Can a new HIV drug combo better protect pregnant women and their babies?
NCT ID NCT03048422
First seen Jul 31, 2026 · Last updated Jul 31, 2026
Summary
This phase 3 trial asks whether a dolutegravir-based HIV regimen works as well as or better than an efavirenz-based regimen in pregnant women living with HIV-1. The study compares how well each treatment suppresses the virus at delivery and checks safety for both mothers and their infants. Around 643 pregnant women are taking part, with outcomes including viral load, pregnancy complications, and serious side effects.
What this could mean
Our plain-language read of the trial. This is informational only, not medical advice or a prediction.
- Active substance
- Dolutegravir (DTG) and efavirenz (EFV) as part of combination antiretroviral therapy
- What this could lead to
- If successful, this could identify the safest and most effective HIV treatment for pregnant women, reducing mother-to-child transmission and improving outcomes for both.
- What could go wrong
- The trial is in phase 3 but still may not show clear superiority or non-inferiority. Potential risks include side effects for mothers or infants, and results may not apply to all populations.
This is an AI summary of the original study and may miss details. Read our disclaimer.
Study facts
What this study's own registry entry says, in plain language.
- Phase
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Phase 3
Large-scale testing in a bigger group. Usually the last step before a treatment can be approved.
- Participants
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643 people
The number who actually took part.
- Started
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Jan 2018
- Finished
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Oct 2020
- Lead sponsor
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A government research agency
The lead sponsor is the US National Institutes of Health.
Who can take part
This study's own entry requirements. Only the study team can say for certain whether you qualify.
- Ages
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18 years and older
- Sex
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Female participants only
- Healthy volunteers
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Not accepted
This study is not open to healthy volunteers. The entry requirements below say who it is open to.
Show the full entry requirements Hide the full entry requirements
Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.
Inclusion Criteria: * Mother is able to provide written informed consent for her and her infant's participation in this study * Mother has confirmed HIV-1 infection based on documented testing of two samples collected at different time points: * Sample #1 may be tested using any of the following: * Two rapid antibody tests from different manufacturers or based on different principles and epitopes * One enzyme immunoassay (EIA) OR Western blot OR immunofluorescence assay OR chemiluminescence assay * One HIV DNA polymerase chain reaction (PCR) * One quantitative HIV RNA PCR (above the limit of detection of the assay) * One qualitative HIV RNA PCR * One total HIV nucleic acid test * Sample #2 may be tested using any of the following: * One rapid antibody test. If this option is used in combination with two rapid tests for Sample #1, at least one of the three rapid tests must be FDA-approved and the third rapid test must be from a third manufacturer or based on a third principle or epitope. * One EIA OR Western blot OR immunofluorescence assay OR chemiluminescence assay * One HIV DNA PCR * One quantitative HIV RNA PCR (above the limit of detection of the assay) * One qualitative HIV RNA PCR * One total HIV nucleic acid test. * See the protocol for more information on this inclusion criterion. * At screening, mother is ART-naive, defined as having not received prior antiretroviral therapy other than ARVs received during prior pregnancies or prior periods of breastfeeding (i.e., receipt of any single, dual, or triple ARV regimen during prior time-limited periods of pregnancy and breastfeeding is permitted). Receipt of up to 14 days of ARVs during the current pregnancy is permitted prior to study entry so that initiation of ARVs during the current pregnancy is not delayed during the study screening period. Note: Non-study ART may be initiated in the current pregnancy prior to initiation of the study screening process. For eligible participants, enrollment must occur within 14 days of non-study ART initiation. Note: Receipt of ARVs during a prior pregnancy or prior period of breastfeeding must have concluded at least six months prior to study entry. Receipt of TDF or FTC/TDF for pre-exposure prophylaxis at any time in the past is not exclusionary (even if received within six months prior to study entry). * At screening, mother has the following laboratory test results (based on testing of samples collected within 14 days prior to study entry): * Grade 1 or lower (less than 2.5 times upper limit of normal \[ULN\]) alanine aminotransferase (ALT) and aspartate aminotransferase (AST) * Grade 2 or lower (less than or equal to 1.8 times ULN) creatinine * Grade 2 or lower (greater than or equal to 60 mL/min) estimated creatinine clearance (CrCl; Cockcroft-Gault formula). See the protocol for guidance on severity grading. Laboratory tests may be repeated during the study screening period, with the latest result used for eligibility determination. * At screening and at study entry, no evidence of multiple gestation or fetal anomalies, as assessed by best available method * At study entry, gestational age of 14-28 weeks, defined as greater than 13 weeks plus six days and less than 28 completed weeks gestation, estimated by best available method. Note: For this inclusion criterion and the previous inclusion criterion, fetal ultrasound is preferred but not required for purposes of eligibility determination. If ultrasound cannot be performed during the study screening period prior to study entry, it must be performed within 14 days after study entry. As further explained in the protocol, enrolled participants will not be withdrawn from the study based on ultrasound findings obtained