Tenofovir disoproxil fumarate for prevention of HIV infection in women: a phase 2, double-blind, randomized, placebo-controlled trial.

Abstract

OBJECTIVES:

The objective of this trial was to investigate the safety and preliminary effectiveness of a daily dose of 300 mg of tenofovir disoproxil fumarate (TDF) versus placebo in preventing HIV infection in women.

DESIGN:

This was a phase 2, randomized, double-blind, placebo-controlled trial.

SETTING:

The study was conducted between June 2004 and March 2006 in Tema, Ghana; Douala, Cameroon; and Ibadan, Nigeria.

PARTICIPANTS:

We enrolled 936 HIV-negative women at high risk of HIV infection into this study.

INTERVENTION:

Participants were randomized 1:1 to once daily use of 300 mg of TDF or placebo.

OUTCOME MEASURES:

The primary safety endpoints were grade 2 or higher serum creatinine elevations (>2.0 mg/dl) for renal function, grade 3 or 4 aspartate aminotransferase or alanine aminotransferase elevations (>170 U/l) for hepatic function, and grade 3 or 4 phosphorus abnormalities (<1.5 mg/dl). The effectiveness endpoint was infection with HIV-1 or HIV-2.

RESULTS:

Study participants contributed 428 person-years of laboratory testing to the primary safety analysis. No significant differences emerged between treatment groups in clinical or laboratory safety outcomes. Study participants contributed 476 person-years of HIV testing to the primary effectiveness analysis, during which time eight seroconversions occurred. Two were diagnosed in participants randomized to TDF (0.86 per 100 person-years) and six in participants receiving placebo (2.48 per 100 person-years), yielding a rate ratio of 0.35 (95% confidence interval = 0.03-1.93), which did not achieve statistical significance. Owing to premature closures of the Cameroon and Nigeria study sites, the planned person-years of follow-up and study power could not be achieved.

CONCLUSION:

Daily oral use of TDF in HIV-uninfected women was not associated with increased clinical or laboratory adverse events. Effectiveness could not be conclusively evaluated because of the small number of HIV infections observed during the study.

• Authors: Leigh Peterson, Doug Taylor, Ronald Roddy, Ghiorghis Belai, Pamela Phillips, Kavita Nanda, Robert Grant, Edith Essie Kekawo Clarke, Anderson Sama Doh, Renee Ridzon, Howard S Jaffe, Willard Cates
• Journal: PLoS clinical trials (PLoS Clin Trials) Vol. 2 Issue 5 Pg. e27 (May 25 2007) ISSN: 1555-5887 [Electronic] England
• PMID: 17525796 (Publication Type: Journal Article)