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HIV InfectionsPhase 2VOLVERNCT04880785

Lamivudine/Dolutegravir in Virologically Suppressed Subjects With Expected or Confirmed Resistance to Lamivudine

A Phase 2 study testing Dolutegravir 50 MG / Lamivudine 300 MG Oral Tablet [Dovato] in people with HIV Infections, run by Fundacion SEIMC-GESIDA at 17 sites in Spain.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Dolutegravir (DTG) plus lamivudine (3TC) is a dual regimen combination recommended for both naïve and suppressed persons with HIV-1 infection1. However, data regarding the efficacy of this regimen in suppressed persons with history of past resistance or virologic failures is currently insufficient. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
HIV Infections
What is being tested?
Dolutegravir 50 MG / Lamivudine 300 MG Oral Tablet [Dovato]
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
167 participants
Where
17 sitesSpain
Study dates
28 Jul 2021to 9 Apr 2024
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Adults (>=18 years old) with HIV-1 infection able to understand and give informed written consent.
  • Stable ART in the 12 weeks prior to screening visit.
  • Only switch for tolerability/convenience/access reasons to generic drugs or switch from ritonavir to cobicistat or TDF to TAF would be allowed in the 12-week window and as long as the components of the regimen are unchanged.
  • Viral load <50 copies/mL at screening and in the year prior to study entry.
  • A blip (50-500 copies/ml) would be allowed within 48 weeks prior to inclusion in the study, if preceded and followed by an undetectable VL determination.
  • CD4 count > 200 cel/μL at screening.
Show all 10Show fewer
  • History of 3TC resistance: either confirmed historical 3TC resistance (historical RNA Sanger or RNA NGS>20% threshold genotype with M184V/I mutation) OR suspected historical 3TC resistance.
  • Suspicion of past 3TC resistance is defined as any of the following:
  • Previous treatment with only 2 NRTIs (1 of them being emtricitabine or 3TC [XTC]).
  • Two consecutive VL > 200 cp/mL while on treatment including XTC. iii. One VL > 200 cp/mL while on treatment including XTC PLUS change of ART as consequence of that elevated VL.

Who cannot join

  • Participants with M184V/I or K65R in screening visit proviral DNA Sanger genotype.
  • Prior virologic failure (VF) under integrase inhibitor (INSTI)- based regimen. defined as two consecutive VL > 200 copies/mL while receiving INSTI regardless of genotypic test results
  • INSTI resistance mutations in historical RNA genotype.
  • Positive Surface Hepatitis B Ag (HBAgS) OR negative HBAgS and negative hepatitis B surface antibody (anti-HBs) with positive anti-core antibody (anti-HBc) and positive HBV DNA.
  • Pregnant, breastfeeding women, women with a positive pregnancy test at the time of screening, sexually active fertile women wishing to conceive or unwilling to commit to contraceptive methods (see Appendix 1 for the accepted list of the highly effective methods for avoiding pregnancy), for the duration of the study and until 4 weeks after the last dose of study medication. All women are considered fertile unless they have undergone a sterilizing surgery or are over the age of 50 with spontaneous amenorrhea for over 12 months prior to study entry.
  • Patients with active opportunistic infections or cancer requiring intravenous treatment and/or chemotherapy at screening.
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  • Any comorbidities or treatment with experimental drugs that according to the investigator could bias study results or entail additional risks for the participant.
  • Participants receiving other medications that according to study drug label are contraindicated.
  • Severe hepatic impairment (Class C) as determined by Child-Pugh classification.
  • Alanine aminotransferase (ALT) over 5 times the upper limit of normal (ULN) or ALT over 3xULN and bilirubin over 1.5xULN.
  • Unstable liver disease (as defined by the presence of ascites, encephalopathy, coagulopathy, hypoalbuminemia, oesophageal or gastric varices, or persistent jaundice), cirrhosis, known biliary abnormalities (apart from hyperbilirubinemia or jaundice due to Gilbert's syndrome or asymptomatic gallstones);
  • Creatinine clearance of <30 mL/min/1.73m2 via CKD-EPI method.
  • Any verified Grade 4 laboratory abnormality that to the investigators criteria would affect the safety of the participant if included in the study.
  • History or presence of allergy to dolutegravir or lamivudine.

Trial locations and contacts

17 sites in 1 country.

