Phase IV, multi-site, open-label, non-randomized study of the pharmacokinetics (PK) of long-acting injectable cabotegravir and rilpivirine (CAB LA + RPV LA) during pregnancy and postpartum.
Up to 40 adult-participants with HIV viral suppression will be enrolled, in pairs with their infants, to achieve 30 evaluable adult-participants overall. The study will include women who initiated CAB LA + RPV LA outside the study, prior to study entry, either pre-conception (including on the day of conception) or post-conception.
Study Type
OBSERVATIONAL
Enrollment
40
Long-acting injectable cabotegravir and rilpivirine, initiated pre- or post-conception. Participants will receive these drugs as prescribed outside the study by their non-study clinical care provider
Site 4601, University of California, UC San Diego CRS
La Jolla, California, United States
Site 5048, University of Southern California
Los Angeles, California, United States
Site 5052, University of Colorado
Aurora, Colorado, United States
Population PK: geometric mean clearance of CAB and RPV in second trimester, third trimester, and postpartum derived from a population PK model
Population PK: geometric mean clearance of CAB and RPV in second trimester, third trimester, and postpartum derived from a population PK model
Time frame: Measured from study entry through six weeks postpartum
Geometric mean pharmacokinetic trough of CAB and RPV from every 4 week (Q4W) CAB LA and RPV LA measured every 4 weeks in plasma in second trimester, third trimester, and postpartum
Geometric mean pharmacokinetic trough of CAB and RPV from every 4 week (Q4W) CAB LA and RPV LA measured every 4 weeks in plasma in second trimester, third trimester, and postpartum
Time frame: Measured from study entry through six weeks postpartum
Percentage of adult participants with HIV RNA less than 50 copies/mL at delivery
Percentage of adult participants with HIV RNA less than 50 copies/mL at delivery
Time frame: Delivery
Percentage of adult participants with virologic escape
Percentage of adult participants with virologic escape, defined as a single measurement of HIV RNA greater than or equal to 200 copies/mL
Time frame: Measured from study entry through six weeks postpartum
Percentage of adult participants with confirmed virologic failure
Percentage of adult participants with confirmed virologic failure, defined as two successive HIV RNA test results greater than or equal to 200 copies/mL from separate specimens collected at least two weeks apart
Time frame: Through 6 weeks postpartum
Number of adult participants with HIV resistance to CAB or RPV who had confirmed virologic failure
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Site 5030, Emory University School of Medicine
Atlanta, Georgia, United States
Site 4001, Lurie Children's Hospital of Chicago CRS
Chicago, Illinois, United States
Site 5092, Johns Hopkins University
Baltimore, Maryland, United States
Site 5013, Jacobi Medical Center Bronx
The Bronx, New York, United States
Site 6201, University of Pennsylvania
Philadelphia, Pennsylvania, United States
Site 6501, St Jude Children's Research Hospital
Memphis, Tennessee, United States
Site 5128, Baylor College of Medicine/Texas Children's Hospital
Houston, Texas, United States
Number of adult participants with HIV resistance to CAB or RPV using IAS-USA, in participants who experienced confirmed virologic failure
Time frame: Through 6 weeks postpartum
Number of infant participants with perinatal transmission
Number of infant participants with perinatal transmission
Time frame: Birth and six weeks post-birth
Percentage of adult participants with at least one Grade 3 or higher adverse event
Percentage of adult participants with at least one Grade 3 or higher adverse event
Time frame: Measured from study entry through six weeks postpartum
Percentage of adult participants with at least one serious adverse event
Percentage of adult participants with at least one serious adverse event
Time frame: Measured from study entry through six weeks postpartum
Percentage of infant participants with at least one serious adverse event
Percentage of infant participants with at least one serious adverse event
Time frame: Measured from birth through six weeks post-birth
Percentage of adult participants with spontaneous abortion
Percentage of adult participants with spontaneous abortion less than 20 weeks gestation
Time frame: Through 6 weeks postpartum
Percentage of adult participants with fetal demise/stillbirth
Percentage of adult participants with fetal demise/stillbirth, at greater than or equal to 20 weeks gestation
Time frame: Through 6 weeks postpartum
Percentage of infant participants born small for gestational age
Percentage of infant participants born small for gestational age, where birthweight is less than 10th percentile for sex and gestational age assigned at birth, based on Intergrowth 21st Standards
Time frame: Birth
Percentage of infant participants with low birth weight
Percentage of infant participants with low birth weight, defined as less than 2500 grams
Time frame: Birth
Percentage of infant participants born preterm
Percentage of infant participants born preterm, defined as less than 37 weeks gestation
Time frame: Birth
Percentage of mother-infant pairs with occurrence of any adverse pregnancy outcome
Percentage of mother-infant pairs with occurrence of any adverse pregnancy outcome. Outcomes include: spontaneous abortion (\<20 weeks gestation), stillbirth (≥20 weeks gestation), preterm delivery (\<37 gestational weeks), small for gestational age (\<10th percentile per INTERGROWTH 21st Standards), or neonatal death
Time frame: Through 6 weeks postpartum
Percentage of infant participants with a congenital anomaly
Percentage of infant participants with a congenital anomaly based on the Metropolitan Atlanta Congenital Defects Program (MACDP) definition of defect
Time frame: Birth
Percentage of infant deaths
Percentage of infant deaths
Time frame: Measured from birth through six weeks post-birth
Percentage of adult participants who would recommend CAB LA and RPV LA injections for other people living with HIV during pregnancy
Percentage of adult participants who would recommend CAB LA and RPV LA injections
Time frame: Six weeks postpartum