Could a Two-Drug pill replace triple therapy for kids with HIV?
NCT ID NCT04337450
First seen Jun 27, 2026 · Last updated Jun 27, 2026
Summary
This study tests whether a two-drug combination (dolutegravir and lamivudine) is as safe and effective as the standard three-drug HIV treatment for children aged 2 to 15. About 386 children who already have undetectable HIV levels will take either the two-drug pill or their usual three-drug regimen. The goal is to see if the simpler treatment can keep the virus suppressed for up to 96 weeks.
What this could mean
Our plain-language read of the trial. This is informational only, not medical advice or a prediction.
- Active substance
- dolutegravir and lamivudine (two anti-HIV medicines)
- What this could lead to
- If successful, this could offer a simpler, two-drug daily pill for children with HIV, reducing side effects and treatment burden while maintaining viral suppression.
- What could go wrong
- This is a mid-stage trial with 386 children, so results may not apply to all. There is a risk that the two-drug combo may not suppress the virus as well as three-drug regimens, leading to viral rebound.
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 2/3
Runs two stages together: whether the treatment works, then large-scale confirmation.
- Participants
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386 people
The number who actually took part.
- Started
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Apr 2022
- Expected to finish
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Sep 2026
An estimate. End dates often move.
- Lead sponsor
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A research network
The lead sponsor is a research network or cooperative group.
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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2 to 15 years
- Sex
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Anyone
- 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 for the Main trial: 1. HIV-1 infected children who are virologically suppressed for at least the last 6 months 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 at least 3 months 5. Girls who have reached menarche must have a negative pregnancy test at screening and randomisation 6. Girls who are sexually active must be willing to adhere to highly effective methods of contraception 7. A parent or legal guardian is willing and able to give informed consent on behalf of the 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 deems them old enough and able to understand the age-appropriate information about participation in the study Inclusion Criteria for the Extended Follow up: 1. Participants remain on DTG/3TC at the end of the randomised phase, and in the opinion of the treating physician, derive ongoing benefit from DTG/3TC 2. Participants have no access to weight-appropriate DTG/3TC formulation via their national programme Exclusion Criteria for the Main trial : 1. Any previous switch in ART regimen for virological, immunological or clinical treatment failure 2. Any changes in ART in the last 6 months for reasons other than due to child's growth, 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 a course of zidovudine for PMTCT 5. Known allergy or contraindications to dolutegravir or lamivudine 6. Diagnosis of tuberculosis and on anti-tuberculosis treatment; children can be enrolled after successful tuberculosis treatment 7. Treatment of co-morbidities with drugs which have significant interactions with antiretroviral treatment, requiring dose adjustment of the study drugs (children can be 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 prior to the primary endpoint. 11. Screening ALT equal to 3 or more times the upper limit of normal AND bilirubin equal to 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 the presence of ascites, encephalopathy, coagulopathy, hypoalbuminaemia, oesophageal or gastric varices, or persistent jaundice), or known biliary abnormalities (with the exception 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 by Columbia-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 or guardian able to provide informed consent on their behalf.
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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
Kampala, Uganda
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Birmingham Heartlands Hospital
Birmingham, United Kingdom
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Chiangrai Prachanukroh Hospital
Chiang Rai, Thailand
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Great Ormand Street Hospital
London, United Kingdom
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Hospital Universitario 12 de Octubre
Madrid, Spain
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Joint Clinical Research Centre
Kampala, Uganda
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Khon Kaen Hospital
Khon Kaen, Thailand
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King Edward VIII Hospital
Durban, South Africa
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MUJHU
Kampala, Uganda
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Nakornping Hospital
Chiang Mai, Thailand
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PHRU
Soweto, South Africa
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PHRU Klerksdorp
Klerksdorp, South Africa
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Prapokklao Hospital
Chanthaburi, Thailand
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St. Mary's Hospital
London, United Kingdom
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