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Tenofovir/Emtricitabine for PMTCT in Africa and Asia (ANRS 12109 TEmAA)

This study has been completed.
Sponsor:
Collaborators:
European and Developing Countries Clinical Trials Partnership (EDCTP)
Gilead Sciences
Information provided by (Responsible Party):
French National Agency for Research on AIDS and Viral Hepatitis
ClinicalTrials.gov Identifier:
NCT00334256
First received: June 6, 2006
Last updated: December 2, 2011
Last verified: December 2011

June 6, 2006
December 2, 2011
October 2006
July 2009   (final data collection date for primary outcome measure)
Pharmacokinetic parameters of TDF and FTC in the mother and child [ Time Frame: during labor and first 72 hours of life ] [ Designated as safety issue: No ]
Pharmacokinetic parameters of TDF and FTC in the mother and child
Complete list of historical versions of study NCT00334256 on ClinicalTrials.gov Archive Site
  • Safety of TDF + FTC in pregnant women [ Time Frame: during labor and 2 months after delivery ] [ Designated as safety issue: Yes ]
  • Safety of TDF + FTC in children [ Time Frame: 2 months after birth ] [ Designated as safety issue: Yes ]
  • Frequency of viral resistance to TDF and FTC in the mothers and in the infected children [ Time Frame: at D2 and W4 postpartum/postnatal ] [ Designated as safety issue: No ]
  • Effect of the antiretroviral combination on maternal viral load [ Time Frame: D2 and W4 post-partum ] [ Designated as safety issue: No ]
  • Estimation of the mother-to-child HIV-1 transmission rate (exploratory study) [ Time Frame: D3, W4, W6 ] [ Designated as safety issue: No ]
  • Safety of TDF + FTC in pregnant women
  • Safety of TDF + FTC in children
  • Frequency of viral resistance to TDF and FTC in the mothers at D2 and W4 postpartum and in the infected children at D2 and W4 postnatal
  • Effect of the antiretroviral combination on maternal viral load
  • Estimation of the mother-to-child HIV-1 transmission rate (exploratory study)
Not Provided
Not Provided
 
Tenofovir/Emtricitabine for PMTCT in Africa and Asia (ANRS 12109 TEmAA)
Phase II Trial, Multicentre, Opened Label Evaluating the Pharmacokinetics and the Safety and Toxicity of the Tenofovir-Emtricitabine Combination in Pregnant Women and Infants in Africa and Asia

To study the pharmacokinetic properties, safety and viral resistance pattern of the combination of tenofovir disoproxil fumarate and emtricitabine in HIV-1-infected pregnant women and their newborns, with a view to prevention of mother-to-child transmission (PMTCT) of HIV-1 in Africa and Asia.

Single-dose nevirapine (sdNVP) is the option of choice for the prevention of mother-to-child transmission (PMTCT) of HIV-1 in countries with limited resources. However, the use of sdNVP results in resistance mutations with an estimated frequency at of least 15 to 70% in women at W4-W6 postpartum. These mutations could compromise the success of subsequent treatments of mother and child with antiretroviral combinations that include NVP. Pre-clinical and clinical studies suggest that a combination of TDF and FTC, drugs with interesting pharmacokinetic properties that may be a useful alternative or complement to sdNVP.

The objectives are to study the pharmacokinetic properties, safety and viral resistance pattern of the combination of tenofovir disoproxil fumarate {TDF, 600 mg} and emtricitabine {FTC, 400 mg}) in HIV-1-infected pregnant women and their newborns, with a view to prevention of mother-to-child transmission (PMTCT) of HIV-1 in Africa and Asia.

Phase II trial, multicentre, open-label will be conducted in two steps with 30 mother-infant pairs per step and with a balanced allocation in Abidjan (Côte d'Ivoire), Soweto (South Africa) and Phnom Penh (Cambodia):

Step 1: administration of TDF/FTC to the mother; Step 2: administration of TDF/FTC to the mother and the newborn.

