By Metohuey Michael Adoglo
The global study led by researchers at University College London and published in The New England Journal of Medicine found that dolutegravir-based regimens, which are already widely used to treat adults, reduced the chances of treatment failure among young people aged three to 18 by around 40 per cent compared to standard treatments.
As reported by EurekAlert, the findings were based on a randomised controlled trial called ODYSSEY involving more than 700 children from 29 clinical centres in Africa, Europe, and Asia, who were randomly given either dolutegravir or standard anti-HIV drugs, and who were followed up for at least two years.
The findings from the trial, which was sponsored by the Penta Foundation and funded by ViiV Healthcare, informed new guidance by the World Health Organisation, recommending the use of dolutegravir-based treatment for children.
In the study, researchers found that 14% of children receiving dolutegravir experienced treatment failure over two years compared to 22% of children receiving standard treatment.
Evidence from adults shows dolutegravir has a high genetic barrier to resistance, meaning viruses are less likely to become resistant to it over time. This was replicated in the ODYSSEY trial, with much less resistance occurring among children and adolescents on dolutegravir-based treatment.
Past studies have suggested dolutegravir may be associated with weight gain among adults but the researchers said the new findings were reassuring for children, with those given dolutegravir gaining 1kg more and growing 1cm higher over two years – both indicating better growth rather than abnormal weight gain. Children in the dolutegravir arm had better lipid profiles, meaning a lower risk of cardiovascular disease in the long term.
The trial participants were enrolled in Uganda, Zimbabwe, South Africa, Thailand, the UK, Spain, Portugal, and Germany. Most of the participants were based in sub-Saharan Africa, where most children living with HIV are.
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