- ICH GCP
- Registr klinických studií v USA
- Klinická studie NCT00000869
A Study of Nevirapine for the Prevention of HIV Transmission From Mothers to Their Babies
A Phase III Randomized, Blinded Study of Nevirapine for the Prevention of Maternal-Fetal Transmission in Pregnant HIV-Infected Women
The purpose of this study is to see if giving the anti-HIV drug nevirapine (NVP) to HIV-positive pregnant women and their babies can help reduce the chance that a mother will give HIV to her baby during delivery. This study will also test the safety of the drug and see how well it is tolerated by the mother and her baby.
Previous studies suggest that NVP is a promising medication for blocking HIV transmission from HIV-positive mothers to their babies.
Přehled studie
Detailní popis
Nevirapine has several properties that make it an attractive candidate for antiretroviral therapy to interrupt HIV-1 transmission in the intrapartum and early postpartum period. The pharmacokinetic profile suggested that nevirapine would be rapidly absorbed and transferred to the infant in utero when given during labor and delivery. In addition, nevirapine has been shown to penetrate cell-free virions and inactivate virion-associated reverse transcriptase (RT) in situ. This property would be potentially useful in inactivating cell-free virions in the genital tract as well as in breast milk. These characteristics of nevirapine suggest that treatment of an HIV-infected pregnant woman in labor with an oral dose of nevirapine may provide a prophylactic level of nevirapine in the infant during the time of exposure to virus in the birth canal and/or maternal blood. In addition, nevirapine may inactivate the virion-associated RT present in cell-free virions in the genital tract or breast milk.
Women are randomized to receive either NVP or the corresponding placebo in active labor. Women are randomized at any time after their 32nd week gestation [AS PER AMENDMENT 1/13/98: 28th week gestation] [AS PER AMENDMENT 2/23/00: 20th week gestation]. The randomization is stratified using two factors: (1) use of [AS PER AMENDMENT 2/23/00: current or anticipated] antiretroviral therapy during the current pregnancy (no therapy at all; monotherapy for any duration; multi-agent therapy for any duration), and (2) CD4 cell count at the time of randomization (less than 200 cells; 200 - 399 cells; 400 cells or greater). Mothers are followed on study for 4 to 6 weeks postpartum. Mothers are also encouraged to follow the regimen of zidovudine (ZDV) outlined in the Office of Public Health and Science (PHS) treatment guidelines for both themselves and their infants. Infants are administered either NVP or placebo between 48 and 72 hours of life. The infant's study drug is the same as the mother's randomized treatment assignment. Infants are dosed with the study drug according to their randomization group regardless of whether the mother received the study drug. Infants are followed for 4 to 6 weeks, and are tested for HIV at 4 to 6 weeks, 3 months, and 6 months.
Typ studie
Zápis
Fáze
- Fáze 3
Kontakty a umístění
Studijní místa
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Bayamon, Portoriko, 00956
- Ramon Ruiz Arnau Univ Hosp / Pediatrics
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San Juan, Portoriko, 009367344
- San Juan City Hosp
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San Juan, Portoriko, 009365067
- Univ of Puerto Rico / Univ Children's Hosp AIDS
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Alabama
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Birmingham, Alabama, Spojené státy, 35233
- Univ of Alabama at Birmingham - Pediatric
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Mobile, Alabama, Spojené státy, 36604
- Univ of South Alabama
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California
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La Jolla, California, Spojené státy, 920930672
- UCSD Med Ctr / Pediatrics / Clinical Sciences
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Long Beach, California, Spojené státy, 90801
- Long Beach Memorial (Pediatric)
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Los Angeles, California, Spojené státy, 90033
- Los Angeles County - USC Med Ctr
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Los Angeles, California, Spojené státy, 905022004
- Harbor - UCLA Med Ctr / UCLA School of Medicine
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Los Angeles, California, Spojené státy, 900951752
- UCLA Med Ctr / Pediatric
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San Francisco, California, Spojené státy, 94110
- San Francisco Gen Hosp
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San Francisco, California, Spojené státy, 941430105
- UCSF / Moffitt Hosp - Pediatric
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Colorado
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Denver, Colorado, Spojené státy, 802181088
- Children's Hosp of Denver
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Connecticut
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Farmington, Connecticut, Spojené státy, 06032
- Univ of Connecticut / Farmington
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Farmington, Connecticut, Spojené státy, 060303805
