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Safety and Effectiveness of Lopinavir/Ritonavir in HIV Infected Infants
This study is ongoing, but not recruiting participants.
First Received: May 31, 2002   Last Updated: August 7, 2008   History of Changes
Sponsor: National Institute of Allergy and Infectious Diseases (NIAID)
Collaborator: Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
Information provided by: National Institute of Allergy and Infectious Diseases (NIAID)
ClinicalTrials.gov Identifier: NCT00038480
  Purpose

The purpose of this study is to find out if the drug lopinavir/ritonavir (LPV/RTV) is safe and well tolerated in HIV infected infants. This study will also determine the most effective dose of LPV/RTV for infants.


Condition Intervention Phase
HIV Infections
Drug: Lopinavir/Ritonavir
Phase I

Study Type: Interventional
Study Design: Treatment, Non-Randomized, Open Label, Dose Comparison, Single Group Assignment, Safety/Efficacy Study
Official Title: A Phase I/II Study of Lopinavir/Ritonavir in HIV-1 Infected Infants Less Than 6 Months of Age

Resource links provided by NLM:


Further study details as provided by National Institute of Allergy and Infectious Diseases (NIAID):

Primary Outcome Measures:
  • Trough concentration of LPV and pharmacokinetic parameters [ Time Frame: Weeks 8, 16, 24, 36, 48, 60, 72, 84, and 96 ]
  • Recurrent treatment-related Grade 3 and non-life threatening Grade 4 toxicity or single occurence of life-threatening Grade 4 toxicity [ Time Frame: Throughout study ]

Secondary Outcome Measures:
  • Change in CD4 and CD8 count and percentage from baseline. HIV-1 specific CD4 count and CD8 mediated and humoral responses [ Time Frame: Study entry and Weeks 12, 24, 36, 48, 60, 72, 84, and 96 ]
  • Time to virologic failure [ Time Frame: Throughout study ]
  • Suppression of viral load to less than 400 copies/ml and less than 50 copies/ml [ Time Frame: Study entry and Weeks 2, 4, 8, 12, 16, 20, 24, 32, 36, 40, 48, 60, 72, 84, and 96 ]

Estimated Enrollment: 26
Estimated Study Completion Date: September 2007
Detailed Description:

LPV/RTV has shown significant antiviral activity and tolerability in clinical trials in adults and children over 6 months of age. LPV/RTV has been approved by the FDA to treat older children and adults with HIV. Data for children under 6 months, however, have not been available. LPV/RTV has not been approved for infants less than 6 months old, and the appropriate dose for young infants is not known. Dosing guidelines are needed for young infants, most of whom are in the early stages of primary infection. This study will help identify an appropriate dose range of LPV/RTV and evaluate response to therapy in infants less than 6 months of age. The study will also evaluate whether early therapy allows normal development of the immune system.

Infants between 14 days and 6 months of age will receive LPV/RTV in combination with 2 nucleoside reverse transcriptase inhibitors (NRTIs) chosen by their physicians. Twelve-hour pharmacokinetic sampling is performed on Day 14 of drug treatment and when the patient reaches 12 months of age. Patients will undergo a physical exam, medical history assessment, and blood collection at selected study visits. Study visits will occur every 2 weeks for the first 8 weeks, then every 4 weeks until the end of the first year of the study. Study visits during the second year will be every 12 weeks until the end of the study. The parent or guardian will be contacted by phone every 6 weeks to monitor adverse drug effects. Participants between the ages of 6 weeks but less than 6 months old will be followed for 96 weeks after the enrollment of the last participant. Participants between the ages of 14 weeks but less than 6 weeks will be followed for 48 weeks after the enrollment of the last participant.

  Eligibility

Ages Eligible for Study:   up to 6 Months
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria

  • HIV infected
  • Viral load greater than 10,000 copies/ml within 30 days prior to study entry
  • Weigh more than 5.5 lbs at the time of enrollment
  • Agree to take 2 nucleoside reverse transcriptase inhibitors (NRTIs) in addition to LPV/RTV
  • Have consent of parent or guardian willing to provide signed informed consent and to have the infant followed at a PACTG site

Exclusion Criteria

  • Currently taking a nonnucleoside reverse transcriptase inhibitor or protease inhibitor (PI) while on study
  • Previously used LPV/RTV. Patients who were treated previously with other PIs are not excluded. Prior or concurrent maternal treatment with LPV/RTV is not excluded.
  • For patients less than 6 weeks old at time of enrollment, less than 34 weeks gestation at delivery OR for patients 6 or more weeks old at time of enrollment, less than 32 weeks gestation at delivery
  • Any laboratory toxicity of Grade 3 or greater. Hyperlipasemia of Grade 2 or higher is also excluded.
  • Newly diagnosed acute opportunistic or serious bacterial infection requiring therapy at the time of enrollment
  • Chemotherapy for active cancer
  • Certain medications
  • Any other clinically significant conditions, other than HIV infection, that would interfere with the study
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00038480

