- ICH GCP
- 미국 임상 시험 레지스트리
- 임상시험 NCT00409591
Maternal/Infant Peripartum NVP, Versus Infant Only Peripartum NVP, or Maternal LPV/r in Addition to Standard ZDV Prophylaxis for the Prevention of Perinatal (PMTCT) HIV in Thailand (PHPT-5)
Maternal and Infant Peripartum Nevirapine, Versus Infant Only Peripartum Nevirapine, or Maternal Lopinavir/Ritonavir in Addition to Standard Zidovudine Prophylaxis for the Prevention of Perinatal HIV in Thailand.
연구 개요
상태
상세 설명
Multicenter, placebo-controlled, double blind, clinical trial where non immunocompromised women receiving the ZDV prophylaxis regimen from 28 weeks gestation, as recommended in Thailand, will be randomized to one of two arms:
Arm 1: NVP-NVP:
- In women, one NVP 200 mg tablet at onset of labor+;
- In neonates, NVP oral suspension 6 mg in the delivery room immediately after birth plus a second dose between 48 and 72 hours+++
Arm 2: PL-NVP:
- In women, one placebo tablet at onset of labor++;
- In neonates, NVP oral suspension 6 mg in the delivery room immediately after birth plus a second dose between 48 and 72 hours+++
Arm 3: LPV/r:
In women, LPV/r 400/100 mg bid from 28 weeks' gestation until delivery
- women in Arm 1 will also receive 7-day ZDV 300mg bid plus 3TC 150mg bid from delivery. ++women in Arm 2 will also receive 7-day (ZDV+3TC) Placebo from delivery. +++If the new born weight less than 2500 g, nevirapine will be administered 2 mg./1 kg (As per Thai Guideline).
All infants will receive ZDV for at least one week. Follow-up of women and infants is carried out on an outpatient basis except for delivery and the first three days after delivery. Mothers and infants are followed-up for 24 months after delivery.
Note: The study was stopped and data unblinded upon DSMB recommendations in September 2010 because of changes in Thai PMTCT guidelines recommending use of HAART in all HIV infected pregnant women regardless of their CD4 count. At the time of unblinding 435 pregnant women had been enrolled and follow-up of these women and their children is continuing.
연구 유형
등록 (실제)
단계
- 3단계
연락처 및 위치
연구 장소
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Bangkok, 태국, 10220
- Health Promotion Hospital Regional Center I
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Chiang Mai, 태국, 50100
- Health Promotion Center Region 10,
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Chiang Mai, 태국, 50110
- Fang Hospital
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Chiang Mai, 태국, 50160
- Chomthong hospital
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Chonburi, 태국, 20180
- Somdej Pranangchao Sirikit Hospital
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Khon Kaen, 태국, 40000
- Regional Health Promotion Centre 6,
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Lamphun, 태국, 51000
- Lamphun Hospital
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Phayao, 태국, 56000
- Phayao Provincial Hospital
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Phuket, 태국, 83000
- Vachira Phuket Hospital
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Samutprakarn, 태국, 10280
- Samutprakarn Hospital
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Bangkok
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Kannayao, Bangkok, 태국, 10230
- Nopparat Rajathanee Hospital
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Saimai, Bangkok, 태국
- Bhumibol Adulyadej Hospital
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Chachoengsao
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Muang, Chachoengsao, 태국, 24000
- Chachoengsao Hospital
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Chantaburi
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Muang, Chantaburi, 태국, 22000
- Prapokklao Hospital
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Chiang Mai
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Mae Rim, Chiang Mai, 태국, 50180
- Nakornping Hospital
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Sanpatong, Chiang Mai, 태국
- Sanpatong Hospital
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Chiang Rai
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Mae Chan, Chiang Rai, 태국
- Mae Chan Hospital
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Mae Sai, Chiang Rai, 태국
- Mae Sai Hospital
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Phan, Chiang Rai, 태국
- Phan Hospital
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Chiangrai
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Chiang Saen, Chiangrai, 태국, 57150
- Chiang Saen Hospital
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Muang, Chiangrai, 태국, 57000
- Chiangrai Prachanukroh Hospital