after study entry. * At study entry, mother expects to remain in the geographic area of the study site during pregnancy and for 50 weeks postpartum \[Eligibility criteria added per Letter of Amendment 1 to V2; July 2018\]: * At study entry, mother reports that she does not wish to become pregnant again for at least 50 weeks after her current pregnancy and that she is willing to use effective contraception during this period. Effective contraception may include surgical sterilization (i.e., hysterectomy, bilateral oophorectomy, tubal ligation, or salpingectomy) or any of the following methods: * Contraceptive intrauterine device (IUD) or intrauterine system (IUS) * Subdermal contraceptive implant * Progestogen injections * Progestogen only oral contraceptive pills * Combined estrogen and progestogen oral contraceptive pills * Percutaneous contraceptive patches * Contraceptive vaginal rings * Note: IUDs, IUSs, implants, and injections are strongly recommended due to their lower failure rates with typical use. Male or female condom use is recommended with all contraceptive methods for dual protection against pregnancy and to avoid transmission of HIV and other sexually transmitted infections. Exclusion Criteria: * Mother is currently incarcerated or involuntarily confined in a medical facility * Mother is currently receiving: * A psychoactive medication for treatment of a psychiatric illness * Treatment for active tuberculosis * Treatment for active hepatitis C infection * Mother is expected to require treatment with interferon and/or ribavirin for hepatitis C infection during the study follow-up period * Mother has a history of any of the following, as determined by the site investigator or designee based on maternal report and available medical records: * Hypersensitivity or clinically significant adverse reaction to any of the ARVs included in the three study drug regimens (ever) * Antiretroviral drug resistance mutations that would impact selection of ART regimen (ever) * Clinically significant heart disease and/or known prolonged corrected QT (QTc) interval (ever) * Suicidal ideation or attempt (ever) * HIV-2 infection (ever) * Zika virus infection, diagnosed or suspected, during the current pregnancy * Receipt of any antiretroviral medication within six months prior to study entry, with two exceptions: receipt of any duration of TDF or FTC/TDF for pre-exposure prophylaxis or receipt of up to 14 days of ARVs during the current pregnancy * Receipt of any prohibited medication within 14 days prior to study entry (see the protocol for more information) * Clinically significant acute illness requiring systemic treatment and/or hospitalization (i.e., major medical condition that is likely to lead to hospitalization and/or to an adverse pregnancy outcome) within 14 days prior to study entry * Unstable liver disease (defined by the presence of ascites, encephalopathy, coagulopathy, hypoalbuminemia, esophageal or gastric varices, or persistent jaundice) or known biliary abnormalities (with the exception of Gilbert's syndrome or asymptomatic gallstones) within 14 days prior to study entry * Note: Testing to rule out HIV-2 infection is not required. * Mother or fetus has any other condition that, in the opinion of the site investigator or designee, would make participation in the study unsafe, complicate interpretation of study outcome data, or otherwise interfere with achieving the study objectives
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Conditions
The condition(s) this trial relates to.
As listed by the trial registrant
The condition terms exactly as the trial's registrant entered them.
Contacts and locations
Locations
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Baylor-Uganda CRS
Kampala, Uganda
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Byramjee Jeejeebhoy Medical College (BJMC) CRS
Pune, Maharashtra, 411001, India
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Chiang Mai University HIV Treatment (CMU HIV Treatment) CRS
Chiang Mai, 50200, Thailand
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Chiangrai Prachanukroh Hospital NICHD CRS
Chiang Mai, 50100, Thailand
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Famcru Crs
Tygerberg, Western Cape, 7505, South Africa
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Gaborone CRS
Gaborone, South-East District, Botswana
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Harare Family Care CRS
Harare, Zimbabwe
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Hosp. Geral De Nova Igaucu Brazil NICHD CRS
Rio de Janeiro, 26030, Brazil
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Hospital Federal dos Servidores do Estado NICHD CRS
Rio de Janeiro, 20221-903, Brazil
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Instituto de Puericultura e Pediatria Martagao Gesteira - UFRJ NICHD CRS
Rio de Janeiro, 21941-612, Brazil
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Kilimanjaro Christian Medical Centre (KCMC)
Moshi, Tanzania
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Molepolole CRS
Gaborone, Botswana
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Pediatric Perinatal HIV Clinical Trials Unit CRS
Miami, Florida, 33136, United States
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SOM Federal University Minas Gerais Brazil NICHD CRS
Belo Horizonte, Minas Gerais, 30.130-100, Brazil
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Seke North CRS
Chitungwiza, Zimbabwe
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Siriraj Hospital ,Mahidol University NICHD CRS
Bangkok, Bangkoknoi, 10700, Thailand
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Soweto IMPAACT CRS
Johannesburg, Gauteng, 1862, South Africa
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St Mary's CRS
Chitungwiza, Zimbabwe
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Umlazi CRS
Durban, KwaZulu-Natal, 4001, South Africa
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Univ. of Florida Jacksonville NICHD CRS
Jacksonville, Florida, 32209, United States
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Wits RHI Shandukani Research Centre CRS
Johannesburg, Gauteng, 2001, South Africa
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