  Hide Study Locations
Locations
United States, California
UCSD Mother, Child, & Adolescent HIV Program
San Diego, California, United States, 92103
UCSF Moffitt Hosp (Pediatric)
San Francisco, California, United States, 94143-0105
Childrens Hosp, Oakland (Pediatric)
Oakland, California, United States, 94609-1809
United States, Colorado
Childrens Hospital (U. Colorado, Denver)
Denver, Colorado, United States, 80218-1088
United States, District of Columbia
Howard Univ Hosp
Washington, District of Columbia, United States, 20060
Children's National Med Ctr
Washington, District of Columbia, United States, 20010-2970
United States, Florida
Univ of Florida Health Science Ctr / Pediatrics
Jacksonville, Florida, United States, 32209
Univ of Miami (Pediatric)
Miami, Florida, United States, 33136
Univ of South Florida
St. Petersburg, Florida, United States, 33701
North Broward Hospital District
Fort Lauderdale, Florida, United States, 33316
United States, Illinois
Chicago Children's Memorial Hosp
Chicago, Illinois, United States, 606143394
The Univ of Chicago Childrens Hospital
Chicago, Illinois, United States, 60637
United States, Louisiana
Tulane Univ, Charity Hosp of New Orleans
New Orleans, Louisiana, United States, 70112
United States, Maryland
Johns Hopkins Univ (Pediatric)
Baltimore, Maryland, United States, 21287
Univ of Maryland (Pediatric)
Baltimore, Maryland, United States, 21201
United States, Massachusetts
Children's Hosp of Boston
Boston, Massachusetts, United States, 021155724
Baystate Med Ctr of Springfield
Springfield, Massachusetts, United States, 01199
Univ of Massachusetts Med School
Worcester, Massachusetts, United States, 016550001
United States, New Jersey
Univ of Med & Dentistry of NJ/Univ Hospital
Newark, New Jersey, United States, 07103
United States, New York
State Univ of New York at Stony Brook
Stony Brook, New York, United States, 11776
Bronx Lebanon Hosp Ctr
Bronx, New York, United States, 10457
SUNY Upstate Med Univ
Syracuse, New York, United States, 13210
Harlem Hosp
New York, New York, United States, 10037
Columbia Presbyterian Med Ctr
New York, New York, United States, 10032
New York Univ School of Medicine
New York, New York, United States, 10016
United States, North Carolina
Univ of North Carolina at Chapel Hill
Chapel Hill, North Carolina, United States, 27599-7220
Duke Univ (Pediatric)
Durham, North Carolina, United States, 27705
United States, Tennessee
Saint Jude Children's Research Hosp of Memphis
Memphis, Tennessee, United States, 381052794
United States, Texas
Childrens Medical Center of Dallas
Dallas, Texas, United States, 75235
Brazil
Faculdade de Medicina de Ribeirao Preto Unvi. de S
Sao Paulo, Brazil, 14025-270
Brazil, mg
Escola de Medicina, Universidade Federal de Minas
Belo Horizonte, mg, Brazil, 30130-100
Puerto Rico
San Juan City Hosp
San Juan, Puerto Rico
Sponsors and Collaborators
Investigators
Study Chair: Ellen G. Chadwick, MD Children's Memorial Hospital, Division of Pediatric Infectious Diseases
Study Chair: Jorge Pinto, MD, DSc Escola de Medicine, Universidade Federal de Minas Gerais
  More Information

Additional Information:
Publications:
Additional publications automatically indexed to this study by National Clinical Trials Identifier (NCT ID):
Study ID Numbers: PACTG P1030
Study First Received: May 31, 2002
Last Updated: August 7, 2008
ClinicalTrials.gov Identifier: NCT00038480     History of Changes
Health Authority: United States: Food and Drug Administration

Keywords provided by National Institute of Allergy and Infectious Diseases (NIAID):
Lopinavir
HIV-1
Drug Therapy, Combination
HIV Protease Inhibitors
Ritonavir
Reverse Transcriptase Inhibitors

Additional relevant MeSH terms:
Anti-Infective Agents
Sexually Transmitted Diseases, Viral
Slow Virus Diseases
Molecular Mechanisms of Pharmacological Action
Infection
Reverse Transcriptase Inhibitors
Lopinavir
Anti-Retroviral Agents
Therapeutic Uses
Retroviridae Infections
Nucleic Acid Synthesis Inhibitors
RNA Virus Infections
HIV Protease Inhibitors
Anti-HIV Agents
Immune System Diseases
Acquired Immunodeficiency Syndrome
Enzyme Inhibitors
Antiviral Agents
Immunologic Deficiency Syndromes
Pharmacologic Actions
Protease Inhibitors
Virus Diseases
HIV Infections
Ritonavir
Sexually Transmitted Diseases
Lentivirus Infections

ClinicalTrials.gov processed this record on November 30, 2009