Nevirapine (NVP) Use to Prevent Mother-to-Child Transmission of HIV

Condition(s) targeted: HIV Infections

Intervention: Nevirapine (Drug)

Phase: Phase 3

Status: Active, not recruiting

Sponsored by: National Institute of Allergy and Infectious Diseases (NIAID)

HIV can be transmitted from an HIV infected mother to her infant through her breast milk. The purpose of this study is to determine whether giving infants of HIV infected mothers the anti-HIV drug nevirapine (NVP) for six weeks will reduce the risk of HIV transmission.

Study hypothesis: Six weeks of nevirapine prophylaxis provided to the infant will decrease HIV transmission through breastfeeding.

Official title: Nevirapine (NVP) Use to Prevent Maternal-Infant HIV Transmission: A Randomized Clinical Trial of Two Doses of NVP Compared to Six Weeks of NVP for the Prevention of Maternal-Infant HIV Transmission in the Breastfeeding Infant

Study design: Prevention, Randomized, Double-Blind, Active Control, Factorial Assignment, Safety/Efficacy Study

Primary outcome: Infant HIV infection status at 6 and 12 months of age

Secondary outcome:

Infant mortality rate

infant morbidity rate

Detailed description: The use of antiretroviral therapy during late pregnancy, intrapartum, and immediately postpartum prevents a high proportion of vertical transmission. Potential means of decreasing HIV transmission through breastfeeding, along with the risks and benefits of early weaning, need to be further evaluated. The potential impact of early weaning interventions on the breastfeeding habits of the HIV uninfected population needs to be considered as well. This study seeks to identify a way to make breastfeeding safe for HIV infected women who choose to breastfeed.

A single dose of NVP given to infants of HIV infected mothers appears to provide some protection against vertical transmission. NVP's long half-life allows simple dosing, making it more feasible and affordable to implement in a developing country. This study will determine whether extending the NVP dosing to six weeks will significantly decrease transmission during the first several months of breastfeeding.

Minimum age: N/A. Maximum age: N/A. Gender(s): Female.

Criteria:

Inclusion Criteria:

- HIV infection, documented on two separate specimens

- Estimated gestational age at enrollment of 32 weeks or more as indicated by last

menstrual cycle and fundal height

- Permanent residency in Addis Ababa

- Plan to deliver at a hospital affliated with the study (Tikur Anbessa Hospital, Gandhi

hospital, or St. Paul's Hospital)

- Hemoglobin >= 7. 5 gm/dl within 4 weeks prior to study entry

- Serum glutamic pyruvic transaminase (SGPT) < 5 times upper limit of normal within 4

weeks prior to study entry

- Serum creatinine < 1. 5 mg/dl within 4 weeks prior to study entry

- Consent form signed by the mother and, when possible, by the father, prior to the

onset of labor

Tikur Anbessa Hospital, Addis Ababa, Ethiopia

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Starting date: February 2001
Last updated: September 17, 2007