Interventional
Phase 2
Allocation: Non-Randomized
Endpoint Classification: Pharmacokinetics Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Prevention
  • HIV Infection
  • Pregnancy
  • Drug: Tenofovir (TDF)
  • Drug: Emtricitabine (FTC)
Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Completed
72
December 2009
July 2009   (final data collection date for primary outcome measure)

Inclusion Criteria:

  • Women received voluntary counselling and testing and knows her serological status
  • HIV-1 or HIV-1+2 infection whose serological diagnosis is confirmed by two samples
  • Aged 18 years or over on the day of the inclusion
  • Ongoing pregnancy of between 28 and 38 weeks of gestation from the day of the inclusion. This estimate will be based on the date of the last menstruation, or ultrasound scan, or uterine height measurement
  • Indication for antiretroviral treatment in the Prevention of Mother-To-Child-Transmission (PMTCT), in line with international or national recommendations in force: WHO's clinical stage 1, 2 and CD4≥200/mm3or stage 3 and CD4≥350/mm3 (No indication of antiretroviral treatment)
  • Haemoglobin over 8 g/dL in the month preceding inclusion
  • Blood creatinine less than three times the upper limit of normal values
  • Creatinine clearance > 49 mL/min
  • Transaminases (ALAT or ASAT) less than five times the upper limit of normal values
  • Neutrophils ≥750/mm3
  • No hypersensitivity to emtricitabine, tenofovir, tenofovir disoproxil fumarate, zidovudine, nevirapine or to the excipients
  • Signed informed-consent form by the woman and, by the father of the child to be born
  • Planned delivery in a hospital setting and stay for at least 72 hours afterwards
  • Agreement to take no other medication during the trial without telling the investigator
  • Naïve to all antiretroviral treatment and to antiretroviral prophylaxis for PMTCT during a previous pregnancy
  • Permanent residence close enough to the study centre to enable follow-up as stipulated in the protocol

Exclusion Criteria:

  • Under 18 years of age
  • Infected by HIV-2 alone
  • One of the two parents (father) refuses to sign the consent to participate (available only for Abidjan and Phnom Penh) or the mother ( for the Soweto site)
  • Indication for antiretroviral treatment (stage 4 or CD4 <200/mm3 or stage 3 and CD4 <350/mm3)
  • Has already taken antiretrovirals, including any exposure to previous treatment or prophylaxis for PMTCT, before inclusion in the study
  • Use of drugs which can interfere with the study such as :

    • nephrotoxic drugs amphotericin B, ganciclovir, valganciclovir or cidofovir, foscarnet, aminosides, pentamidine, cisplatin
    • anticoagulants (heparin)
  • Regular use of drug or alcohol
  • Health problem requiring systematic treatment or hospitalization
  • Severe pregnancy disease (pre-eclampsia) that is life-threatening for the mother, the infant, or for both
  • Severe vomiting preventing ingestion of tablets
  • Refuses to give birth at a study site and to stay in hospital for at least 72 hours afterwards
  • Renal insufficiency defined by blood creatinine more than three times the upper limit of normal values
  • Creatinine clearance under or equal to 49 mL/min
  • Hepatic insufficiency defined by transaminases (ALAT or ASAT) more than five times the upper limit of normal values
  • Neutrophils <750/mm3
  • Haemoglobin <8 grams/dL in the month preceding inclusion
  • Hypersensitivity to emtricitabine, tenofovir, tenofovir disoproxil fumarate, zidovudine, nevirapine or to the excipients
Female
18 Years and older
No
Contact information is only displayed when the study is recruiting subjects
Cambodia,   Côte D'Ivoire,   South Africa
 
NCT00334256
ANRS 12109 TEmAA
Yes
French National Agency for Research on AIDS and Viral Hepatitis
French National Agency for Research on AIDS and Viral Hepatitis
  • European and Developing Countries Clinical Trials Partnership (EDCTP)
  • Gilead Sciences
Study Chair: François Dabis, MD, PhD Université Bordeaux 2
Principal Investigator: Didier K Ekouevi, MD, PhD Programme PACCI Abidjan
French National Agency for Research on AIDS and Viral Hepatitis
December 2011

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP