- ICH GCP
- Yhdysvaltain kliinisten tutkimusten rekisteri
- Kliininen tutkimus NCT00028145
Prenatal and Postnatal Studies of Interventions for Prevention of Mother-To-Child Transmission
Perinatal Core Protocol
The purpose of this study is to collect and study clinical and laboratory information about a pregnant or new mother and her medical care that will increase our knowledge of the best care for HIV-infected pregnant women and their children.
The rate of transmission of HIV from mothers to their infants has gone down. Specific U.S. Public Health Service guidelines recommend that HIV-infected pregnant women be treated with anti-HIV therapies; but the effectiveness of treatment and safety for the mother and her infant have not been fully examined. This study will monitor the health of women and their infants while they receive anti-HIV therapy. Also, this study will provide information that may be used for future studies.
Tutkimuksen yleiskatsaus
Tila
Interventio / Hoito
Yksityiskohtainen kuvaus
The current low rate of vertical transmission of HIV in the U.S. limits the number and types of questions concerning transmission risk and pathogenesis that can be addressed by a single clinical trial. Specific U.S. Public Health Service guidelines recommend antiretroviral therapy (ART) during pregnancy to maximize health of women. However, data regarding the effectiveness and safety of and adherence to ART during pregnancy are limited. It is both appropriate and necessary for theInternational Maternal Pediatric Adolescent AIDS Clinical Trials Group (IMPAACT) to recruit pregnant women into a non-interventional, analytic, epidemiologic study to methodically collect clinical and laboratory data from them and their infants. This way, the IMPAACT can achieve the aims of evaluating management of HIV-infected women during pregnancy and determining the safety and effectiveness of ART and other interventions intended to prevent vertical transmission and/or improve maternal health. In addition, longitudinally collected core protocol data and repository specimens will enable future substudies.
Participants receive no protocol specific treatment or other intervention as part of this study. The study involves the follow-up of HIV-infected women enrolled during pregnancy or at the time of delivery for 6 months postpartum and their infants for the first 6 months of life. There will be 8 study visits for enrolled participants and 6 study visits for infants. Data concerning ART use, adherence to medications, and review of symptoms relevant to side effects and toxicities are collected through administration of questionnaires at all maternal visits. Phlebotomy is conducted to obtain specimens for a repository and for required laboratory tests. During labor and delivery, maternal blood is obtained for lymphocyte subset and viral load assays and for repository storage. Collection of amniotic fluid at the time of cesarean section is encouraged. These collections are submitted to a central repository. Data for the core protocol are abstracted from the infant's medical record at the time of birth and at each postnatal visit.
Opintotyyppi
Ilmoittautuminen (Todellinen)
Yhteystiedot ja paikat
Opiskelupaikat
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San Juan, Puerto Rico, 00936-5067
- University of Puerto Rico Pediatric HIV/AIDS (6601)
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San Juan, Puerto Rico, 00936-7344
- San Juan City Hosp. PR NICHD CRS (5031)
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Alabama
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Birmingham, Alabama, Yhdysvallat, 35233
- Univ. of Alabama Birmingham NICHD CRS (5096)
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Mobile, Alabama, Yhdysvallat, 36688
- University of South Alabama
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Arizona
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Phoenix, Arizona, Yhdysvallat, 85006
- Phoenix Childrens Hospital
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California
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Long Beach, California, Yhdysvallat, 90801
- Long Beach Memorial (Pediatric)
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Long Beach, California, Yhdysvallat, 90806
- Miller Children's Hospital Long Beach (5093)
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Los Angeles, California, Yhdysvallat, 900951752
- UCLA Med Ctr / Pediatric
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Los Angeles, California, Yhdysvallat, 90033
- Usc La Nichd Crs (5048)
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Los Angeles, California, Yhdysvallat, 90095
- UCLA-Los Angeles/Brazil AIDS Consortium (LABAC) CR (3601)
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Los Angeles, California, Yhdysvallat, 90033
- Los Angeles County Medical Center/USC
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San Diego, California, Yhdysvallat, 92103
- Univ of California, San Diego (4601)
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San Francisco, California, Yhdysvallat, 94117
- Univ. of California San Francisco NICHD CRS (5091)
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Torrance, California, Yhdysvallat, 90509
- Harbor-UCLA Med Ctr (5045)
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Colorado
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Denver, Colorado, Yhdysvallat, 80218-1088
- University of Colorado Denver NICHD CRS (5052)
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Connecticut
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Farmington, Connecticut, Yhdysvallat, 06030-3805
- Connecticut Childrens Medical Center (Pediatric)
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Farmington, Connecticut, Yhdysvallat, 06030-3805
- University of Connecticut, Farmington
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New Haven, Connecticut, Yhdysvallat, 06504
- Yale Univ School of Med
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District of Columbia
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Washington, District of Columbia, Yhdysvallat, 20010-2970
- Children's National Medical Center Washington DC NICHD CRS (5015)
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Washington, District of Columbia, Yhdysvallat, 200102931
- Washington Hospital Center NICHD CRS (5023)
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Washington, District of Columbia, Yhdysvallat, 20060
- Howard Univ Hosp (5044)
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Florida
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Fort Lauderdale, Florida, Yhdysvallat, 33311
- North Broward Hosp District
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Ft Lauderdal, Florida, Yhdysvallat, 33316
- South Florida CDC Ft Lauderdale NICHD CRS (5055)
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Jacksonville, Florida, Yhdysvallat, 32209
- University of Florida Jacksonville (5051)
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Miami, Florida, Yhdysvallat, 33136
- University of Miami Pediatric/Perinatal HIV/AIDS (4201)
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Miami, Florida, Yhdysvallat, 33136
- Jackson Memorial Hosp
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St Petersburg, Florida, Yhdysvallat, 33701
- University of South Florida at Tampa (5018)
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Georgia
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Augusta, Georgia, Yhdysvallat, 30912
- Med College of Georgia
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Columbus, Georgia, Yhdysvallat, 31901
- The Medical Center
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Illinois
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Chicago, Illinois, Yhdysvallat, 60612
- Cook County Hospital
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Chicago, Illinois, Yhdysvallat, 60608
- Mt Sinai Hosp Med Ctr / Dept of Pediatrics
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Chicago, Illinois, Yhdysvallat, 60612
- Rush University Cook County Hospital NICHD CRS (5083)
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Chicago, Illinois, Yhdysvallat, 60608-1797
- Womens & Childrens HIV Program
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Chicago, Illinois, Yhdysvallat, 60612-7234
- Univ of Illinois
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Chicago, Illinois, Yhdysvallat, 60614
- Chicago Childrens Memorial Hosp (Pediatric)
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Chicago, Illinois, Yhdysvallat, 60637-1470
- Univ of Chicago Children's Hosp (4001)
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Louisiana
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New Orleans, Louisiana, Yhdysvallat, 70112-2699
- Tulane University New Orleans (5095)
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New Orleans, Louisiana, Yhdysvallat, 70112-2699
- Tulane-Lakeside Hospital
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New Orleans, Louisiana, Yhdysvallat, 70112
- Tulane University Charity Hosp of New Orleans (7201)
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Maryland
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Baltimore, Maryland, Yhdysvallat, 21287
- Johns Hopkins University NICHD CRS (5092)
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Baltimore, Maryland, Yhdysvallat, 21201
- University of Maryland Baltimore NICHD CRS (5094)
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Massachusetts
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Boston, Massachusetts, Yhdysvallat, 02115
- Children's Hospital of Boston NICHD CRS (5009)
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Boston, Massachusetts, Yhdysvallat, 02118
- Boston Med Ctr (Pediatric) (5011)
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Boston, Massachusetts, Yhdysvallat, 02478
- Brigham and Women's Hosp
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Springfield, Massachusetts, Yhdysvallat, 01199
- Baystate Med Ctr of Springfield
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Worcester, Massachusetts, Yhdysvallat, 01605
- WNE Maternal Pediatric Adolescent AIDS CRS (7301)
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Worcester, Massachusetts, Yhdysvallat, 01655
- Univ of Massachusetts Med School
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Michigan
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Detroit, Michigan, Yhdysvallat, 48201-1427
- Hutzel Hospital (5089)
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Detroit, Michigan, Yhdysvallat, 48201
- Wayne State University Detroit Children's Hosp of Michigan (5041)
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Missouri
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St. Louis, Missouri, Yhdysvallat, 63108-2138
- St. Louis Children's Hosp
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New Jersey
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Newark, New Jersey, Yhdysvallat, 07103
- Univ of Med & Dentistry of New Jersey/Univ Hosp
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Newark, New Jersey, Yhdysvallat, 07103-2714
- Univ of Medicine & Dentistry of New Jersey / Univ Hosp (P2802)
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Newark, New Jersey, Yhdysvallat, 07103
- New Jersey Medical School (2802)
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New York
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Bronx, New York, Yhdysvallat, 19461
- Montefiore Medical / AECOM
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Bronx, New York, Yhdysvallat, 10451
- Lincoln Medical & Mental Health Center
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Bronx, New York, Yhdysvallat, 10461
- Jacobi Med. Ctr. Bronx NICHD CRS (5013)
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Bronx, New York, Yhdysvallat, 10457
- Bronx-Lebanon Hospital IMPAACT (6901)
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Brooklyn, New York, Yhdysvallat, 11203-2098
- Children's Hospital at Downstate
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New York, New York, Yhdysvallat, 10016
- New York University NY (5012)
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New York, New York, Yhdysvallat, 10032
- Columbia IMPAACT CRS (4101)
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New York, New York, Yhdysvallat, 10016