- Connecticut Children's Med Ctr
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District of Columbia
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Washington, District of Columbia, Spojené státy, 200102931
- Washington Hosp Ctr
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Washington, District of Columbia, Spojené státy, 20060
- Howard Univ Hosp
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Florida
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Fort Lauderdale, Florida, Spojené státy, 33311
- North Broward Hosp District
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Gainesville, Florida, Spojené státy, 32610
- Univ of Florida Gainesville
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Jacksonville, Florida, Spojené státy, 32209
- Univ of Florida Health Science Ctr / Pediatrics
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Miami, Florida, Spojené státy, 33161
- Univ of Miami (Pediatric)
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Miami, Florida, Spojené státy, 33136
- Univ of Miami / Jackson Memorial Hosp
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Georgia
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Augusta, Georgia, Spojené státy, 30912
- Med College of Georgia
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Columbus, Georgia, Spojené státy, 31901
- The Med Ctr Inc
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Illinois
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Chicago, Illinois, Spojené státy, 60612
- Cook County Hosp
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Chicago, Illinois, Spojené státy, 606143394
- Chicago Children's Memorial Hosp
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Chicago, Illinois, Spojené státy, 606371470
- Univ of Chicago Children's Hosp
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Chicago, Illinois, Spojené státy, 60612
- Univ of Illinois College of Medicine / Pediatrics
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Louisiana
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New Orleans, Louisiana, Spojené státy, 701122699
- Tulane Univ / Charity Hosp of New Orleans
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New Orleans, Louisiana, Spojené státy, 701122699
- Tulane Univ Hosp of New Orleans
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New Orleans, Louisiana, Spojené státy, 70112
- Univ Hosp
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Maryland
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Baltimore, Maryland, Spojené státy, 21201
- Univ of Maryland at Baltimore / Univ Med Ctr
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Baltimore, Maryland, Spojené státy, 212874933
- Johns Hopkins Hosp - Pediatric
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Massachusetts
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Boston, Massachusetts, Spojené státy, 02115
- Brigham and Women's Hosp
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Boston, Massachusetts, Spojené státy, 021155724
- Children's Hosp of Boston
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Boston, Massachusetts, Spojené státy, 02118
- Boston City Hosp / Pediatrics
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Springfield, Massachusetts, Spojené státy, 01199
- Baystate Med Ctr of Springfield
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Worcester, Massachusetts, Spojené státy, 016550001
- Univ of Massachusetts Med School
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Michigan
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Detroit, Michigan, Spojené státy, 48201
- Children's Hosp of Michigan
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Mississippi
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Jackson, Mississippi, Spojené státy, 39213
- Univ of Mississippi Med Ctr
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New Jersey
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Camden, New Jersey, Spojené státy, 08103
- Cooper Hosp - Univ Med Ctr / UMDNJ - New Jersey Med Schl
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New Brunswick, New Jersey, Spojené státy, 089030019
- UMDNJ - Robert Wood Johnson Med School / Pediatrics
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New Brunswick, New Jersey, Spojené státy, 08903
- St Peter's Med Ctr
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Newark, New Jersey, Spojené státy, 071032714
- Univ of Medicine & Dentistry of New Jersey / Univ Hosp
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Newark, New Jersey, Spojené státy, 07103
- Saint Joseph's Hosp and Med Ctr/UMDNJ - New Jersey Med Schl
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New York
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Albany, New York, Spojené státy, 12208
- Children's Hosp at Albany Med Ctr
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Bronx, New York, Spojené státy, 10461
- Bronx Municipal Hosp Ctr/Jacobi Med Ctr
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Bronx, New York, Spojené státy, 10457
- Bronx Lebanon Hosp Ctr
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Great Neck, New York, Spojené státy, 11021
- North Shore Univ Hosp