17 sites in 1 country

Spain17 sites
  • CHUAC

    A Coruña, Coruña

  • H. de Elche

    Alicante, Alicante

  • H. General de Alicante

    Alicante, Alicante

  • H. Bellvitge

    Barcelona, Barcelona

  • H. Clinic

    Barcelona, Barcelona

  • H. del Mar

    Barcelona, Barcelona

  • H. de Donosti

    Donostia / San Sebastian, Donostia

  • H. Fundación Jimenez Díaz

    Madrid, Madrid

  • H. Infanta Leonor

    Madrid, Madrid

  • H. La Princesa

    Madrid, Madrid

  • H. Príncipe de Asturias

    Madrid, Madrid

  • H. Severo Ochoa

    Madrid, Madrid

  • Hospital 12 de Octubre

    Madrid, Madrid

  • Hospital General Univ. Gregorio Marañón

    Madrid, Madrid

  • Hospital Univ. La Paz

    Madrid, Madrid

  • H. Virgen de la Victoria

    Málaga, Málaga

  • H. Álvaro Cunqueiro

    Vigo, Pontevedra

Other trials in Spain

About this study

Official title: Virologic Outcomes of Lamivudine/Dolutegravir in Virologically Suppressed Subjects With Expected or Confirmed Resistance to Lamivudine.

Dolutegravir (DTG) plus lamivudine (3TC) is a dual regimen combination recommended for both naïve and suppressed persons with HIV-1 infection1. However, data regarding the efficacy of this regimen in suppressed persons with history of past resistance or virologic failures is currently insufficient. This is a phase IIa, open-label, single arm, multicentric study.

The hypothesis is that therapy with DTG/3TC would be able to maintain viral control in HIV infected participants with prior history of 3TC resistance but without evidence of M184V/I resistance mutation in proviral DNA population sequencing at baseline. The investigators also hypothesize that archived minority 3TC resistance associated mutations detected by next-generation (NGS) sequencing prior to the switch would not have a significant impact on the efficacy of DTG/3TC.

Read the detailed description

This is a multicentre study, and it will be conducted at different healthcare centres in Spain. 117 participants will be recruited. A minimum of 30%-50% of the study population would be required to have historical RNA population genotype with confirmed M184V/I mutation.

Conditions
HIV Infections
Being tested
Dolutegravir 50 MG / Lamivudine 300 MG Oral Tablet [Dovato]
Medical subject headings
HIV Infections

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Dolutegravir 50 MG / Lamivudine 300 MG Oral Tablet [Dovato]Drug

    change of current antiretroviral treatment to DTG 50 mg/3TC 300 mg QD

Study groups in NCT04880785
Study groupRoleWhat they receive
Dovato (Dolutegravir+lamivudine)ExperimentalTreatment: Dolutegravir 50 mg/Lamivudine 300 mg, one film coated-tablet once daily during 96 weeks
Receives: Drug: Dolutegravir 50 MG / Lamivudine 300 MG Oral Tablet [Dovato]

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. The Efficacy of a Switch to DTG/3TC for Maintenance of Virologic Suppression, in Persons With Past Confirmed or Suspected 3TC Resistance, When Proviral DNA Population Sequencing Does Not Detect 3TC Resistance-associated Mutations at Baseline.

    There were eight participants with no data at week 48: one LTFU, one protocol deviation (M184V at screening), two investigator decision (1 lung cancer, 1 M184V mutation detected in plasma RNA population genotyping at transient rebound, suppressed with dolutegravir/lamivudine not fulfilling criteria for virologic withdrawal), one consent withdrawal and three withdrawals for AEs.

    It was pre-specified to report all participants who discontinued with last available HIV-1 RNA ≥50 copies/mL in "Number of Participants with HIV-1 RNA ≥50 copies/mL" category at week 48.

    Measured: Week 48

Secondary outcomes (15)
  1. Estimations of Virological Control

    Proportion of VF (≥50 copies/mL) ITT-e, per protocol population (PP), Proportion of VF (≥200 copies/mL), ITT-e and PP population, FDA snapshot. Proportion of Confirmed Virologic Withdrawal ([CVW]: A VL≥ 50 copies/mL followed by a VL≥ 200 copies/mL in retest), ITT-e and PP population, FDA snapshot. Proportion of Precautionary Virologic Withdrawal ([PVW]: three consecutive VL between 50- 200 copies/mL), ITT-e and PP population, FDA snapshot. Proportion of participants with VL<50 copies/mL, ITT-e and per protocol population, FDA snapshot.

    Measured: Week 48 and week 96

  2. Viral Resistance in Persons Experiencing VF.

    Percentage of VF with drug resistance associated mutations.

    • Describe number and type of resistanceassociated mutations in VF

    Measured: Throughout all the study, an average of 96 weeks

  3. Time to VF

    Due to the low number of events, the analysis of factors associated with VF (i.e., time to VF) was not performed. Additionally, because of the limited number of events, analyses of NGS-related outcomes were conducted only at the 5% level. The pre-specified subgroup analyses were modified and replaced with analyses based on baseline 3TC or FTC use, confirmed prior resistance to 3TC, and prior exposure to INSTIs.