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Wiangpapao, Chiangrai, 태국, 57170
- Wiangpapao Hospital
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Chonburi
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Banglamung, Chonburi, 태국, 20150
- Banglamung Hospital
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Muang, Chonburi, 태국, 20000
- Chonburi Hospital
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Panasnikom, Chonburi, 태국, 20140
- Panasnikom Hospital
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Sri Racha, Chonburi, 태국, 20230
- Ao Udom Hospital
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Kalasin
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Muang, Kalasin, 태국, 46000
- Kalasin Hospital
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Kanjanaburi
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Munag, Kanjanaburi, 태국, 71000
- Phaholpolphayuhasena Hospital
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Khon Kaen
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Muang, Khon Kaen, 태국
- Khon Kaen Hospital
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Lampang
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Muang, Lampang, Lampang, 태국, 52000
- Lampang Hospital
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Mahasarakam
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Muang, Mahasarakam, 태국, 44000
- Mahasarakam Hospital
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Nakhon Si Thammarat
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Muang, Nakhon Si Thammarat, 태국, 80000
- Maharaj Nakhon Si Thammarat Hospital
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Nakhonpathom
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Muang, Nakhonpathom, 태국
- Nakhonpathom Hospital
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Nong Kai
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Muang, Nong Kai, 태국, 43000
- Nong Khai Hospital
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Nonthaburi
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Muang, Nonthaburi, 태국
- Pranangklao Hospital
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Pathumthani
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Muang, Pathumthani, 태국, 12000
- Pathumthani Hospital
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Phayao
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Chiang Kham, Phayao, 태국, 56110
- Chiang Kham Hospital
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Pitsanulok
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Muang, Pitsanulok, 태국
- Buddhachinaraj Hospital
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Rayong
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Muang, Rayong, 태국, 21000
- Rayong Hospital
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Samutsakhon
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Muang, Samutsakhon, 태국, 74000
- Samutsakhon Hospital
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Songkhla
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Muangsongkhla, Songkhla, 태국, 90100
- Songkhla Hospital
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Songkla
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Hat Yai, Songkla, 태국, 90110
- Hat Yai Hospital
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Trat
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Muang, Trat, 태국, 23000
- Trat Hospital
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참여기준
자격 기준
공부할 수 있는 나이
- 어린이
- 성인
- 고령자
건강한 자원 봉사자를 받아들입니다
연구 대상 성별
설명
Pre-Entry Criteria
- Evidence of HIV infection (documented by two HIV antibody tests on two different dates)
- Intend to be followed at a study site for the duration of the study
- At least 18 years old
- Written informed consent.
Inclusion Criteria:
Women are eligible for the study if they
- met all pre-entry criteria
- Evidence of HIV infection, as documented by two serology tests obtained at two different dates;
- between 28 and 36 weeks gestational age;
- antiretroviral naïve except for exposure to ZDV prophylaxis PMTCT;
- CD4 count above 250 cells/mm3 (within 4 months prior to randomization)
- agreement not to breastfeed;
- consent to participate and to be followed for the duration of the study;
- and the following laboratory values within 14 days prior to randomization:
- hemoglobin > 8.5 mg/dl;
- absolute neutrophil count > 750 cells/mm3;
- platelets > 50,000 cells/mm3;
- SGPT ≤ 5 times upper limit of normal;
- serum creatinine ≤ 1.5 times upper limit of normal (women with a serum creatinine > 1.5 times upper limit of normal must have a measured eight-hour urine creatinine clearance > 70 ml/min).
