HIV Infections Clinical Trial
Official title:
Prevention of Maternal to Infant HIV Transmission in India
Infants who are breast-fed by HIV infected mothers have an increased risk of becoming infected with HIV. Standard therapy for the prevention of HIV infections in infants included zidovudine (ZDV) prior to the onset of labor, a single dose of nevirapine (NVP) for women during labor, and a single dose of NVP for newborns given 72 hours after birth. This study will determine if giving low dose daily NVP to breastfed infants of HIV infected mothers, in addition to standard therapy, will be more effective than standard therapy alone at preventing HIV infections in these infants.
This study will evaluate the safety and effectiveness of adding daily infant NVP to standard
prevention measures to decrease vertical transmission of HIV.
According to current statistics from the study site, approximately 70% of the pregnant HIV
infected women in this study will have begun antenatal ZDV prior to the initiation of NVP at
labor. The remaining 30% of the HIV infected women enrolled in this trial will have been
previously undiagnosed. These women will be diagnosed with HIV infection either at the time
they present to the delivery room in stage 1 of labor or immediately postpartum if they
present for delivery late in labor and cannot provide informed consent for HIV screening
prior to delivery.
All infants will receive the standard does of NVP at 72 hours postpartum. Infants will then
be randomized to receive either daily NVP and a daily multivitamin (MVI) or a daily MVI
alone. Infants will take NVP/MVI or MVI alone during Weeks 2 to 6 postpartum. The primary
outcome measure is infant HIV infection rates at 6 months.
Two additional related cohorts of women will be followed for comparison: 1) an equal number
of HIV uninfected women and their children will be enrolled for comparison of postpartum
morbidity and mortality; and 2) consenting HIV infected women and their children who choose
not to enroll in the clinical trial or are ineligible because they are not breastfeeding
will be enrolled in an ancillary cohort.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Crossover Assignment, Masking: Open Label, Primary Purpose: Prevention
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