HIV Infections Clinical Trial
Official title:
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.
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.
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Observational Model: Cohort, Time Perspective: Prospective
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