Antiretroviral Regimens Containing Raltegravir for Prophylaxis of Mother-to-child-transmission of HIV Infection (PregnantHIV)

This study is not yet open for participant recruitment.
Verified May 2013 by Fundação Bahiana de Infectologia
Sponsor:
Information provided by (Responsible Party):
Carlos Brites, Fundação Bahiana de Infectologia
ClinicalTrials.gov Identifier:
NCT01854762
First received: April 22, 2013
Last updated: May 13, 2013
Last verified: May 2013

April 22, 2013
May 13, 2013
June 2013
May 2015   (final data collection date for primary outcome measure)
HIV Viral load at delivery [ Time Frame: 2 months ] [ Designated as safety issue: No ]
Same as current
Complete list of historical versions of study NCT01854762 on ClinicalTrials.gov Archive Site
  • Overall adverse events at delivery [ Time Frame: 2 months ] [ Designated as safety issue: Yes ]
  • Number of children infected with HIV [ Time Frame: 24 months ] [ Designated as safety issue: No ]
Same as current
Not Provided
Not Provided
 
Antiretroviral Regimens Containing Raltegravir for Prophylaxis of Mother-to-child-transmission of HIV Infection
Evaluation of the Use of Antiretroviral Regimens Containing Raltegravir for Prophylaxis of Mother-to-child-transmission of HIV Infection in Pregnant Women Presenting With Detectable Viral Load After 32 Weeks of Gestation: a Pilot Study

The current available antiretroviral (ARV) agents make possible a successful treatment of virtually all HIV-infected patients, even those heavily experienced subjects, with a history of previous failure to ARV drugs of different classes. However, some problems are still present, especially for specific populations, like pregnant women and infants. For these groups, most of currently available drugs are not used, because the lack of information on safety, efficacy, and pharmacokinetic/dynamic behavior of ARVs drugs. The mother to child transmission (MTCT) is still a problem in certain areas of the world, especially in resource-limited settings. In some settings, women often present to their first antenatal care visit late in the pregnancy, posing an additional problem: how to effectively treat these patients to assure they will have an undetectable viral load at the moment of delivering? Depending on the plasma viremia magnitude, and viral susceptibility it can take 6 or more weeks to reduce the viral load to less than the desired 1,000 copies of HIV-1 RNA / ml of plasma. To achieve this goal, it would be necessary the use of a potent, very efficacious ARV regimen that could provide such viral decay in a very short period. Raltegravir (RAL), the first HIV-1 integrase inhibitor, is a potent and safe ARV drug. The available evidence suggest it has no genotoxic potential, and promotes a rapid decline in HIV-1 plasma viremia. In addition, RAL is highly active against viral strains presenting different degree of resistance to other ARV drugs. Thus, RAL could be an ideal candidate to be used for prevention of MTCT for women with detectable viral load, presenting late in the course of pregnancy. Another attractive point is to consider that, due to the similarity between the integrase enzyme of HIV-1 and HTLV; RAL could be active against HTLV-1, blocking its replication. If our hypothesis is correct, the use f RAL-containing ARV regimens would reduce the MTCT of both agents. This study has the objective of evaluating the efficacy of RAL containing ARV regimens in reducing the HIV-1 RNA plasma viral load below 50 copies/ml, at the end of pregnancy, for late-presenters pregnant women and to compare the frequency of adverse events for women using RAL-based ARV regimens and comparators, and for their babies.

A total of 44 late-presenters (gestational age >32 weeks), HIV-infected pregnant women will be randomly assigned to receive an antiretroviral regimen based on AZT+3TC+Raltegravir or AZT+3TC+LPV/r. They will be followed up to the delivery, and plasma viral load will be measured. The rate of HIV mother-to-child-transmission will be compared between groups. The newborns will be followed up to 6 months, to register any adverse event during this period of time.

Interventional
Phase 2
Phase 3
Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
  • HIV
  • Pregnancy
  • Drug: Raltegravir
    a raltegravir-based antiretroviral regimen (AZT+3TC+Raltegravir) will be administered for intervention arm patients (AZT+3TC will be administered in a fixed combination of AZT 300mg +3TC 150 mg, BID. Raltegravir will be administered in a dosis of 1 400 mg pill BID).
  • Drug: Lopinavir/Ritonavir
    The second arm (comparator)patients will use a regimen composed by AZT+3TC (same dosis/schedule of active arm)+ LPV 200mg coformulated with rtv 50 mg, 2 pills BID
  • Experimental: Raltegravir
    Use of Raltegravir plus backbone treatment for pregnant women
    Intervention: Drug: Raltegravir
  • Active Comparator: Lopinavir/Ritonavir
    Use of standard PI treatment (Lopinavir/r) plus backbone treatment for pregnant women
    Intervention: Drug: Lopinavir/Ritonavir
Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Not yet recruiting
40
May 2015
May 2015   (final data collection date for primary outcome measure)

Inclusion Criteria:

  • Pregnant women with confirmed HIV-1 infection (positive Western blot or plasma HIV-1 RNA >1,000 copies/ml)
  • Gestational age higher than 32 weeks
  • Age equal or higher than 18 years
  • HIV-1 plasma viral load ≥ 1,000 copies of HIV-1 RNA/ml

Exclusion Criteria:

  • Age lower than 18 years
  • Undetectable plasma viral load at screening
  • Previous use of RAL
Female
18 Years to 50 Years
No
Contact: Estela Luz, RN, MSci 32838123 eluz5@yahoo.com.br
Brazil
 
NCT01854762
PregnantHIV
No
Carlos Brites, Fundação Bahiana de Infectologia
Fundação Bahiana de Infectologia
Not Provided
Principal Investigator: Carlos Brites, MD, PhD Fundação Bahiana de Infectologia
Fundação Bahiana de Infectologia
May 2013

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