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New York, New York, Spojené státy, 10016
- Bellevue Hosp / New York Univ Med Ctr
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New York, New York, Spojené státy, 10029
- Metropolitan Hosp Ctr
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New York, New York, Spojené státy, 10032
- Columbia Presbyterian Med Ctr
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Rochester, New York, Spojené státy, 146420001
- Univ of Rochester Med Ctr
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Syracuse, New York, Spojené státy, 13210
- SUNY Health Sciences Ctr at Syracuse / Pediatrics
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North Carolina
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Durham, North Carolina, Spojené státy, 277103499
- Duke Univ Med Ctr
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Durham, North Carolina, Spojené státy, 27710
- Univ of North Carolina at Chapel Hill / Duke Univ Med Ctr
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Pennsylvania
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Philadelphia, Pennsylvania, Spojené státy, 191044318
- Children's Hosp of Philadelphia
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Philadelphia, Pennsylvania, Spojené státy, 191341095
- Saint Christopher's Hosp for Children
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Philadelphia, Pennsylvania, Spojené státy, 191341095
- Temple Univ School of Medicine
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Philadelphia, Pennsylvania, Spojené státy, 19104
- Hosp of the Univ of Pennsylvania
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South Carolina
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Charleston, South Carolina, Spojené státy, 294253312
- Med Univ of South Carolina
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Tennessee
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Memphis, Tennessee, Spojené státy, 381052794
- Saint Jude Children's Research Hosp of Memphis
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Memphis, Tennessee, Spojené státy, 38103
- Regional Med Ctr at Memphis
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Memphis, Tennessee, Spojené státy, 381052794
- Methodist Hosp Central
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Nashville, Tennessee, Spojené státy, 372322581
- Vanderbilt Univ Med Ctr
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Texas
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Dallas, Texas, Spojené státy, 75235
- Children's Med Ctr of Dallas
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Houston, Texas, Spojené státy, 77030
- Texas Children's Hosp / Baylor Univ
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Virginia
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Norfolk, Virginia, Spojené státy, 23507
- Children's Hosp of the King's Daughters
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Norfolk, Virginia, Spojené státy, 23507
- Senetara Norfolk Gen Hosp
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Richmond, Virginia, Spojené státy, 23219
- Med College of Virginia
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Washington
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Seattle, Washington, Spojené státy, 981050371
- Children's Hospital & Medical Center / Seattle ACTU
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Tacoma, Washington, Spojené státy, 98405
- Tacoma Gen Hosp
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Kritéria účasti
Kritéria způsobilosti
Věk způsobilý ke studiu
Přijímá zdravé dobrovolníky
Pohlaví způsobilá ke studiu
Popis
Inclusion Criteria
Women may be eligible for this study if they:
- Are HIV-positive.
- Are at least 20 weeks pregnant. (This study has been changed. Women no longer have to be 28 weeks pregnant.)
- Have consent from the child's father (if available).
- Are at least 13 years old (consent of parent or guardian required if under 18).
Exclusion Criteria
Women will not be eligible for this study if they:
- Have ever taken NNRTIs (nonnucleoside reverse transcriptase inhibitors).
- Are enrolled in another pregnancy treatment study.
- Are allergic to benzodiazepines.
- Have liver disease.
- Plan to breast-feed.
Studijní plán
Jak je studie koncipována?
Detaily designu
- Primární účel: Léčba
- Maskování: Dvojnásobek
Spolupracovníci a vyšetřovatelé
Vyšetřovatelé
- Studijní židle: Alejandro Dorenbaum
- Studijní židle: John Sullivan
Publikace a užitečné odkazy
Obecné publikace
- Cunningham CK, Balasubramanian R, Delke I, Maupin R, Mofenson L, Dorenbaum A, Sullivan JL, Gonzalez-Garcia A, Thorpe E, Rathore M, Gelber RD. The impact of race/ethnicity on mother-to-child HIV transmission in the United States in Pediatric AIDS Clinical Trials Group Protocol 316. J Acquir Immune Defic Syndr. 2004 Jul 1;36(3):800-7. doi: 10.1097/00126334-200407010-00006.
- Watts DH, Balasubramanian R, Maupin RT Jr, Delke I, Dorenbaum A, Fiore S, Newell ML, Delfraissy JF, Gelber RD, Mofenson LM, Culnane M, Cunningham CK; PACTG 316 Study Team. Maternal toxicity and pregnancy complications in human immunodeficiency virus-infected women receiving antiretroviral therapy: PACTG 316. Am J Obstet Gynecol. 2004 Feb;190(2):506-16. doi: 10.1016/j.ajog.2003.07.018.
