DTG/3TC Fixed Dose Formulations for the Maintenance of Virological Suppression in Children with HIV Infection Aged 2 to <15 Years Old

Last updated: November 14, 2024
Sponsor: PENTA Foundation
Overall Status: Active - Recruiting

Phase

2/3

Condition

Hiv Infections

Aids And Aids Related Infections

Hiv/aids

Treatment

Dolutegravir (DTG) and lamivudine (3TC)

SOC

Clinical Study ID

NCT04337450
D3 (Penta21)
  • Ages 2-15
  • All Genders

Study Summary

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.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  1. HIV-1 infected children who are virologically suppressed for at least the last 6months prior to enrolment

  2. Aged 2 to <15 years old

  3. Weight 6 kg or higher

  4. Children on the same triple-drug PI/r, NNRTI or INSTI containing ART regimen for atleast 3 months

  5. Girls who have reached menarche must have a negative pregnancy test at screening andrandomisation

  6. Girls who are sexually active must be willing to adhere to highly effective methodsof contraception

  7. A parent or legal guardian is willing and able to give informed consent on behalf ofthe child as per national legislation and willing to adhere to the protocol

  8. Participant is willing to give informed assent if the trial site clinician deemsthem old enough and able to understand the age-appropriate information aboutparticipation in the study

Exclusion

Exclusion Criteria:

  1. Any previous switch in ART regimen for virological, immunological or clinicaltreatment failure

  2. Any changes in ART in the last 6 months for reasons other than due to child'sgrowth, drug stock-outs, changes in country guidelines and treatment simplification

  3. Evidence of previous resistance to 3TC or INSTI

  4. Any prior use of regimens consisting of single or dual NRTIs with the exception of acourse of zidovudine for PMTCT

  5. Known allergy or contraindications to dolutegravir or lamivudine

  6. Diagnosis of tuberculosis and on anti-tuberculosis treatment; children can beenrolled after successful tuberculosis treatment

  7. Treatment of co-morbidities with drugs which have significant interactions withantiretroviral treatment, requiring dose adjustment of the study drugs (children canbe enrolled after the illness resolves)

  8. Randomisation visit more than 12 weeks after the most recent screening visit

  9. Evidence of hepatitis B infection with no protective immunity against hepatitis B:participants positive for HBsAg or HBcAb and negative for HBsAb

  10. Anticipated need for hepatitis C virus therapy with interferon-based regimen priorto the primary endpoint.

  11. Screening ALT equal to 3 or more times the upper limit of normal AND bilirubin equalto 2 or more times the upper limit of normal (ALT ≥3xULN AND bilirubin ≥2xULN)

  12. Screening ALT equal to 5 or more times the upper limit of normal ALT (≥5xULN)

  13. Patients with severe hepatic impairment or unstable liver disease (as defined by thepresence of ascites, encephalopathy, coagulopathy, hypoalbuminaemia, oesophageal orgastric varices, or persistent jaundice), or known biliary abnormalities (with theexception of Gilbert's syndrome or asymptomatic gallstones)

  14. Screening creatinine clearance <50 mL/min/1.73m2

  15. Patients aged ≥6 years at moderate or high risk of suicide as determined byColumbia-Suicide Severity Rating Scale (C-SSRS)

  16. Girls who are pregnant or breastfeeding

  17. Children who are in the legal custody of the State and do not have a parent orguardian able to provide informed consent on their behalf.

Study Design

Total Participants: 370
Treatment Group(s): 2
Primary Treatment: Dolutegravir (DTG) and lamivudine (3TC)
Phase: 2/3
Study Start date:
April 22, 2022
Estimated Completion Date:
September 30, 2025

Study Description

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.

Connect with a study center

  • King Edward VIII Hospital

    Durban,
    South Africa

    Active - Recruiting

  • PHRU Klerksdorp

    Klerksdorp,
    South Africa

    Active - Recruiting

  • PHRU

    Soweto,
    South Africa

    Active - Recruiting

  • Hospital Universitario 12 de Octubre

    Madrid,
    Spain

    Site Not Available

  • Prapokklao Hospital

    Chanthaburi,
    Thailand

    Active - Recruiting

  • Nakornping Hospital

    Chiang Mai,
    Thailand

    Active - Recruiting

  • Chiangrai Prachanukroh Hospital

    Chiang Rai,
    Thailand

    Active - Recruiting

  • Khon Kaen Hospital

    Khon Kaen,
    Thailand

    Active - Recruiting

  • Baylor

    Kampala,
    Uganda

    Active - Recruiting

  • Joint Clinical Research Centre

    Kampala,
    Uganda

    Active - Recruiting

  • MUJHU

    Kampala,
    Uganda

    Active - Recruiting

  • Birmingham Heartlands Hospital

    Birmingham,
    United Kingdom

    Site Not Available

  • Great Ormand Street Hospital

    London,
    United Kingdom

    Site Not Available

  • St. Mary's Hospital

    London,
    United Kingdom

    Site Not Available

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