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Development of Resistance Mutations in Pregnant HIV-Positive (+) Women Following Perinatal Antiretroviral Therapy in Israel

This study is currently recruiting participants.
Verified by Hadassah Medical Organization, September 2005

Sponsored by: Hadassah Medical Organization
Information provided by: Hadassah Medical Organization
ClinicalTrials.gov Identifier: NCT00197366
  Purpose

It has been shown that treatment of HIV-positive women with antiretroviral medication during pregnancy reduces the risk of HIV transmission to the child. However, such treatment could lead to the selection of resistant virus strains in the mother. The object of this study is to check HIV+ pregnant women for resistance mutations in HIV before and after the antiretroviral therapy they receive during pregnancy. HIV-positive newborns will also be tested, to see if a resistant virus strain was transmitted from mother to child.


Condition
HIV Infections

MedlinePlus related topics:   AIDS    AIDS and Pregnancy   

U.S. FDA Resources

Study Type:   Observational
Study Design:   Screening, Longitudinal, Defined Population, Retrospective/Prospective Study
Official Title:   Development of Resistance Mutations in the Human Immunodeficiency Virus (HIV) in Pregnant HIV+ Women Receiving Perinatal Antiretroviral Therapy in Israel

Further study details as provided by Hadassah Medical Organization:

Estimated Enrollment:   50
Study Start Date:   March 2005
Estimated Study Completion Date:   December 2007

Detailed Description:

The project will be performed in collaboration with the Israeli National HIV Reference Center Laboratory, which maintains a national bank of HIV-positive blood samples, and with HIV/AIDS treatment centers located throughout Israel.

An initial survey will identify retrospectively those HIV+ women who were given antiretroviral therapy while pregnant and stopped treatment after delivery. The list of HIV+ deliveries over the past five years in each participating hospital will be reviewed, and all HIV-positive women who received antiretroviral treatment during pregnancy will be invited to participate in the study project. Women who are currently pregnant, or become pregnant during the study, will be invited to participate when pregnancy is diagnosed. After obtaining informed consent, two blood samples will be obtained: one before the initiation of perinatal treatment, and the other following delivery. (Due to technical limitations, only samples with viral loads above 1000 cp/ml can be genotyped. It is expected that HIV loads will rise following cessation of antiretroviral treatment, and that almost all samples will be eligible for resistance testing.)

In addition, after obtaining maternal informed consent, samples from newborns infected perinatally with HIV will also be tested for resistance mutations, and these will be compared with the resistance pattern found in the mother.

The samples obtained will be tested for genotypic resistance mutations. The results will be transmitted to the treating physician to assist in choice of antiretroviral therapy for the women and their children, if needed. The data will also be used to establish a national database to evaluate and improve existing protocols for perinatal antiretroviral treatment, and will be used to contribute to international databases of HIV resistance. All resistance data, except that given to the health care provider(s), will be transmitted without additional identifying information.

  Eligibility
Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Female
Accepts Healthy Volunteers:   No

Criteria

Inclusion Criteria:

  1. HIV-positive women currently pregnant or with a past pregnancy in Israel
  2. Blood/plasma samples available before and/or after perinatal antiretroviral treatment (before or during pregnancy if not treated)
  3. HIV viral load in the samples adequate for resistance testing (approximately 1000 copies/ml)
  4. Informed consent obtained

Exclusion Criteria:

  1. Samples not available or inadequate viral load
  2. Informed consent not obtained
  Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00197366

Contacts
Contact: Shlomo Maayan, Professor     972-2-6776539     shlomo_m@hadassah.org.il    
Contact: Rebekah Karplus, MD     972-50-857-3436     reba_k@netvision.net.il    

Locations
Israel
AIDS Center, Hadassah-Hebrew U Medical Organisation     Recruiting
      Jerusalem, Israel, 92100
      Contact: Shlomo Maayan, Prof     972-2-6776539     shlomo_m@hadassah.org.il    
      Contact: Rebekah Karplus, MD     972-50-857-3436     reba_k@netvision.net.il    
      Sub-Investigator: Rebekah Karplus, MD            
      Sub-Investigator: Dani Engelhard, MD            
      Principal Investigator: Shlomo Maayan, MD            
      Sub-Investigator: Michelle Hauzi, RN            
      Sub-Investigator: Diana Averbuch, MD            
Kaplan Medical Center     Recruiting
      Rehovot, Israel, 76100
      Contact: Zev Shtaeger, Prof     972-8-944-1211     zev_s@clalit.org.il    
      Principal Investigator: Zev Shtaeger, MD            
Soroka University Medical Center     Recruiting
      Beersheva, Israel, 84101
      Contact: Klaris Riesenberg, MD     972-8-6403800     klaris@bgumail.bgu.ac.il    
      Principal Investigator: Klaris Riesenberg, MD            
Meir Hospital Sapir Medical Center     Recruiting
      Kfar Saba, Israel, 95847
      Contact: Michal Chowers, MD     972-1-700-70-7065     chowersm@post.tau.ac.il    
      Principal Investigator: Michal Chowers, MD            
Rambam Medical Center     Recruiting
      Haifa, Israel
      Contact: Shimon Pollack, Prof     972-4-854-2222     pollack@rambam.health.gov    
      Contact: Einat Kedem, MD     972-4-854-2222     e_kedem@rambam.health.gov    
      Principal Investigator: Shimon Pollack, MD            
      Sub-Investigator: Einat Kedem, MD            

Sponsors and Collaborators
Hadassah Medical Organization

Investigators
Principal Investigator:     Shlomo Maayan, MD     Hadassah-Hebrew U Medical Center    
Principal Investigator:     Zehava Grossman, PhD     Central Virology Laboratory Tel HaShomer    
Principal Investigator:     Rebekah Karplus, MD     Hadassah-Hebrew U Medical Center    
  More Information


Study ID Numbers:   16-25.02.05-HMO-CTIL
First Received:   September 14, 2005
Last Updated:   June 11, 2007
ClinicalTrials.gov Identifier:   NCT00197366
Health Authority:   Israel: Israeli Health Ministry Pharmaceutical Administration

Keywords provided by Hadassah Medical Organization:
pregnancy  
HIV-positive  
HIV resistance  
HIV  
pregnancy  

Study placed in the following topic categories:
Virus Diseases
Sexually Transmitted Diseases, Viral
HIV Seropositivity
HIV Infections
Sexually Transmitted Diseases
Acquired Immunodeficiency Syndrome
Retroviridae Infections
Immunologic Deficiency Syndromes

Additional relevant MeSH terms:
RNA Virus Infections
Slow Virus Diseases
Immune System Diseases
Lentivirus Infections
Infection

ClinicalTrials.gov processed this record on September 23, 2008




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