    Measured: Throughout all the study, an average of 96 weeks

  4. Proportion of VF in Subgroups: Confirmed Historical M184V/I vs No Resistance Mutations

    Measured: Throughout all the study, an average of 96 weeks

  5. Proportion of VF in Subgroups: INSTI Exposure vs No Prior INSTI Exposure

    All participants with M184V/I detected at baseline in proviral DNA NGS had a VL <50 copies/mL at week 48 or last study visit.

    Measured: Throughout all the study, an average of 96 weeks

  6. Time Virologically Suppressed

    Participants were virologically suppressed for 9 years before the study

    Measured: Throughout all the study, an average of 96 weeks

  7. Proportion of VF in Subgroup: Time on 3TC/FTC

    Measured: Throughout all the study, an average of 96 weeks

  8. Percentage of Participants With VF With Baseline 3TC or INSTI Resistanceassociated Mutations Detected at Baseline by NGS With 1, 5, and 20% Threshold.

    Percentage of VF with drug resistance associated mutations and proportion of participants with VF with baseline 3TC or INSTI resistance- associated mutations detected at baseline by NGS with 5% threshold.

    Measured: Throughout all the study, an average of 96 weeks

  9. Proportion of Participants With Transient Viral Rebounds With Baseline 3TC or INSTI Resistance- Associated Mutations Detected at Baseline by NGS With 1, 5, and 20% Threshold.

    Proportion of participants with transient viral rebounds with baseline 3TC or INSTI resistance- associated mutations detected at baseline by NGS with 5% threshold.

    Measured: Throughout all the study, an average of 96 weeks

  10. Number of Participants With M184V/I Presence by Successful Plasma RNA NGS in Participants With Virological Dropout

    Next-generation sequencing (NGS) of plasma RNA was successful in one of the two virological withdrawal cases.

    Measured: Throughout all the study, an average of 96 weeks

  11. Frequency of Resistance Mutations (RT and Integrase) in Proviral DNA Measured by NGS.

    Measured: Throughout all the study, an average of 96 weeks

  12. Change in CD4+ Cell Count

    CD4+ count values were observed throughout the 96 weeks.

    Measured: Basal, Week 4, Week 12, Week 24, Week 36, Week 48, Week 72 and week 96

  13. Change in CD4+/CD8+ Cell Counts Ratio

    Measured: Basal, Week 4, Week 12, Week 24, Week 36, Week 48, Week 72 and week 96

  14. Percentage and Severity of AEs and Laboratory Abnormalities.

    Measured: Basal, Week 48 and week 96

  15. Proportion of Subjects Who Discontinue Treatment Due to AEs

    Participants who discontinue treatment due to AEs (al week 96)

    Measured: Basal, week 48 and week 96

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted11 May 2021
  2. Study start28 Jul 2021
  3. Primary completion12 Jun 2023
  4. Study completion9 Apr 2024

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Model description
Phase IIa, open-label, single arm, multicentric study
Masking
None (open label)
Enrolment
167 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04880785
Sponsor's protocol ID
GESIDA11820
Acronym
VOLVER
Status last verified
Jul 2026
First submitted
29 Apr 2021
Last updated
9 Sep 2026
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • De Lagarde M, De Miguel R, Sigcha MA, Blanco JL, Pinto-Martinez A, Montejano R, Gutierrez Liarte A, Navarro-Soler R, Canas-Ruano E, Inciarte A, Martin-Carbonero L, Imaz A, Hernandez Gutierrez C, Ocampo A, de Miguel M, Delgado R, Pulido F, Arribas JR; VOLVER GESIDA 11820 Study Group. Impact of Proviral-DNA M184V/I on 96-Week Outcomes of DTG/3TC Maintenance Therapy: Results From the VOLVER Clinical Trial. Clin Infect Dis. 2026 Jul 23;83(1):149-157. doi: 10.1093/cid/ciag060.

    PubMed 41665101

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Dolutegravir 50 MG / Lamivudine 300 MG Oral Tablet [Dovato] in people with HIV Infections, run by Fundacion SEIMC-GESIDA at 17 sites in Spain.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 10 inclusion and 14 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 9 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 17 sites in Spain. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 9 Sep 2026). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

The Efficacy of a Switch to DTG/3TC for Maintenance of Virologic Suppression, in Persons With Past Confirmed or Suspected 3TC Resistance, When Proviral DNA Population Sequencing Does Not Detect 3TC Resistance-associated Mutations at Baseline. (time frame: Week 48). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04880785, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 9 Sep 2026.

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