- ICH GCP
- Register voor klinische proeven in de VS.
- Klinische proef NCT01625169
Etravirine Pharmacokinetics and HIV Viral Load in Breast Milk and Plasma
Antiretroviral Drug Concentrations and HIV Viral Load in Breast Milk and Plasma in HIV+ Women Receiving HAART (Highly Active Antiretroviral Therapy) Therapy: Etravirine (ETR) Pharmacokinetics (PK) in Breast Milk and Plasma
HIV positive pregnant women who receive potent combination antiretroviral therapy over at least the last trimester of pregnancy, and who have proper obstetric interventions and are able to avoid breast feeding, decrease the risk of having an infected infant to about 1%. Breast milk HIV-1 RNA (cell free) viral load is significantly associated with breast milk transmission, and a 2-fold increased risk of transmission associated with every 10-fold increase in breast milk viral load has been reported. In addition, cell associated virus (HIV DNA) was associated with a significant increase in risk of transmission independent of the level of cell-free viral RNA.
However, multiple studies of HIV positive women giving birth have shown that exclusive breast-feeding carries a much lower risk of HIV transmission than mixed breast-feeding (defined as breast milk along with complementary food, other milk, and/or infant formula). The proposed study will measure the antiretroviral (ARV) drug etravirine concentrations in blood and breast milk in postpartum HIV positive women on HAART therapy. The short-term goal is to determine how much etravirine penetrates into breast milk, and whether it leads to undetectable HIV viral load in the breast milk and therefore has the potential to decrease the risk of transmission of HIV through breast milk. The long term goal is to see if breast milk HIV levels can be lowered sufficiently to prevent maternal to child transmission (MTCT) of HIV in infants receiving only breast feeding in resource poor areas.
Studie Overzicht
Toestand
Conditie
Interventie / Behandeling
Studietype
Inschrijving (Werkelijk)
Fase
- Niet toepasbaar
Contacten en locaties
Studie Locaties
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California
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Los Angeles, California, Verenigde Staten, 90033
- LAC+USC MCA Clinic
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Geslachten die in aanmerking komen voor studie
Beschrijving
Inclusion Criteria:
- HIV+ pregnant women on HAART for the prevention of MTCT w/ undetectable viral load at time of delivery (w/i 30 days of delivery).
- 18 years and older
- Only women who are deemed by the physician as being capable of understanding that HIV positive women should not breastfeed will be approached.
- Life expectancy greater than 6 months
- No known allergies to etravirine
- Willingness of subject to adhere to protocol requirements.
Exclusion Criteria:
- Pregnant women with medical or psychological contraindications to breast milk expression.
Requirements for prohibited medications:
- ARV: Tipranavir/ritonavir, fosamprenavir/ritonavir, atazanavir/ritonavir, and protease inhibitors administered without ritonavir, nonnucleoside reverse transcriptase inhibitor (NNRTIs).
- Alternative/CAM: St. John's wort
- Anticonvulsants: Phenobarbital, carbamazepine , phenytoin
- Anti-infectives: Rifampin
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Toewijzing: NVT
- Interventioneel model: Opdracht voor een enkele groep
- Masker: Geen (open label)
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
|---|---|
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Ander: HIV + pregnant women
Etravirine pharmacokinetics in breast milk and plasma.
Etravirine 200mg PO BID for 14 days with PK on days 5 and 14
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HIV+ pregnant women will receive etravirine 200mg PO BID for 14 days postpartum.
PK will be done on postpartum days 5 and 14.
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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Peak Plasma Concentration of Etravirine in Plasma
Tijdsspanne: Day 5
|
Cmax ng/ml Note: One participant did not complete the Day 5 evaluation. |
Day 5
|
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Peak Concentration of Etravirine in Breast Milk
Tijdsspanne: day 5
|
Cmax ng/ml Note: One participant did not complete the Day 5 evaluation. |
day 5
|
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Peak Concentration of Etravirine in Breast Milk
Tijdsspanne: day 14
|
Cmax ng/mL
|
day 14
|
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Peak Plasma Concentration of Etravirine in Plasma
Tijdsspanne: day 14
|
Cmax ng/mL
|
day 14
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Area Under the Curve (AUC) 0-12 for Plasma
Tijdsspanne: Day 5: 0, 2,4, 8 and 24 hours post dose
|
AUC 0-12 ng*hr/ml
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Day 5: 0, 2,4, 8 and 24 hours post dose
|
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Area Under the Curve (AUC) 0-12 for Plasma
Tijdsspanne: Day 14: 0, 2,4, 8 and 24 hours post dose
|
AUC 0-12 ng*hr/ml
|
Day 14: 0, 2,4, 8 and 24 hours post dose
|
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Area Under the Curve (AUC) 0-12 for Breast Milk
Tijdsspanne: Day 5
|
AUC 0-12 ng*hr/ml
|
Day 5
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Area Under the Curve (AUC) 0-12 for Breast Milk
Tijdsspanne: Day 14
|
AUC 0-12 ng*hr/ml
|
Day 14
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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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HIV Viral Load in Breast Milk and Plasma
Tijdsspanne: Day 5
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Positive HIV RNA in breast milk and plasma- LDL 40 copies/ml
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Day 5
|
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HIV Viral Load in Breast Milk and Plasma
Tijdsspanne: Day 14
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Positive HIV RNA in breast milk and plasma- LDL 40 copies/ml
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Day 14
|
Medewerkers en onderzoekers
Onderzoekers
- Hoofdonderzoeker: LaShonda Y Spencer, MD, University of Southern California
Studie record data
Bestudeer belangrijke data
Studie start
Primaire voltooiing (Werkelijk)
Studie voltooiing (Werkelijk)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Schatting)
Updates van studierecords
Laatste update geplaatst (Schatting)
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
- HS-09-00698
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