- Cunningham CK, Chaix ML, Rekacewicz C, Britto P, Rouzioux C, Gelber RD, Dorenbaum A, Delfraissy JF, Bazin B, Mofenson L, Sullivan JL. Development of resistance mutations in women receiving standard antiretroviral therapy who received intrapartum nevirapine to prevent perinatal human immunodeficiency virus type 1 transmission: a substudy of pediatric AIDS clinical trials group protocol 316. J Infect Dis. 2002 Jul 15;186(2):181-8. doi: 10.1086/341300. Epub 2002 Jun 26.
- Cunningham CK, Britto P, Gelber R, Dorenbaum A, Mofenson L, Culnane M, Sullivan JL. Genotypic resistance analysis in women participating in PACTG 316 with HIV-1 RNA >400 copies/ml. 8th Conf Retro and Opportun Infect. 2001 Feb 4-8 (abstract no 712)
- Mirochnick M, Dorenbaum A, Cunningham-Schrader B, Cunningham C, Gelber R, Mofenson L, Sullivan J. Cord blood protease inhibitor (PI) concentrations in infants born to mothers receiving PIs. 8th Conf Retro and Opportun Infect. 2001 Feb 4-8 (abstract no 710)
- Dorenbaum A. Report of results of PACTG 316: an international phase III trial of standard antiretroviral (ARV) prophylaxis plus nevirapine (NVP) for prevention of perinatal HIV transmission. 8th Conf Retro and Opportun Infect. 2001 Feb 4-8 (abstract no LB7)
- Mirochnick M, Dorenbaum A, Blanchard S, Cunningham CK, Gelber RD, Mofenson L, Culnane M, Sullivan JL. Predose infant nevirapine concentration with the two-dose intrapartum neonatal nevirapine regimen: association with timing of maternal intrapartum nevirapine dose. J Acquir Immune Defic Syndr. 2003 Jun 1;33(2):153-6. doi: 10.1097/00126334-200306010-00006.
- Newell ML, Huang S, Fiore S, Thorne C, Mandelbrot L, Sullivan JL, Maupin R, Delke I, Watts DH, Gelber RD, Cunningham CK; PACTG 316 Study Team. Characteristics and management of HIV-1-infected pregnant women enrolled in a randomised trial: differences between Europe and the USA. BMC Infect Dis. 2007 Jun 20;7:60. doi: 10.1186/1471-2334-7-60.
Termíny studijních záznamů
Hlavní termíny studia
Dokončení studie (Aktuální)
Termíny zápisu do studia
První předloženo
První předloženo, které splnilo kritéria kontroly kvality
První zveřejněno (Odhad)
Aktualizace studijních záznamů
Poslední zveřejněná aktualizace (Aktuální)
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Naposledy ověřeno
Více informací
Termíny související s touto studií
Klíčová slova
Další relevantní podmínky MeSH
- RNA virové infekce
- Virová onemocnění
- Infekce
- Infekce přenášené krví
- Přenosné nemoci
- Pohlavně přenosné choroby, virové
- Pohlavně přenosné nemoci
- Lentivirové infekce
- Retroviridae infekce
- Syndromy imunologické nedostatečnosti
- Onemocnění imunitního systému
- HIV infekce
- Molekulární mechanismy farmakologického působení
- Antiinfekční látky
- Antivirová činidla
- Inhibitory reverzní transkriptázy
- Inhibitory syntézy nukleových kyselin
- Inhibitory enzymů
- Anti-HIV činidla
- Antiretrovirová činidla
- Induktory enzymu cytochromu P-450
- Cytochrom P-450 Induktory CYP3A
- Nevirapin
Další identifikační čísla studie
- ACTG 316
- 11290 (Identifikátor registru: DAIDS ES Registry Number)
Tyto informace byly beze změn načteny přímo z webu clinicaltrials.gov. Máte-li jakékoli požadavky na změnu, odstranění nebo aktualizaci podrobností studie, kontaktujte prosím register@clinicaltrials.gov. Jakmile bude změna implementována na clinicaltrials.gov, bude automaticky aktualizována i na našem webu .
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