIV nucleic acid test (NAT) result (result not required prior to registration)
* Fetal demise or early neonatal death (prior to enrollment/registration)
* Fetus detected with serious congenital malformation (ultrasound not required to rule out this condition)
* Life threatening infant illness or birth condition incompatible with life
* If delivered, infant birth weight \< 2.0 kg
* Social or other circumstances which would hinder long-term follow-up, in the opinion of the site investigator
* Current documented conduction heart defect (specialized assessments to rule out this condition are not required; a heart murmur alone and/or type 1 second-degree atrioventricular block (also known as Mobitz I or Wenckebach) is not considered exclusionary)
* Positive infant HIV NAT result on specimen drawn prior to entry or no infant HIV NAT result on specimen drawn prior to entry
* Life-threatening infant illness or birth condition incompatible with life
* Infant birth weight less than 2.0 kg
* Social or other circumstances that would hinder long-term follow-up, as judged by the site investigator
* Current or history of TB disease (positive PPD without TB disease is not exclusionary)
* Current documented conduction heart defect (specialized assessments to rule out this condition are not required; a heart murmur alone and/or type 1 second-degree atrioventricular block \[also known as Mobitz I or Wenckebach\] is not considered exclusionary)
* Requires triple ARV therapy (HAART) for own health
* WHO Stage 4 disease
* Clinically significant illness or condition requiring systemic treatment and/or hospitalization within 30 days prior to study entry
* Current or history of TB disease (positive PPD without TB disease is not exclusionary)
* Use of prohibited medications within 14 days prior to study entry
* Social or other circumstances that would hinder long term follow-up as judged by the site investigator
* Current documented conduction heart defect (specialized assessments to rule out this condition are not required; a heart murmur alone and/or type 1 second-degree atrioventricular block \[also known as Mobitz I or Wenckebach\] is not considered exclusionary)
* Requires a triple ARV regimen for own health
Eligible Sex
ALL
Accepts Healthy Volunteers
No
Sponsors
Meet the organizations funding or collaborating on the study and learn about their roles.
National Institute of Allergy and Infectious Diseases (NIAID)
NIH
Sponsor Role
lead
Responsible Party
Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.
Responsibility Role
SPONSOR
Principal Investigators
Learn about the lead researchers overseeing the trial and their institutional affiliations.
Mary Glenn Fowler, MD, MPH
Role: STUDY_CHAIR
Johns Hopkins Medical Institute, Makerere U.-JHU Research Collaboration
Locations
Explore where the study is taking place and check the recruitment status at each participating site.
Byramjee Jeejeebhoy Medical College (BJMC) CRS
Pune, Maharashtra, India
Site Status
Blantyre CRS
Blantyre, , Malawi
Site Status
Malawi CRS
Lilongwe, , Malawi
Site Status
Soweto IMPAACT CRS
Johannesburg, Gauteng, South Africa
Site Status
Shandukani Research CRS
Johannesburg, Gauteng, South Africa
Site Status
Durban Paediatric HIV CRS
Durban, KwaZulu-Natal, South Africa
Site Status
Umlazi CRS
Durban, KwaZulu-Natal, South Africa
Site Status
Family Clinical Research Unit (FAM-CRU) CRS
Cape Town, Western Cape, South Africa
Site Status
Kilimanjaro Christian Medical Centre (KCMC)
Moshi, , Tanzania
Site Status
MU-JHU Research Collaboration (MUJHU CARE LTD) CRS
Kampala, , Uganda
Site Status
George CRS
Lusaka, , Zambia
Site Status
Seke North CRS
Chitungwiza, , Zimbabwe
Site Status
St Mary's CRS
Chitungwiza, , Zimbabwe
Site Status
Harare Family Care CRS
Harare, , Zimbabwe
Site Status
Countries
Review the countries where the study has at least one active or historical site.
India
Malawi
South Africa
Tanzania
Uganda
Zambia
Zimbabwe
References
Explore related publications, articles, or registry entries linked to this study.
