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CompletedNCT00000751Updated Sep 30, 2008

A Phase III Randomized, Double-Blind, Controlled Study of the Use of Anti-HIV Immune Serum Globulin (HIVIG) for the Prevention of Maternal-Fetal HIV Transmission in Pregnant Women and Newborns Receiving Zidovudine (AZT)

A Phase 3 interventional study of Anti-HIV Immune Serum Globulin (Human) and Globulin, Immune in HIV Infections and Pregnancy, sponsored by Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). Completed at 51 sites in 2 countries. Open to female participants aged 13 Years to 60 Years. Per ClinicalTrials.gov, last updated 2008-09-30.

Sponsored by Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) · Phase 3, Interventional, and Treatment

Phase
Phase 3
Study type
Interventional
Enrollment
1,600
Ages
13 Years to 60 Years
Sex
Female
01

Study summary

To evaluate the effect of anti-HIV immune serum globulin (HIVIG) versus immune globulin (IVIG) administered during pregnancy and to the newborn, in combination with zidovudine (AZT) administered intrapartum and to the newborn, on incidence of HIV infection in infants born to HIV-infected women who received AZT during pregnancy for medical indications.

Vertical transmission of HIV from mother to child may occur before, during, or after parturition (via breast-feeding). It is believed that therapy administered both during pregnancy and intrapartum may help prevent vertical transmission. Additionally, adjunctive short-term antiretroviral therapy for the newborn, following the intensive viral exposure presumed to occur at birth, may be necessary.

Read the detailed description

Vertical transmission of HIV from mother to child may occur before, during, or after parturition (via breast-feeding). It is believed that therapy administered both during pregnancy and intrapartum may help prevent vertical transmission. Additionally, adjunctive short-term antiretroviral therapy for the newborn, following the intensive viral exposure presumed to occur at birth, may be necessary.

Pregnant women who are currently receiving AZT are randomized at 20-30 weeks of gestation to begin receiving either HIVIG or IVIG every 28 days up to delivery. Within 12 hours after birth, the infant receives an infusion of matching study drug. During labor, all women receive an intravenous loading dose of AZT administered over 1 hour, followed by continuous infusion during the intrapartum period until the umbilical cord is clamped. All infants receive AZT syrup every 6 hours, beginning as soon as oral fluids are tolerated but within 8-12 hours after birth and continuing for 6 weeks. Women are followed until 26 weeks postpartum. Infants are followed at weeks 1, 2, 4, and then every 4 weeks through week 24, every 12 weeks through week 60, at week 78 (18 months), and at week 104 (24 months).

02

Conditions studied

  • HIV Infections
  • Pregnancy

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Keywords

  • Pregnancy
  • Pregnancy Complications, Infectious
  • Drug Therapy, Combination
  • Acquired Immunodeficiency Syndrome
  • AIDS-Related Complex
  • Zidovudine
  • Immunoglobulins, Intravenous
  • Immunization, Passive
03

In context

HIV Infections

4,257 studies on the registry are indexed under HIV Infections; 240 are open to participants now.

This study's enrollment of 1,600 is above the median of 83 across 3,250 interventional studies indexed under HIV Infections.

Browse HIV Infections studies →

Lead sponsor

Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) is the lead sponsor of 416 studies on the registry; 25 are open to participants now.

Of its 13 completed or terminated interventional studies of FDA-regulated products, 10 (77%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
13 Years to 60 Years
Sexes eligible
Female
Accepts healthy volunteers
No

Inclusion criteria

Concurrent Medication:

Allowed:

  • Women - Medications as required for obstetrical management of HIV infection (e.g., acyclovir, ketoconazole, isoniazid, antibiotics, or other antiretroviral therapy if intolerant or failing on AZT), unless specifically excluded.
  • Infants - Drug treatment for signs of drug withdrawal (phenobarbital, chlorpromazine, tincture of opium, paregoric or Valium).
  • Infants - Medications as indicated for management of an HIV-exposed infant (e.g., hepatitis B vaccine, syphilis treatment, Pneumocystis carinii pneumonia prophylaxis).

Patients must have:

  • Documented HIV infection.
  • Been receiving AZT during current pregnancy for medical indications.
  • Gestational age between 20 and 30 weeks.
  • Intention to carry pregnancy to term.
  • Available venous access (placement of central line or Hickman catheter not indicated for study purposes).
  • Willingness to be followed by a participating site for study duration.

NOTE:

  • Father of fetus (if available after a reasonable attempt to contact him) must also provide informed consent.

Exclusion criteria

Exclusion Criteria

Co-existing Condition:

Patients with the following symptoms or conditions are excluded:

  • Illness associated with excessive protein loss, e.g., severe proteinuria (protein >= 4 g protein in a 24-hour urine collection).

Patients with the following prior conditions are excluded:

  • Evidence of pre-existing fetal anomalies (e.g., anencephaly, renal agenesis, or Potter's syndrome) that may result in a high probability that the fetus-infant would not survive to the end of the study period.
  • Chorionic villus sampling (CVS) or percutaneous umbilical blood sampling (PUBS) occurring in this pregnancy prior to study entry.
  • Illness associated with excessive protein loss, e.g., chronic diarrhea with no documented weight gain in a 3-month period during pregnancy.
  • Pre-existing conditions such as hypogammaglobulinemia or immune thrombocytopenia that are felt to require IVIG therapy.