Exclusion criteria:
- Evidence of pre-existing fetal anomalies incompatible with life;
- patients who meet the criteria of Classes III/IV of the WHO classification of HIV-associated clinical disease;
- known hypersensitivity to any benzodiazepine;
- active tuberculosis;
- concurrent participation to any other clinical trial;
- receipt of benzodiazepines or antiretroviral agent other than ZDV;
- uncontrolled hypertension;
- anticoagulant therapy or magnesium sulfate within 2 weeks of enrollment or the need for them during labor or at delivery.
If any of these conditions occurs after randomization, the women will be excluded from study drug dosing. Women with CD4 count lower than 250 cells/mm3 will be excluded from the study and offered HAART in the context of the national program.
공부 계획
연구는 어떻게 설계됩니까?
디자인 세부사항
- 주 목적: 방지
- 할당: 무작위
- 중재 모델: 병렬 할당
- 마스킹: 없음(오픈 라벨)
무기와 개입
참가자 그룹 / 팔 |
개입 / 치료 |
---|---|
활성 비교기: 1
NVP-NVP:
|
In addition, all women and infants in the 3 arms will receive standard ZDV prophylaxis, as per Thai and WHO guidelines.
|
실험적: 2
PL-NVP:
|
In addition, all women and infants in the 3 arms will receive standard ZDV prophylaxis, as per Thai and WHO guidelines.
Comparison between Arms 1 and 2 is double-blinded. |
실험적: 3
LPV/r:
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In addition, all women and infants in the 3 arms will receive standard ZDV prophylaxis, as per Thai and WHO guidelines.
- In women, LPV/r 400/100 mg bid from 28 weeks' gestation until delivery
|
연구는 무엇을 측정합니까?
주요 결과 측정
결과 측정 |
기간 |
---|---|
Definitive HIV infection in infants as assessed by positive HIV DNA PCR on two peripheral blood samples
기간: At birth, 7-10 days, 1, 2, 4 and 6 months of age
|
At birth, 7-10 days, 1, 2, 4 and 6 months of age
|
2차 결과 측정
결과 측정 |
기간 |
---|---|
Safety for mothers and children of two NVP doses in neonates with and without maternal single dose NVP at onset of labor or LPV/r from 28 weeks gestation.
기간: From randomization during pregnancy until 24 months after delivery
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From randomization during pregnancy until 24 months after delivery
|
공동 작업자 및 조사자
협력자
수사관
- 수석 연구원: Marc Lallemant, MD, Institut de Recherche pour le Developpment
간행물 및 유용한 링크
일반 간행물
- Lallemant M, Jourdain G, Le Coeur S, Mary JY, Ngo-Giang-Huong N, Koetsawang S, Kanshana S, McIntosh K, Thaineua V; Perinatal HIV Prevention Trial (Thailand) Investigators. Single-dose perinatal nevirapine plus standard zidovudine to prevent mother-to-child transmission of HIV-1 in Thailand. N Engl J Med. 2004 Jul 15;351(3):217-28. doi: 10.1056/NEJMoa033500. Epub 2004 Jul 9.
- Jourdain G, Ngo-Giang-Huong N, Le Coeur S, Bowonwatanuwong C, Kantipong P, Leechanachai P, Ariyadej S, Leenasirimakul P, Hammer S, Lallemant M; Perinatal HIV Prevention Trial Group. Intrapartum exposure to nevirapine and subsequent maternal responses to nevirapine-based antiretroviral therapy. N Engl J Med. 2004 Jul 15;351(3):229-40. doi: 10.1056/NEJMoa041305. Epub 2004 Jul 9.
- Shapiro RL, Thior I, Gilbert PB, Lockman S, Wester C, Smeaton LM, Stevens L, Heymann SJ, Ndung'u T, Gaseitsiwe S, Novitsky V, Makhema J, Lagakos S, Essex M. Maternal single-dose nevirapine versus placebo as part of an antiretroviral strategy to prevent mother-to-child HIV transmission in Botswana. AIDS. 2006 Jun 12;20(9):1281-8. doi: 10.1097/01.aids.0000232236.26630.35.