Taha T, Nour S, Li Q, Kumwenda N, Kafulafula G, Nkhoma C, Broadhead R. The effect of human immunodeficiency virus and breastfeeding on the nutritional status of African children. Pediatr Infect Dis J. 2010 Jun;29(6):514-8. doi: 10.1097/INF.0b013e3181cda531.
Reference Type
BACKGROUND
Becquet R, Ekouevi DK, Arrive E, Stringer JS, Meda N, Chaix ML, Treluyer JM, Leroy V, Rouzioux C, Blanche S, Dabis F. Universal antiretroviral therapy for pregnant and breast-feeding HIV-1-infected women: towards the elimination of mother-to-child transmission of HIV-1 in resource-limited settings. Clin Infect Dis. 2009 Dec 15;49(12):1936-45. doi: 10.1086/648446.
Reference Type
BACKGROUND
U.S. Department of Health and Human Services, National Institutes of Health, National Institute of Allergy and Infectious Diseases, Division of AIDS. Division of AIDS Table for Grading the Severity of Adult and Pediatric Adverse Events, Version 1.0. [Updated August 2009]. Available from: http://rsc.tech-res.com/docs/default-source/safety/table_for_grading_severity_of_adult_pediatric_adverse_events.pdf
Reference Type
RESULT
WHO Case Definitions of HIV for Surveillance and Revised Clinical Staging and Immunological Classification of HIV-related Disease in Adults and Children, World Health Organization, 2007. Available: http://apps.who.int/iris/handle/10665/43699
Reference Type
RESULT
Bhattacharya D, Tierney C, Butler K, Kiweewa FM, Moodley D, Govender V, Vhembo T, Mohtashemi N, Ship H, Dula D, George K, Chaktoura N, Fowler MG, Peters MG, Currier JS. Comparison of Antiretroviral Therapies in Pregnant Women Living With Human Immunodeficiency Virus and Hepatitis B Virus: A Randomized Controlled Trial. Obstet Gynecol. 2023 Sep 1;142(3):613-624. doi: 10.1097/AOG.0000000000005302. Epub 2023 Aug 3.
Reference Type
DERIVED
Vhembo T, Baltrusaitis K, Tierney C, Owor M, Dadabhai S, Violari A, Theron G, Moodley D, Mukwasi-Kahari C, George K, Shepherd J, Siberry GK, Browning R, Fowler MG, Stranix-Chibanda L; IMPAACT P1084s study team. Bone and Renal Health in Infants With or Without Breastmilk Exposure to Tenofovir-Based Maternal Antiretroviral Treatment in the PROMISE Randomized Trial. J Acquir Immune Defic Syndr. 2023 Aug 15;93(5):431-437. doi: 10.1097/QAI.0000000000003218.
Reference Type
DERIVED
Nevrekar N, Butler K, Shapiro DE, Atuhaire P, Taha TE, Makanani B, Chinula L, Owor M, Moodley D, Chipato T, McCarthy K, Flynn PM, Currier J, Fowler MG, Gupta A, Suryavanshi N. Self-reported Antiretroviral Adherence: Association With Maternal Viral Load Suppression in Postpartum Women Living With HIV-1 From Promoting Maternal and Infant Survival Everywhere, a Randomized Controlled Trial in Sub-Saharan Africa and India. J Acquir Immune Defic Syndr. 2023 Jan 1;92(1):76-83. doi: 10.1097/QAI.0000000000003102. Epub 2022 Sep 28.
Reference Type
DERIVED
Baltrusaitis K, Makanani B, Tierney C, Fowler MG, Moodley D, Theron G, Nyakudya LH, Tomu M, Fairlie L, George K, Heckman B, Knowles K, Browning R, Siberry GK, Taha TE, Stranix-Chibanda L; PROMISE P1084s Study Team. Maternal and infant renal safety following tenofovir disoproxil fumarate exposure during pregnancy in a randomized control trial. BMC Infect Dis. 2022 Jul 20;22(1):634. doi: 10.1186/s12879-022-07608-8.
