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A Study of HIV Levels During Pregnancy and After Childbirth



A Study of HIV Levels During Pregnancy and After Childbirth

For Condition: HIV Infections,Pregnancy
Status: Recruiting
Sponsor(s): National Institute of Allergy and Infectious Diseases (NIAID) ,
Synopsis: The purpose of this study is to find out if HIV-infected pregnant women taking anti-HIV drugs have an increased amount of HIV in their blood (viral load) after having the baby. The purpose of A5153s, a substudy of A5150, is to characterize two anti-HIV drugs (nelfinavir [NFV] and lopinavir/ritonavir [LPV/r]) in HIV-infected women during pregnancy and after childbirth. Sometimes pregnant women have an increase in their HIV viral load after their baby is born. This study will try to find out how often this happens. It will also examine possible reasons why the increase in viral load occurs.
Details: Limited data suggest that HIV-infected pregnant women develop postpartum viral rebound. However, viral load changes in the postpartum period have not been adequately characterized. Changes in adherence to antiretroviral therapy, pregnancy-related changes in pharmacokinetics of antiretroviral medications, and decline in immune competence are mechanisms by which postpartum viral load rebound may occur. This study is designed to characterize the incidence and magnitude of postpartum viral rebound during the initial 24 weeks postpartum and to explore the mechanisms and consequences of viral rebound. Eligible patients are evaluated at gestational weeks 34 and 36, at delivery, and at regular visits for 96 weeks postpartum. Most evaluations include a medical history, physical exam, laboratory tests, and adherence and quality-of-life questionnaires. Viral load and CD4/CD8 cell counts are measured frequently. Patients are expected to receive at least 8 weeks of stable HAART before delivery, and to continue HAART throughout the remainder of the study. The choice of HAART is left to the primary provider. No antiretroviral drugs are provided by this study. Patients participating in the A5153s substudy receive either NFV or LPV/r as part of their HAART. Pharmacokinetic blood sampling takes place at 36 weeks gestation, 6 weeks postpartum, and 24 weeks postpartum. Patients record the administration times and doses of their NFV or LPV/r for 48 hours prior to each substudy visit, and hold their regularly scheduled doses of antiretroviral medications on substudy days. Patients arrive at the clinic fasting (no food or drink for the previous 8 hours) and are given a standardized breakfast prior to supervised administration of their NFV or LPV/r dose. An intravenous catheter is placed in an arm vein for blood collection at pre-dose and 1, 2, 4, and 6 hours post-dose.
Eligibility:
Study Type:
  Observational, Natural History
Minimum Age/Maximum Age: 13 Years/
Genders: Female
Protocol Entry Criteria: Inclusion Criteria Patients may be eligible for this study if they: - Are age 13 or older. - Are between 22 and 30 weeks pregnant. - Have had their pregnancy confirmed by ultrasound at 14 weeks gestation or later. - Are infected with HIV. - Are planning to receive at least 8 weeks of highly active antiretroviral therapy (HAART) by the time they have their baby. - Are available for follow-up for the duration of the study. Exclusion Criteria Patients may not be eligible for this study if they: - Intend to terminate their pregnancy. - Intend to breast-feed their baby. - Are carrying a baby with major abnormalities, including spina bifida, anencephaly, hydrops, or ascites. - Have taken certain medications. - Are enrolled in other studies that require large blood draws. - Will be taking anti-HIV drugs only to prevent mother-to-child transmission of HIV, and not to treat the maternal infection itself. - Actively abuse drugs or alcohol in a way that would interfere with participation in the study.
Total Enrollment: 129

Location and Contact Information:

Overall Study Official:
AliceStek,  Study Chair, 

State Univ of New York at Stony Brook *Recruiting*
Stony Brook,  New York,  11794-8111
United States
Recruiting Michell  Davi 631-444-1313

Duke Univ Med Ctr *Recruiting*
Durham,  North Carolina,  27710
United States
Recruiting Suzanne  Aycock 919-684-8216

Cook County Hosp Core Ctr *Recruiting*
Chicago,  Illinois,  60612
United States
Recruiting Joanne  Despotes 315-572-4545

MetroHealth Med Ctr *Recruiting*
Cleveland,  Ohio,  44109-1998
United States
Recruiting Ann  Conrad 216-778-5489

Rush Presbyterian - Saint Luke's Med Ctr *Recruiting*
Chicago,  Illinois,  60612
United States
Recruiting Jan  Fritsche 312-942-5865

Univ of Med & Dentistry of NJ/Univ Hosp *Recruiting*
Newark,  New Jersey,  07103
United States
Recruiting Mary  Hoyt 973-972-3118

The Regional Med Ctr, Memphis *Recruiting*
Memphis,  Tennessee,  38105-2794
United States
Recruiting Laura  Utech 901-495-3490

Comprehensive Care Clinic *Recruiting*
Nashville,  Tennessee,  37203
United States
Recruiting Janet  Nicotera 615-467-0154

San Francisco General Hosp *Recruiting*
San Francisco,  California,  94110
United States
Recruiting Michele  Downing 415-514-0550

Univ of Florida- Health Science Ctr *Recruiting*
Jacksonville,  Florida,  32209
United States
Recruiting Melissa  Scites 904-244-3108

Univ of North Carolina *Recruiting*
Chapel Hill,  North Carolina,  27514
United States
Recruiting Cheryl  Marcus 919-843-8761

Miriam Hosp / Brown Univ *Recruiting*
Providence,  Rhode Island,  02906
United States
Recruiting Joan  Gormley 401-793-4396

Los Angeles County Medical Center/USC *Recruiting*
Los Angeles,  California,  90033
United States
Recruiting Eva  Operskalski 323-226-2226

Emory Univ *Recruiting*
Atlanta,  Georgia,  30308
United States
Recruiting Ericka  Patrick 404-616-6313

San Juan City Hosp *Recruiting*
San Juan,  , 
Puerto Rico
Recruiting Maria  Pilar Thurin 787-765-4186

Case Western Reserve Univ *Recruiting*
Cleveland,  Ohio,  44106
United States
Recruiting Michael  Chance 216-844-8051

Univ of Alabama at Birmingham *Recruiting*
Birmingham,  Alabama,  35294
United States
Recruiting Betty  McCulloch 205-975-7925

Jacobi Med Ctr *Recruiting*
Bronx,  New York,  10461
United States
Recruiting Wanda  Biernick 718-918-4903

Univ of Washington (Seattle) *Recruiting*
Seattle,  Washington,  98104
United States
Recruiting Jeanne  Conley 206-731-8877

Indiana Univ Hosp *Recruiting*
Indianapolis,  Indiana,  46202
United States
Recruiting Beth  Zwickl 317-274-8456

Hennepin County Med Clinic *Recruiting*
Minneapolis,  Minnesota,  55455-0392
United States
Recruiting Ellen  Kane 612-347-2690

UCSD Mother, Child & Adolescent HIV Program *Recruiting*
San Diego,  California,  92103
United States
Recruiting Linda  Proctor 619-543-8080

University of Pittsburgh *Recruiting*
Pittsburgh,  Pennsylvania,  15213-2582
United States
Recruiting Christine  Tripoli 412-647-0771

University of Texas, Southwestern Medical Center *Recruiting*
Dallas,  Texas,  75235-9173
United States
Recruiting Chip  Lohner 214-590-0414


Additional Information:
Study ID Numbers:
  ACTG A5150;  AACTG A5150,ACTG A5153s,AACTG A5153s
Study Start Date: 
Record last reviewed: May 2004
Additional information available at: clinicaltrials.gov
Clinicaltrials.gov Reference link: NCT00041964

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