- NYU/Bellevue Hospital
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New York, New York, Yhdysvallat, 10029
- Metropolitan Hosp Ctr (5003)
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Rochester, New York, Yhdysvallat, 14642
- Univ of Rochester Med Ctr
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Stony Brook, New York, Yhdysvallat, 11776
- State Univ of New York at Stony Brook (5040)
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Syracuse, New York, Yhdysvallat, 13210
- SUNY Upstate Medical Univ
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North Carolina
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Durham, North Carolina, Yhdysvallat, 27705
- Duke Univ (Pediatric) (DUMC) (4701)
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Oregon
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Portland, Oregon, Yhdysvallat, 97239
- Oregon Health and Science University
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Pennsylvania
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Philadelphia, Pennsylvania, Yhdysvallat, 19104
- Hospital of the University of Pennsylvania
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Philadelphia, Pennsylvania, Yhdysvallat, 19102-1192
- Hahnemann University Hospital (6706)
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Philadelphia, Pennsylvania, Yhdysvallat, 19134
- The Children's Hospital of Philadelphia (6701)
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Tennessee
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Memphis, Tennessee, Yhdysvallat, 38105
- St. Jude Childrens Research Hosp, Memphis (6501)
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Memphis, Tennessee, Yhdysvallat, 38105-2794
- The Regional Med Ctr, Memphis (6502)
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Nashville, Tennessee, Yhdysvallat, 37232
- Vanderbilt Univ Med Ctr
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Texas
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Houston, Texas, Yhdysvallat, 77030
- Texas Children's Hosp / Baylor Univ (3801)
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Washington
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Seattle, Washington, Yhdysvallat, 98105
- Harborview Medical Center NICHD CRS (5027)
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Seattle, Washington, Yhdysvallat, 98105
- University of Washington NICHD CRS (5029)
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Seattle, Washington, Yhdysvallat, 98105-0371
- Univ of Washington Children's Hospital Seattle (5017)
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Osallistumiskriteerit
Kelpoisuusvaatimukset
Opintokelpoiset iät
Hyväksyy terveitä vapaaehtoisia
Sukupuolet, jotka voivat opiskella
Näytteenottomenetelmä
Tutkimusväestö
Kuvaus
Inclusion Criteria:
- HIV infected
- At least 14 weeks pregnant OR have delivered a liveborn or stillborn infant and are within 14 days of the delivery
- Currently receiving care at an IMPAACT or other participating site
- Have a parent or guardian willing to provide signed informed consent, if applicable
- Mentally capable of giving informed consent to have the infant and self followed at an IMPAACT site
Exclusion Criteria:
- Intend to end the pregnancy
- Unable to come for a study visit within 14 days after delivery (if known to be HIV infected prior to delivery) OR within 28 days after delivery (if found to be HIV infected at the time of labor and delivery or within 14 days after delivery)
Opintosuunnitelma
Miten tutkimus on suunniteltu?
Suunnittelun yksityiskohdat
Kohortit ja interventiot
Ryhmä/Kohortti |
Interventio / Hoito |
|---|---|
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1
Pregnant, HIV-infected women
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Adherence will be assessed using questionnaires at all study visits.
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Mitä tutkimuksessa mitataan?
Ensisijaiset tulostoimenpiteet
Tulosmittaus |
Aikaikkuna |
|---|---|
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Maternal and infant response to prescribed interventions
Aikaikkuna: Throughout study
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Throughout study
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Immune and viral parameters of participants taking prescribed interventions
Aikaikkuna: Throughout study
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Throughout study
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Toissijaiset tulostoimenpiteet
Tulosmittaus |
Aikaikkuna |
|---|---|
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Occurrences of genotypic and phenotypic resistance in HIV-infected mothers
Aikaikkuna: Throughout study
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Throughout study
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Clinical, immunological, and virological responses in HIV-infected women
Aikaikkuna: Throughout study
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Throughout study
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Mother-to-child transmission rates of resistance mutations
Aikaikkuna: Throughout study
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Throughout study
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Adherence to ART among HIV-infected pregnant women during pregnancy and postpartum
Aikaikkuna: Throughout study
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Throughout study
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Yhteistyökumppanit ja tutkijat
Yhteistyökumppanit
Tutkijat
- Opintojen puheenjohtaja: Ruth Tuomala, MD, Director of Obstetrics and Gynecology, Brigham and Women's Hospital
- Opintojen puheenjohtaja: Gwen Scott, MD, Pediatric Infectious Diseases, University of Miami School of Medicine
Julkaisuja ja hyödyllisiä linkkejä
Yleiset julkaisut
- Ciambrone D, Loewenthal HG, Bazerman LB, Zorilla C, Urbina B, Mitty JA. Adherence among women with HIV infection in Puerto Rico: the potential use of modified directly observed therapy (MDOT) among pregnant and postpartum women. Women Health. 2006;44(4):61-77. doi: 10.1300/j013v44n04_04.
