This study aims to find out whether treating children and young people living with HIV with two anti HIV medicines, dolutegravir and lamivudine, is safe and as effective as the three-medicine anti-HIV treatments currently used in routine practice.
This study will include 370 children and young people aged 2 to less than 15 years old who are living with HIV and are being treated with anti-HIV medicines for the first time. Participants will be split into two groups, by chance, by a process called "randomisation". One group will continue to receive the anti-HIV medicines already taken according to country-specific routine practice. The second group will change to the new combination of medicine, dolutegravir and lamivudine (with the combination written usually as "DTG/3TC"). Depending on the weight, participants in the second group will be able take the new medicine either as one tablet a day or as a small number of dispersible tablets that are also taken once a day. All children and young people in the study will have regular clinic assessments that are at a similar frequency to the clinic visits that participants would have outside of the study. Blood tests will be performed to check that the medicine is safe and, at some visits, participants and their carers will also be asked to answer some questions on how they feel about taking their medicine. All children and young people will be followed until the last participant who joins the study has been in the study for 96 weeks. After 96 weeks, children who were randomised to the DTG/3TC arm will enter the extended follow-up continuing to receive DTG/3TC.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
386
Children randomised to the DTG/3TC arm will receive once daily DTG/3TC fixed dose combination dispersible or film-coated tablets dosed using WHO weight bands criteria
2 nucleos(t)ide reverse transcriptase inhibitor (NRTI) and a third (anchor) drug (either an integrase strand transfer inhibitor (INSTI), a protease inhibitor (PI) or a non- nucleoside reverse transcriptase inhibitor (NNRTI)
King Edward VIII Hospital
Durban, South Africa
PHRU Klerksdorp
Klerksdorp, South Africa
PHRU
Soweto, South Africa
Proportion of children with confirmed viral rebound (defined as the first of two consecutive HIV-1 RNA ≥50c/mL) by week 96
Time frame: by Week 96
Proportion of children with confirmed viral rebound (defined as the first of two consecutive HIV-1 RNA ≥50c/mL) by week 48
Time frame: by Week 48
Proportion of children with confirmed HIV-1 RNA ≥50c/mL at weeks 48 and 96 (modified FDA snapshot)
Time frame: at Week 48 and 96
Proportion of children with HIV-1 RNA ≥50c/mL at weeks 24, 48 and 96 (including blips and confirmed measures ≥50c/mL)
Time frame: at Week 24, 48 and 96
New resistance-associated mutations in those with confirmed HIV-1 RNA ≥50c/mL
Time frame: by Week 96
Time to any new or recurrent WHO 3 or WHO 4 event or death
Time frame: through study completion, up to 5 years
Change in CD4 (absolute and percentage) from baseline to weeks 24, 48 and 96
Time frame: Week 24, 48 and 96
Incidence of serious adverse events, grade 3 and 4 clinical and laboratory adverse events
Time frame: through study completion, up to 5 years
Incidence of adverse events leading to discontinuation or modification of the treatment regimen
Time frame: through study completion, up to 5 years
Proportion of children with a change in ART for toxicity or switch to second-line
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Hospital Universitario 12 de Octubre
Madrid, Spain
Prapokklao Hospital
Chanthaburi, Thailand
Nakornping Hospital
Chiang Mai, Thailand
Chiangrai Prachanukroh Hospital
Chiang Rai, Thailand
Khon Kaen Hospital
Khon Kaen, Thailand
Baylor
Kampala, Uganda
Joint Clinical Research Centre
Kampala, Uganda
...and 4 more locations
Time frame: through study completion, up to 5 years
Change in blood lipids from baseline to weeks 48 and 96
Time frame: Week 48 and 96
Change in creatinine clearance estimated using bedside-Schwartz to weeks 48 and 96
Time frame: Week 48 and 96