TDF Long Term Study

The HIV Netherlands Australia Thailand Research Collaboration36 enrolled

Overview

This study will assess the safety and efficacy of generic TDF from Governmental Pharmaceutical Organization (GPO) in HIV-infected children

TDF is a nucleotide reverse transcriptase inhibitor (NRTI) which can be taken only once per day and continues to have good efficacy even in patients who have resistance to other NNRTI in the absence of K65R mutation. TDF is a choice for patients with NRTI resistance, or those that require once-daily regimen to improve adherence. Currently, TDF has not been approved by the US FDA for children less than 18 years, but pediatricians has been using TDF in children who have treatment failure because of limitation of a more appropriate pediatric ARV. The Thai national guideline for pediatric 2009 recommend the use of TDF in children who have failed the first line therapy with multi-NRTI mutation and are more than 30 kilograms or have tanner stage 4 or more. However, the problem is that there is no pediatric TDF formulation. The available preparation of 300 mg tear drop tablet, if cut in half, may increase dosing errors, more or less by 18-37%. This will affect the blood level and/or toxicities. Therefore, the Thai Governmental Pharmaceutical Organization (GPO) has produced a generic TDF formulation that can be used in HIV-infected children. This study will assess the safety and efficacy information in children using this generic pediatric TDF formulation.

Study Type

OBSERVATIONAL

Enrollment

Conditions

HIV-infected Thai Children

Interventions

tenofovir (TDF)DRUG

Eligibility

Sex: ALLMin age: 8 YearsMax age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * children who are changing to TDF due to adherence problem or treatment failure * children who are already on TDF due to their clinical indication Exclusion Criteria: * child/caretaker refuse to participate in this study * cannot adhere to the study schedule

Locations (2)

HIV-NAT

Bangkok, Thailand

King Chulalongkorn Hospital, Chulalongkorn University

Bangkok, Thailand

Outcomes

Primary Outcomes

viral load

Number of patients who have viral load less than 50 copies/ml at week 48 and week 96

Time frame: week 48 and 96

Secondary Outcomes

renal status

Number of patients with renal toxicity assessed by GFR and with proximal tubular effect

Time frame: weeks 24, 48, 72, and 96

adherence

Agreement between self reported adherence by visual analogue scale (VAS) pill count and TDM Sensitivity and specificity of self-reported adherence and pill count against gold standards of TDM and undetectable viral load

Time frame: every 3 months

resistance

Resistant mutations in patients who fail TDF-based regimen and response to new regimen

Time frame: every 3 months

adverse events

Proportion of patients who develop adverse events which are related to TDF and other ARVs

Time frame: weeks 24, 48, 72, and 96

Data from ClinicalTrials.gov

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