Reference Type
DERIVED
Fowler MG, Aizire J, Sikorskii A, Atuhaire P, Ogwang LW, Mutebe A, Katumbi C, Maliwichi L, Familiar I, Taha T, Boivin MJ; PROMISE-NEURODEV study team. Growth deficits in antiretroviral and HIV-exposed uninfected versus unexposed children in Malawi and Uganda persist through 60 months of age. AIDS. 2022 Mar 15;36(4):573-582. doi: 10.1097/QAD.0000000000003122.
Reference Type
DERIVED
Stranix-Chibanda L, Tierney C, Pinilla M, George K, Aizire J, Chipoka G, Mallewa M, Naidoo M, Nematadzira T, Kusakara B, Violari A, Mbengeranwa T, Njau B, Fairlie L, Theron G, Mubiana-Mbewe M, Khadse S, Browning R, Fowler MG, Siberry GK; PROMISE Study Team. Effect on growth of exposure to maternal antiretroviral therapy in breastmilk versus extended infant nevirapine prophylaxis among HIV-exposed perinatally uninfected infants in the PROMISE randomized trial. PLoS One. 2021 Aug 20;16(8):e0255250. doi: 10.1371/journal.pone.0255250. eCollection 2021.
Reference Type
DERIVED
Theron G, Brummel S, Fairlie L, Pinilla M, McCarthy K, Owor M, Chinula L, Makanani B, Violari A, Moodley D, Chakhtoura N, Browning R, Hoffman R, Fowler MG. Pregnancy Outcomes of Women Conceiving on Antiretroviral Therapy (ART) Compared to Those Commenced on ART During Pregnancy. Clin Infect Dis. 2021 Jul 15;73(2):e312-e320. doi: 10.1093/cid/ciaa805.
Reference Type
DERIVED
Aizire J, Sikorskii A, Ogwang LW, Kawalazira R, Mutebe A, Familiar-Lopez I, Mallewa M, Taha T, Boivin MJ, Fowler MG; PROMISE-NEURODEV study team. Decreased growth among antiretroviral drug and HIV-exposed uninfected versus unexposed children in Malawi and Uganda. AIDS. 2020 Feb 1;34(2):215-225. doi: 10.1097/QAD.0000000000002405.
Reference Type
DERIVED
Hoffman RM, Angelidou KN, Brummel SS, Saidi F, Violari A, Dula D, Mave V, Fairlie L, Theron G, Kamateeka M, Chipato T, Chi BH, Stranix-Chibanda L, Nematadzira T, Moodley D, Bhattacharya D, Gupta A, Coletti A, McIntyre JA, Klingman KL, Chakhtoura N, Shapiro DE, Fowler MG, Currier JS; IMPAACT PROMISE 1077BF/FF team. Maternal health outcomes among HIV-infected breastfeeding women with high CD4 counts: results of a treatment strategy trial. HIV Clin Trials. 2018 Dec;19(6):209-224. doi: 10.1080/15284336.2018.1537327.
Reference Type
DERIVED
Fowler MG, Qin M, Fiscus SA, Currier JS, Flynn PM, Chipato T, McIntyre J, Gnanashanmugam D, Siberry GK, Coletti AS, Taha TE, Klingman KL, Martinson FE, Owor M, Violari A, Moodley D, Theron GB, Bhosale R, Bobat R, Chi BH, Strehlau R, Mlay P, Loftis AJ, Browning R, Fenton T, Purdue L, Basar M, Shapiro DE, Mofenson LM; IMPAACT 1077BF/1077FF PROMISE Study Team. Benefits and Risks of Antiretroviral Therapy for Perinatal HIV Prevention. N Engl J Med. 2016 Nov 3;375(18):1726-1737. doi: 10.1056/NEJMoa1511691.
Reference Type
DERIVED
Related Links
Access external resources that provide additional context or updates about the study.
http://www.impaactnetwork.org/studies/1077BF.asp
IMPAACT Study 1077BF
https://www.meddra.org/
MedDra coding of complications
Other Identifiers
Review additional registry numbers or institutional identifiers associated with this trial.