- Cressey TR, Jourdain G, Rawangban B, Varadisai S, Kongpanichkul R, Sabsanong P, Yuthavisuthi P, Chirayus S, Ngo-Giang-Huong N, Voramongkol N, Pattarakulwanich S, Lallemant M; PHPT-5 Team. Pharmacokinetics and virologic response of zidovudine/lopinavir/ritonavir initiated during the third trimester of pregnancy. AIDS. 2010 Sep 10;24(14):2193-200. doi: 10.1097/QAD.0b013e32833ce57d.
- Lallemant M, Le Coeur S, Sirirungsi W, Cressey TR, Ngo-Giang-Huong N, Traisathit P, Klinbuayaem V, Sabsanong P, Kanjanavikai P, Jourdain G, Mcintosh K, Koetsawang S; PHPT-5 study investigators. Randomized noninferiority trial of two maternal single-dose nevirapine-sparing regimens to prevent perinatal HIV in Thailand. AIDS. 2015 Nov 28;29(18):2497-507. doi: 10.1097/QAD.0000000000000865.
- Sripan P, Le Coeur S, Amzal B, Ingsrisawang L, Traisathit P, Ngo-Giang-Huong N, McIntosh K, Cressey TR, Sangsawang S, Rawangban B, Kanjanavikai P, Treluyer JM, Jourdain G, Lallemant M, Urien S. Modeling of In-Utero and Intra-Partum Transmissions to Evaluate the Efficacy of Interventions for the Prevention of Perinatal HIV. PLoS One. 2015 May 19;10(5):e0126647. doi: 10.1371/journal.pone.0126647. eCollection 2015. Erratum In: PLoS One. 2015;10(6):e0130917. PLoS One. 2015;10(8):e0137368.
연구 기록 날짜
연구 주요 날짜
연구 시작
기본 완료 (실제)
연구 완료 (실제)
연구 등록 날짜
최초 제출
QC 기준을 충족하는 최초 제출
처음 게시됨 (추정)
연구 기록 업데이트
마지막 업데이트 게시됨 (추정)
QC 기준을 충족하는 마지막 업데이트 제출
마지막으로 확인됨
추가 정보
이 연구와 관련된 용어
추가 관련 MeSH 약관
- RNA 바이러스 감염
- 바이러스 질환
- 감염
- 혈액 매개 감염
- 전염병
- 성병, 바이러스성
- 성병
- 렌티바이러스 감염
- 레트로바이러스과 감염
- 면역 결핍 증후군
- 면역계 질환
- HIV 감염
- 약리작용의 분자기전
- 항감염제
- 항바이러스제
- 역전사 효소 억제제
- 핵산 합성 억제제
- 효소 억제제
- 항HIV제
- 항레트로바이러스제
- 항대사물질
- 프로테아제 억제제
- 시토크롬 P-450 CYP3A 억제제
- 시토크롬 P-450 효소 억제제
- 시토크롬 P-450 효소 유도제
- 시토크롬 P-450 CYP3A 유도제
- HIV 프로테아제 억제제
- 바이러스성 프로테아제 억제제
- 네비라핀
- 리토나비어
- 로피나비르
- 지도부딘
기타 연구 ID 번호
- PHPT-5 First Phase
- R01HD052461 (미국 NIH 보조금/계약)
- R01HD056953 (미국 NIH 보조금/계약)
약물 및 장치 정보, 연구 문서
미국 FDA 규제 의약품 연구
미국 FDA 규제 기기 제품 연구
미국에서 제조되어 미국에서 수출되는 제품
이 정보는 변경 없이 clinicaltrials.gov 웹사이트에서 직접 가져온 것입니다. 귀하의 연구 세부 정보를 변경, 제거 또는 업데이트하도록 요청하는 경우 register@clinicaltrials.gov. 문의하십시오. 변경 사항이 clinicaltrials.gov에 구현되는 즉시 저희 웹사이트에도 자동으로 업데이트됩니다. .
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