The purpose of this study is to assess the evolution of raltegravir concentration in the mother (between the 3rd trimester of pregnancy and one month post-delivery) and her neonate, when this drug is used to prevent mother-to-child HIV-1 transmission as part of a combined antiretroviral regimen.
1. Objectives 1. Principal objective * To study pharmacokinetic properties of raltegravir in pregnant women infected by HIV-1, during the third trimester of pregnancy (between 30 and 37 weeks of amenorrhea) and 1 month after childbirth (between W4 and W6 postpartum), as well as in their neonate. 2. Secondary objectives * Estimate the frequency of women receiving raltegravir and having indetectable viral load at delivery (and those having a strictly indetectable viral load, with no signal under the threshold of the technique used). * Describe the tolerance to raltegravir in pregnant women during the third trimester and in her neonates 2. Methodology * National multicenter pharmacokinetic study conducted among pregnant women infected by HIV-1 and exposed to raltegravir during pregnancy. 3. Statistical method * Method of population pharmacokinetic with 5 samples: before the drug intake, 0.5, 3, 8 and 12 hours after the intake at each of the 2 visits (between 30 and 37 weeks of amenorrhea, and 4 to 6 weeks after delivery).
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
83
Introduction of a catheter for performing 5 blood samples in pregnant women infected by HIV-1, before the raltegravir intake, 0.5, 3, 8 and 12 hours after the intake at each of two visits (between 30 and 37 weeks of amenorrhea, and 4 to 6 weeks after delivery)
CHU Hôtel Dieu
Paris, France
Comparison of the AUC and raltegravir trough concentration during and after pregnancy
Time frame: 5 samples: before the drug intake, 0.5, 3, 8 and 12 hours after the intake at each of the 2 visits (between 30 and 37 weeks of amenorrhea, and 4 to 6 weeks after delivery)
Estimation of placental transfer of raltegravir
Cmin, Cmax, AUC, t1/2 of raltegravir in newborns.
Time frame: Up to 72 hours after delivery
Study of genetic polymorphism which could modify raltegravir concentrations
Time frame: Up to 72 hours after delivery
Proportion of women having a viral load < 50 cp/mL at delivery
Time frame: Up to 72 hours after delivery
Proportion of maternal-to-child HIV transmission
Time frame: Up to 72 hours after delivery
Untimely stop of raltegravir for toxicity or intolerance
Time frame: Up to 72 hours after delivery
Clinical and biological anomaly occurring during the third trimester of pregnancy and during the first 6 months of life of the neonate.
Number of newborns with adverse events as a measure of safety and tolerability. Newborns will be followed up to 24 weeks of age.
Time frame: Month 6
Estimation of neonatal elimination of raltegravir
Cmin, Cmax, AUC, t1/2 of raltegravir in newborns.
Time frame: Up to 72 hours after delivery
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