10777
Identifier Type: REGISTRY
Identifier Source: secondary_id
IMPAACT 1077BF
Identifier Type: -
Identifier Source: secondary_id
1077BF (PROMISE)
Identifier Type: -
Identifier Source: org_study_id
NCT01253538
Identifier Type: -
Identifier Source: nct_alias
More Related Trials
Additional clinical trials that may be relevant based on similarity analysis.
Using Nevirapine to Prevent Mother-to-Child HIV Transmission During Breastfeeding
NCT00074412
COMPLETED
PHASE3
UNCPM 22314 - Pregnancy, Infant and Maternal Health Outcomes Study
NCT06158126
RECRUITING
PHASE4
Antiviral Responses to NNRTI-Based vs. PI-Based ARV Therapy in HIV Infected Infants Who Have or Have Not Received Single Dose NVP for Prevention of Mother-to-Child Transmission of HIV
NCT00307151
COMPLETED
PHASE2
IMPAACT P1074: Long-Term Outcomes in HIV-Infected Infants, Children, and Adolescents
NCT01061164
COMPLETED
IMPAACT 1077HS: Examining Benefits of HAART Continuation in Postpartum Women
NCT00955968
COMPLETED
PHASE4
Very Early Intensive Treatment of Infants Living With HIV to Achieve HIV Remission
NCT02140255
RECRUITING
PHASE1/PHASE2
PrEP in Breastfeeding Study
NCT02776748
COMPLETED
PHASE2/PHASE3
HIV Diagnosis and Treatment at Birth for Newborn With High Risk HIV Exposure
NCT03642704
COMPLETED
PHASE4
A Study of Zidovudine/Lamivudine and Either Nevirapine or Nelfinavir for Reduction of Mother-to-child HIV Transmission During Breastfeeding
NCT00146380
COMPLETED
PHASE2
Breastfeeding, Antiretroviral, and Nutrition Study
NCT00164736
COMPLETED
PHASE3
Anti-HIV Drugs for Treating Infants Who Acquired HIV Infection at Birth
NCT00102960
COMPLETED
PHASE3
ARVs to Prevent Breastmilk HIV:Viral and Immune Responses
NCT00167674
COMPLETED
PHASE2
Prevention of Mother-to-child Transmission of HIV-1 Using a Responsive Intervention
NCT03870438
COMPLETED
PHASE3
Trial of Three Neonatal Antiretroviral Regimens for Prevention of Intrapartum HIV Transmission
NCT00099359
COMPLETED
PHASE3
Comparison of Efficacy and Safety of Infant Peri-exposure Prophylaxis With Lopinavir/Ritonavir Versus Lamivudine to Prevent HIV-1 Transmission by Breastfeeding
NCT00640263
COMPLETED
PHASE3
Daily Nevirapine to Prevent Mother to Infant Transmission of HIV
NCT00061321
COMPLETED
PHASE3
A Study of HIV Levels During Pregnancy and After Childbirth
NCT00041964
COMPLETED
Surveillance Monitoring for ART Toxicities Study in HIV Uninfected Children Born to HIV Infected Women
NCT01310023
COMPLETED
Perinatal Antiretroviral Intensification for PMTCT of HIV in Late Comers
NCT01511237
COMPLETED
PHASE3
Trizivir Vs. Kaletra and Combivir for the Prevention of Mother-to-Child Transmission of HIV
NCT00270296
COMPLETED
PHASE2
Safety and Pharmacokinetics Study of PGT121.414.LS Alone and in Combination With VRC07-523LS in Infants Exposed to HIV-1
NCT06517693
RECRUITING
PHASE1
HIV Treatment Reinitiation in Women Who Received Anti-HIV Drugs to Prevent Mother-to-Child Transmission of HIV
NCT00442962
COMPLETED
PHASE4
Study to Improve Survival Among HIV-Exposed Infants in Botswana
NCT01229761
COMPLETED
PHASE2
Safety and Drug Detection Study of Dapivirine Vaginal Ring and Oral TRUVADA® in Breastfeeding Mother-Infant Pairs
NCT04140266
COMPLETED
PHASE3