Prior Medication:

Excluded:

  • Receipt of anti-HIV vaccines or passive immunotherapy with HIVIG or IVIG during this pregnancy prior to study entry.
  • Receipt of antiretroviral agents other than AZT during this pregnancy prior to study entry (e.g., rCD4, CD4-IgG, d4T, ddC, ddI).
05

Study design

Phase
Phase 3
Primary purpose
Treatment
Intervention model
Parallel assignment
Enrollment
1,600 participants

Interventions

  • DrugAnti-HIV Immune Serum Globulin (Human)
  • DrugGlobulin, Immune
  • DrugZidovudine
06

Study locations

51 sites
  • UCSD Med Ctr / Pediatrics / Clinical Sciences
    La Jolla, California 920930672, United States
  • Los Angeles County - USC Med Ctr
    Los Angeles, California 90033, United States
  • UCLA Med Ctr / Pediatric
    Los Angeles, California 900951752, United States
  • Harbor - UCLA Med Ctr / UCLA School of Medicine
    Los Angeles, California 905022004, United States
  • San Francisco Gen Hosp
    San Francisco, California 94110, United States
  • UCSF / Moffitt Hosp - Pediatric
    San Francisco, California 941430105, United States
  • Denver Gen Hosp
    Denver, Colorado 802044507, United States
  • Children's Hosp of Denver
    Denver, Colorado 802181088, United States
  • Univ of Connecticut / Farmington
    Farmington, Connecticut 06032, United States
  • Children's Hosp of Washington DC
    Washington, District of Columbia 200102916, United States
  • Washington Hosp Ctr
    Washington, District of Columbia 200102931, United States
  • Howard Univ Hosp
    Washington, District of Columbia 20060, United States
  • Univ of Florida Health Science Ctr / Pediatrics
    Jacksonville, Florida 32209, United States
  • Univ of Miami (Pediatric)
    Miami, Florida 33161, United States
  • Univ of Illinois College of Medicine / Pediatrics
    Chicago, Illinois 60612, United States
  • Tulane Univ / Charity Hosp of New Orleans
    New Orleans, Louisiana 701122699, United States
  • Univ Hosp
    New Orleans, Louisiana 70112, United States
  • Univ of Maryland at Baltimore / Univ Med Ctr
    Baltimore, Maryland 21201, United States
  • Johns Hopkins Hosp - Pediatric
    Baltimore, Maryland 212874933, United States
  • Children's Hosp of Boston
    Boston, Massachusetts 021155724, United States
  • Brigham and Women's Hosp
    Boston, Massachusetts 02115, United States
  • Boston City Hosp / Pediatrics
    Boston, Massachusetts 02118, United States
  • Baystate Med Ctr of Springfield
    Springfield, Massachusetts 01199, United States
  • Univ of Massachusetts Med School
    Worcester, Massachusetts 016550001, United States
  • Children's Hosp of Michigan
    Detroit, Michigan 48201, United States
  • Univ of Medicine & Dentistry of New Jersey / Univ Hosp
    Newark, New Jersey 071032714, United States
  • Children's Hosp at Albany Med Ctr
    Albany, New York 12208, United States
  • Bronx Lebanon Hosp Ctr
    Bronx, New York 10457, United States
  • Bellevue Hosp / New York Univ Med Ctr
    New York, New York 10016, United States
  • Mount Sinai Med Ctr / Pediatrics
    New York, New York 10029, United States
  • Columbia Presbyterian Med Ctr
    New York, New York 10032, United States
  • State Univ of New York at Stony Brook
    Stony Brook, New York 117948111, United States
  • SUNY Health Sciences Ctr at Syracuse / Pediatrics
    Syracuse, New York 13210, United States
  • Univ of North Carolina at Chapel Hill / Duke Univ Med Ctr
    Durham, North Carolina 27710, United States
  • Case Western Reserve Univ - Pediatric
    Cleveland, Ohio 44106, United States
  • Children's Hosp of Philadelphia
    Philadelphia, Pennsylvania 191044318, United States
  • Hosp of the Univ of Pennsylvania
    Philadelphia, Pennsylvania 19104, United States
  • Thomas Jefferson Univ Hosp
    Philadelphia, Pennsylvania 191075098, United States
  • Saint Christopher's Hosp for Children
    Philadelphia, Pennsylvania 191341095, United States
  • Temple Univ School of Medicine
    Philadelphia, Pennsylvania 191341095, United States
  • Med Univ of South Carolina
    Charleston, South Carolina 294253312, United States
  • Regional Med Ctr at Memphis
    Memphis, Tennessee 38103, United States
  • Methodist Hosp Central
    Memphis, Tennessee 381052794, United States
  • Saint Jude Children's Research Hosp of Memphis
    Memphis, Tennessee 381052794, United States
  • Children's Med Ctr of Dallas
    Dallas, Texas 75235, United States
  • Hermann Hosp / Univ Texas Health Science Ctr
    Houston, Texas 77030, United States
  • Texas Children's Hosp / Baylor Univ
    Houston, Texas 77030, United States
  • Children's Hospital & Medical Center / Seattle ACTU
    Seattle, Washington 981050371, United States
  • Ramon Ruiz Arnau Univ Hosp / Pediatrics
    Bayamon, 00956, Puerto Rico
  • Univ of Puerto Rico / Univ Children's Hosp AIDS
    San Juan, 009365067, Puerto Rico
  • San Juan City Hosp
    San Juan, 009367344, Puerto Rico
07

