Status:

COMPLETED

Efavirenz (EFV) in HIV-Infected and HIV/Tuberculosis (TB) Coinfected Children

Lead Sponsor:

National Institute of Allergy and Infectious Diseases (NIAID)

Collaborating Sponsors:

Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

Conditions:

HIV Infections

Tuberculosis

Eligibility:

All Genders

3-35 years

Phase:

PHASE1

Brief Summary

Efavirenz (EFV) is an anti-HIV medicine that is commonly used to treat HIV infection in adults and children older than 3 years of age. This study is being conducted to look at the safety of EFV, blood...

Detailed Description

An increasing number of children in resource-limited countries require treatment for both HIV and tuberculosis (TB); however, the options for antiretroviral therapy (ART) that is compatible with concu...

Eligibility Criteria

Inclusion

  • Inclusion Criteria (Cohort I, Step 1 and Cohort II)
  • Older than 3 months but younger than 36 months of age (up to but not including the 3rd birthday) at the time of enrollment
  • Documentation of HIV-1 infection defined as positive results from two samples collected at different time points. More details on this criterion can be found in the protocol.
  • Treatment-eligible as defined by country-specific guidelines, World Health Organization (WHO) treatment algorithm, or by clinician's determination that the participant should be treated on other clinical grounds and will initiate antiretroviral (ARV) therapy (ART) AND has determined that in-country access to ART will be available at study conclusion
  • Able to swallow the contents of efavirenz (EFV) as opened capsules in food or liquid vehicle
  • Parent, legal guardian, or designated guardian according to country-specific guidelines able and willing to provide signed informed consent and to have the participant followed at the clinical site
  • Inclusion Criteria (Cohort I, Step 2 ONLY)
  • Currently enrolled in Cohort I, Step 1
  • Clinically diagnosed with HIV/TB co-infection and requires rifampin-containing therapy, in the clinical judgment of the site investigator
  • Chemistry and hematology laboratory values drawn during Cohort I, Step 1 are all Grade 3 or lower, except for aspartate aminotransferase/alanine aminotransferase (AST/ALT), which must be Grade 2 or lower within 4 weeks of entry into Cohort I, Step 2
  • Inclusion Criteria (Cohort II ONLY)
  • Clinically diagnosed with HIV/TB coinfection and requires rifampin-containing therapy, in the clinical judgment of the site investigator
  • Participant is tolerating a rifampin-containing anti-TB drug regimen for at least 1 week prior to study entry
  • Participant plans to continue anti-TB and study treatment for at least 16 weeks from initiation of study treatment
  • Exclusion Criteria (Cohort I, Step 1 and Cohort II)
  • Known hypersensitivity to any component of EFV capsule formulation.
  • Participants with severe malnutrition defined in the protocol
  • Infants/children who have previously been treated with EFV-based ART
  • Infants/children younger than 24 months of age with documented receipt of nevirapine (NVP) therapy, including single dose NVP for prevention of mother-to-child transmission (PMTCT). More information on this criterion can be found in the protocol.
  • Infants/children younger than 24 months of age whose mothers have documentation of receiving NVP as part of PMTCT unless they meet criteria under the exception detailed in the protocol. More information on this criterion can be found in the protocol.
  • Grade 2 or higher AST or ALT at screening
  • Any Grade 3 or higher laboratory toxicity at screening
  • Higher than Grade 3 clinical toxicity at screening
  • Participants with acute, serious infections requiring active treatment (e.g. pneumocystis pneumonia \[PCP\], etc.) may not enroll until judged to be clinically stable by the site investigator. Participants may enroll while completing active opportunistic infection treatment. Prophylaxis against opportunistic infections, including isoniazid, will be allowed.
  • Chemotherapy for active malignancy
  • Active central nervous system (CNS) infection, such as TB meningitis or cryptococcal meningitis, receiving primary therapy
  • Breastfeeding infants whose mothers are receiving or plan to initiate EFV-based highly active antiretroviral therapy (HAART) before the results of the intensive pharmacokinetic (PK) studies are available will be excluded from enrollment in this study due to the potential effect on the infant's EFV PK levels that will be evaluated in the study. More information on this criterion can be found in the protocol.

Exclusion

    Key Trial Info

    Start Date :

    February 10 2010

    Trial Type :

    INTERVENTIONAL

    Allocation :

    ACTUAL

    End Date :

    February 16 2018

    Estimated Enrollment :

    67 Patients enrolled

    Trial Details

    Trial ID

    NCT00802802

    Start Date

    February 10 2010

    End Date

    February 16 2018

    Last Update

    November 1 2021

    Active Locations (7)

    Enter a location and click search to find clinical trials sorted by distance.

    Page 1 of 2 (7 locations)

    1

    Byramjee Jeejeebhoy Medical College (BJMC) CRS

    Pune, Maharashtra, India, 411001

    2

    Soweto IMPAACT CRS

    Johannesburg, Gauteng, South Africa, 1862

    3

    Shandukani Research CRS

    Johannesburg, Gauteng, South Africa, 2001

    4

    Durban Paediatric HIV CRS

    Durban, KwaZulu-Natal, South Africa, 4001