- Kingston MA, Letham CJ, McQuillan O. Adherence to antiretroviral therapy in pregnancy. Int J STD AIDS. 2007 Nov;18(11):787-9. doi: 10.1258/095646207782212216.
- Bardeguez AD, Lindsey JC, Shannon M, Tuomala RE, Cohn SE, Smith E, Stek A, Buschur S, Cotter A, Bettica L, Read JS; PACTG 1025 Protocol Team. Adherence to antiretrovirals among US women during and after pregnancy. J Acquir Immune Defic Syndr. 2008 Aug 1;48(4):408-17. doi: 10.1097/QAI.0b013e31817bbe80.
- Momplaisir F, Hussein M, Kacanek D, Brady K, Agwu A, Scott G, Tuomala R, Bennett D. Perinatal Depressive Symptoms, Human Immunodeficiency Virus (HIV) Suppression, and the Underlying Role of Antiretroviral Therapy Adherence: A Longitudinal Mediation Analysis in the IMPAACT P1025 Cohort. Clin Infect Dis. 2021 Oct 20;73(8):1379-1387. doi: 10.1093/cid/ciab416.
- Jao J, Kacanek D, Williams PL, Geffner ME, Livingston EG, Sperling RS, Patel K, Bardeguez AD, Burchett SK, Chakhtoura N, Scott GB, Van Dyke RB, Abrams EJ; Pediatric HIV/AIDS Cohort Study and the International Maternal Pediatric Adolescent AIDS Clinical Trials P1025 Protocol; Pediatric HIV/AIDS Cohort Study and the International Maternal Pediatric Adolescent AIDS Clinical Trials P1025 Protocol. Birth Weight and Preterm Delivery Outcomes of Perinatally vs Nonperinatally Human Immunodeficiency Virus-Infected Pregnant Women in the United States: Results From the PHACS SMARTT Study and IMPAACT P1025 Protocol. Clin Infect Dis. 2017 Sep 15;65(6):982-989. doi: 10.1093/cid/cix488.
- Scott GB, Brogly SB, Muenz D, Stek AM, Read JS; International Maternal Pediatric Adolescent AIDS Clinical Trials Group (IMPAACT) P1025 Study Team. Missed Opportunities for Prevention of Mother-to-Child Transmission of Human Immunodeficiency Virus. Obstet Gynecol. 2017 Apr;129(4):621-628. doi: 10.1097/AOG.0000000000001929.
- Livingston EG, Huo Y, Patel K, Tuomala RE, Scott GB, Stek A; P1025 Team of the International Maternal Pediatric Adolescent AIDS Clinical Trials (IMPAACT) Group. Complications and Route of Delivery in a Large Cohort Study of HIV-1-Infected Women-IMPAACT P1025. J Acquir Immune Defic Syndr. 2016 Sep 1;73(1):74-82. doi: 10.1097/QAI.0000000000001021.
- Katz IT, Leister E, Kacanek D, Hughes MD, Bardeguez A, Livingston E, Stek A, Shapiro DE, Tuomala R. Factors associated with lack of viral suppression at delivery among highly active antiretroviral therapy-naive women with HIV: a cohort study. Ann Intern Med. 2015 Jan 20;162(2):90-9. doi: 10.7326/M13-2005.
Opintojen ennätyspäivät
Opi tärkeimmät päivämäärät
Opiskelun aloitus
Ensisijainen valmistuminen (Todellinen)
Opintojen valmistuminen (Todellinen)
Opintoihin ilmoittautumispäivät
Ensimmäinen lähetetty
Ensimmäinen toimitettu, joka täytti QC-kriteerit
Ensimmäinen Lähetetty (Arvio)
Tutkimustietojen päivitykset
Viimeisin päivitys julkaistu (Arvio)
Viimeisin lähetetty päivitys, joka täytti QC-kriteerit
Viimeksi vahvistettu
Lisää tietoa
Tähän tutkimukseen liittyvät termit
Muita asiaankuuluvia MeSH-ehtoja
Muut tutkimustunnusnumerot
- PACTG P1025
- U01AI068632 (Yhdysvaltain NIH-apuraha/sopimus)
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