References and documents

Publications

  • Mofenson LM. Interventions to reduce perinatal transmission. Natl Conf Women HIV. 1997 May 4-7:125 (abstract no 2011)
  • McKinney RE Jr. Ongoing and future trials of antiretroviral therapy in the pediatric AIDS clinical trials group (PACTG). Conf Retroviruses Opportunistic Infect. 1996 Jan 28-Feb 1;3rd:173
  • Lambert J, Fletcher C, Mofenson L, Stiehm ER, Moye J, Meyer W, Nemo G, Mathieson B, Hirsch G. Pharmacokinetics (PK) of hyperimmune HIV immunoglobulin (HIVIG) in HIV+ pregnant females & newborns. Natl Conf Hum Retroviruses Relat Infect (2nd). 1995 Jan 29-Feb 2:148
  • Lambert JS, Watts DH, Mofenson L, Stiehm ER, Harris DR, Bethel J, Whitehouse J, Jimenez E, Gandia J, Scott G, O'Sullivan MJ, Kovacs A, Stek A, Shearer WT, Hammill H, van Dyke R, Maupin R, Silio M, Fowler MG. Risk factors for preterm birth, low birth weight, and intrauterine growth retardation in infants born to HIV-infected pregnant women receiving zidovudine. Pediatric AIDS Clinical Trials Group 185 Team. AIDS. 2000 Jul 7;14(10):1389-99. doi: 10.1097/00002030-200007070-00012. PubMed 10930154 ↗
  • Mofenson LM, Lambert JS, Stiehm ER, Bethel J, Meyer WA 3rd, Whitehouse J, Moye J Jr, Reichelderfer P, Harris DR, Fowler MG, Mathieson BJ, Nemo GJ. Risk factors for perinatal transmission of human immunodeficiency virus type 1 in women treated with zidovudine. Pediatric AIDS Clinical Trials Group Study 185 Team. N Engl J Med. 1999 Aug 5;341(6):385-93. doi: 10.1056/NEJM199908053410601. PubMed 10432323 ↗
  • Lambert JS, Mofenson LM, Fletcher CV, Moye J Jr, Stiehm ER, Meyer WA 3rd, Nemo GJ, Mathieson BJ, Hirsch G, Sapan CV, Cummins LM, Jimenez E, O'Neill E, Kovacs A, Stek A. Safety and pharmacokinetics of hyperimmune anti-human immunodeficiency virus (HIV) immunoglobulin administered to HIV-infected pregnant women and their newborns. Pediatric AIDS Clinical Trials Group Protocol 185 Pharmacokinetic Study Group. J Infect Dis. 1997 Feb;175(2):283-91. doi: 10.1093/infdis/175.2.283. PubMed 9203648 ↗
  • Lambert JS, Moye J, Sapan C, Mofenson L, Fletcher C, Whitehouse J, Fowler MG, Nemo G, Stiehm ER. Demonstration of feasibility and preliminary safety and pharmaco-kinetics in a phase III study of hyperimmune HIV intravenous immunoglobulin (HIV-IG) to prevent maternal-fetal HIV transmission. Int Conf AIDS. 1996 Jul 7-12;11(2):84 (abstract no WeB3163)
  • Frenkel LM. Therapeutic issues pertaining to HIV-1 infected pregnant women in developed countries. 39th Intersci Conf Antimicrob Agents Chemother. 1999 Sept 26-29
  • Watts DH, Lambert J, Stiehm ER, Harris DR, Bethel J, Mofenson L, Meyer WA 3rd, Mathieson B, Fowler MG, Nemo G; PACTG 185 Study Team. Progression of HIV disease among women following delivery. J Acquir Immune Defic Syndr. 2003 Aug 15;33(5):585-93. doi: 10.1097/00126334-200308150-00006. PubMed 12902802 ↗
  • Lambert JS. HIV vaccines in infants and children. Paediatr Drugs. 2005;7(5):267-76. doi: 10.2165/00148581-200507050-00001. PubMed 16220994 ↗
08

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Sep 30, 2008, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT00000751
Lead sponsor
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
Collaborators
National Institute of Allergy and Infectious Diseases (NIAID)
First posted
Aug 31, 2001
Completion
Aug 2007
Last update
Sep 30, 2008

Study contacts

ER Stiehm
study chair
J Lambert
study chair
View the source record on ClinicalTrials.gov ↗

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