RecruitingPhase 3NCT06747507

Ndovu RCT: Investing the Optimal Management of Dolutegravir Resistance

Investigating the Optimal Management of Dolutegravir Resistance: an Open-label Randomised Controlled Trial of Maintaining Dolutegravir or Switch to Ritonavir-boosted Darunavir


Sponsor

University of Nairobi

Enrollment

392 participants

Start Date

Sep 1, 2025

Study Type

INTERVENTIONAL

Conditions

Summary

This clinical trial will address the gap in published data on the effect of dolutegravir (DTG)-associated drug-resistant mutations on viral suppression among people remaining on DTG-based antiretroviral therapy. It will also address the gap in the optimal management strategy for this population.


Eligibility

Min Age: 3 Years

Inclusion Criteria6

  • Enrolled in the Ndovu cohort study
  • Able and willing to understand and comply with the protocol requirements, instructions and restrictions
  • Able and willing to provide informed consent for the nested clinical trial (assent as appropriate and legal guardian consent if \< 18 years)
  • Age ≥ 3 years
  • Most recent HIV-1 RNA ≥ 200 copies/mL
  • At least one major DTG-associated DRM (substitution at codon 66K, 92Q, 118R, 138K/A/T, 140S/A/C, 148H/R/K, 155H or 263K)

Exclusion Criteria5

  • Pregnant or breastfeeding
  • Using any concomitant therapy disallowed as per the reference safety information and product labelling for the study drugs
  • WHO stage 3 or 4 opportunistic infection which would prevent randomisation to either arm (e.g. due to drug interactions or significant liver or renal injury) within 4 weeks prior to RCT screening
  • Investigator opinion that the potential participant should discontinue DTG immediately for clinical reasons
  • Investigator opinion that the potential participant should not switch to DRV/r for clinical reasons

Interventions

DRUGDolutegravir Pill

Dose will be based on weight; brand names will be as supplied through the respective national programs

DRUGDarunavir+Ritonavir

Dose will be based on weight


Locations(9)

Jaramogi Oginga Odinga Teaching and Referral Hospital

Kisumu, Kenya

Bomu Hospital

Mombasa, Kenya

Kenyatta National Hospital

Nairobi, Kenya

Butha-Buthe District Hospital

Butha-Buthe, Lesotho

Mokhotlong District Hospital

Mokhotlong, Lesotho

CS Ponta Gea

Beira, Sofala, Mozambique

CS Machava II

Maputo, Mozambique

CS Ndlavela

Maputo, Mozambique

MUHAS Clinical Trial Unit

Dar es Salaam, Tanzania

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NCT06747507


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