Blood Levels of Tenofovir Gel in HIV Uninfected Pregnant Women Planning Cesarean Delivery

This study has been completed.
Sponsor:
Collaborators:
Microbicide Trials Network
Information provided by (Responsible Party):
National Institute of Allergy and Infectious Diseases (NIAID)
ClinicalTrials.gov Identifier:
NCT00540605
First received: October 5, 2007
Last updated: May 17, 2012
Last verified: May 2012

October 5, 2007
May 17, 2012
Not Provided
Not Provided
  • Maternal third trimester pharmacokinetic (PK) measures (AUC and Cmax) [ Time Frame: Throughout study ] [ Designated as safety issue: No ]
  • Endometrial tenofovir levels [ Time Frame: At Hours 1, 2, 4, 6, 8, 12, and 24 after drug administration ] [ Designated as safety issue: No ]
  • Placental transfer (cord blood tenofovir levels, placental tissue tenofovir levels, and amniotic fluid tenofovir levels) [ Time Frame: At Hours 1, 2, 4, 6, 8, 12, and 24 after drug administration ] [ Designated as safety issue: No ]
  • Maternal third trimester pharmacokinetic (PK) measures (AUC and Cmax)
  • Endometrial tenofovir levels [ Time Frame: At Hours 1, 2, 4, 6, 8, 12, and 24 after drug administration ]
  • Placental transfer (cord blood tenofovir levels, placental tissue tenofovir levels, and amniotic fluid tenofovir levels) [ Time Frame: At Hours 1, 2, 4, 6, 8, 12, and 24 after drug administration ]
Complete list of historical versions of study NCT00540605 on ClinicalTrials.gov Archive Site
Not Provided
Not Provided
Not Provided
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Blood Levels of Tenofovir Gel in HIV Uninfected Pregnant Women Planning Cesarean Delivery
Phase I Study of the Maternal Single-Dose Pharmacokinetics and Placental Transfer of Tenofovir 1% Vaginal Gel Among Healthy Term Gravidas

A new approach to HIV prevention currently being studied includes the use of topical microbicides, substances that kill microbes. The purpose of this study is to determine the levels of tenofovir, a microbicide in gel form, in HIV uninfected pregnant women who are expecting to deliver by cesarean.

There is an urgent need for HIV prevention methods that women can initiate and control themselves. Topical microbicides represent one such method. Tenofovir 1% vaginal gel was chosen as a high priority microbicide candidate due to its activity in target cells for HIV infection of the vagina and cervix and the low frequency of local and systemic toxicity observed in a prior HIV Prevention Trials Network (HPTN) trial utilizing tenofovir 1% gel. The purpose of this study is to assess term pregnancy single-dose pharmacokinetics (PK) of tenofovir 1% gel in HIV uninfected pregnant women.

The expected duration of participation for individually enrolled participants will depend on how early they enroll prior to the date of cesarean section, but may range from approximately 3 to 6 weeks. An initial screening/enrollment visit will occur approximately 1 to 4 weeks prior to the participant's scheduled cesarean section, but no more than 4 weeks before the delivery date. A targeted physical exam, medical and medication history assessment, blood and urine collection, and a pelvic exam will occur at screening/enrollment. Tenofovir gel will be administered vaginally approximately 2 hours before the expected time of cesarean section. On the day of gel administration and cesarean delivery, a targeted physical exam, medical and medication history assessment, a pelvic exam, maternal blood tenofovir level measurement, and collection of placental and endometrial tissues, cord blood, and amniotic fluid will occur.

After gel administration, PK measures will be taken at Hours 1, 2, 4, 6, 8, and 12; maternal blood tenofovir level measurement and a review of adverse events will also occur at these times. A 24-hour evaluation will occur between Hours 22 and 26. At this evaluation, a targeted physical exam, a review of adverse events, and tenofovir level measurement will occur. Each participant will be contacted between Days 10 and 18 to collect data on any adverse events they experience. In addition, an unscheduled visit may be necessary if an unresolved adverse event occurs on or after the 24-hour evaluation. If an unscheduled visit is required, the participant will undergo a targeted physical exam, medical and medication history assessment, blood and urine collection, a pelvic exam, and tenofovir level measurement.

Interventional
Phase 1
Allocation: Non-Randomized
Endpoint Classification: Pharmacokinetics Study
Intervention Model: Single Group Assignment
Masking: Open Label
HIV Infections
Drug: Tenofovir 1% vaginal gel
topical gel containing 1% tenofovir
Experimental: 1
4g tenofovir 1% gel applied vaginally 2 hours prior to expected time of cesarean delivery
Intervention: Drug: Tenofovir 1% vaginal gel

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Completed
21
January 2010
Not Provided

Inclusion Criteria:

  • General good health
  • HIV uninfected
  • Hepatitis B surface antigen negative at screening and enrollment
  • Viable, single pregnancy delivered by cesarean section planned between 37 0/7 to 41 6/7 weeks of pregnancy
  • Normal Pap smear in the 12 months prior to study entry
  • Willing to abstain from vaginal, anal, and receptive oral sex for at least 2 weeks after gel administration
  • Willing to abstain from intravaginal products and practices (including douching) during study participation

Exclusion Criteria:

  • Maternal or fetal condition that requires urgent cesarean section
  • Documented rupture of the amniotic membranes
  • Known disease in the mother that has a predictable negative effect on placental function
  • Known placental/fetal abnormalities that could affect placental transfer. More information on this criterion can be found in the protocol.
  • Previously demonstrated hypersensitivity to any components of tenofovir 1% gel
  • Certain abnormal laboratory values
  • Use of vaginal medications within 48 hours of study entry
  • Untreated sexually transmitted infection (STI) or exposure to partner's STI, including chlamydia, gonorrhea, trichomoniasis, and nongonococcal urethritis
  • Symptomatic vaginitis, including bacterial vaginosis and vulvovaginal candidiasis. Participants with asymptomatic signs of bacterial vaginosis and/or yeast not excluded.
  • Participation in any other investigational drug or device trial within 30 days of study entry
  • Any social or medical condition that, in the opinion of the investigator, would interfere with the study
Female
18 Years to 45 Years
Yes
Contact information is only displayed when the study is recruiting subjects
United States
 
NCT00540605
MTN-002, 10600, 1-U01-AI068633-0
Yes
National Institute of Allergy and Infectious Diseases (NIAID)
National Institute of Allergy and Infectious Diseases (NIAID)
  • Microbicide Trials Network
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
Study Chair: Richard Beigi, MD, MSc, FACOG Magee-Women's Hospital of UPMC, Department of Obstetrics/Gynecology
Principal Investigator: Sharon Hillier, PhD Microbicides Trial Network
National Institute of Allergy and Infectious Diseases (NIAID)
May 2012

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