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HIV InfectionPhase 2UNIVERSAL1NCT05993767

UNIVERSAL 1: Pharmacokinetic Study of a Novel DTG/FTC/TAF Dose Ratio for Children

A Phase 2 study testing dolutegravir (DTG)/emtricitabine (FTC)/tenofovir alafenamide (TAF) regimen and Dolutegravir (DTG)/ Emtricitabine (FTC)/tenofovir alafenamide (TAF) in people with HIV Infection, run by PENTA Foundation at 3 sites in 2 countries.

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

This study aims to find out whether treating children living with HIV with three anti-HIV medicines, dolutegravir (DTG), emtricitabine (FTC) and tenofovir alafenamide (TAF), with a novel dose ratio will achieve adequate drug concentrations and is safe. Read more about this study

Who is it for?
Ages 28 days to 10 years
Conditions the study is for
HIV Infection
What is being tested?
dolutegravir (DTG)/emtricitabine (FTC)/tenofovir alafenamide (TAF) regimen and Dolutegravir (DTG)/ Emtricitabine (FTC)/tenofovir alafenamide (TAF)
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
53 participants
Where
3 sitesin 2 countries
Study dates
11 Dec 2024to 20 Jan 2026
Phase
Phase 2
Are there results?
None posted in the registry

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 28 days to 10 years
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Age between 28 days and 10 years old
  • Weighing 3 to <25 kg
  • Confirmed HIV-1 infection (local, molecular methods)
  • 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
  • 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
  • Girls who have reached menarche must have a negative pregnancy test at screening
  • Subject is willing to start DTG/FTC/TAF regimen in the novel dose ratio for HIV treatment
  • Subjects already on a DTG-based ART regimen should be virologically suppressed at screening

Who cannot join

  • Age between 28 days and 10 years old
  • Weighing 3 to <25 kg
  • Confirmed HIV-1 infection (local, molecular methods)
  • 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
  • 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
  • Girls who have reached menarche must have a negative pregnancy test at screening
Show all 15Show fewer
  • Subject is willing to start DTG/FTC/TAF regimen in the novel dose ratio for HIV treatment
  • Subjects already on a DTG-based ART regimen should be virologically suppressed at screening
  • History or presence of known allergy to DTG, FTC or TAF
  • Alanine aminotransferase (ALT) ≥5 times the upper limit of normal (ULN), OR ALT ≥3xULN AND bilirubin ≥2xULN
  • 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), known biliary abnormalities (with the exception of Gilbert's syndrome or asymptomatic gallstones)
  • Current or anticipated need for TB therapy during the study
  • Use of rifampicin-based therapy within 4 weeks before start trial
  • Presence of comedication known to interact with trial medications
  • Known resistance to INSTI or NRTI

Trial locations and contacts

3 sites in 2 countries.

3 sites in 2 countries

Uganda2 sites
  • Baylor College of Medicine Children's Foundation

    Kampala

  • Joint Research Centre

    Kampala

Other trials in Uganda

Zimbabwe1 site
  • University of Zimbabwe Clinical Research Centre

    Harare

Other trials in Zimbabwe

About this study

Official title: Pharmacokinetic Study of an Optimized Dose Ratio of Dolutegravir/Emtricitabine/Tenofovir Alafenamide Fumarate: Expediting a UNIVERSAL First Line Regimen for All Children Living With HIV in Africa

This study aims to find out whether treating children living with HIV with three anti-HIV medicines, dolutegravir (DTG), emtricitabine (FTC) and tenofovir alafenamide (TAF), with a novel dose ratio will achieve adequate drug concentrations and is safe. The optimal DTG/FTC/TAF dose ratio will be used for the development of a fixed-dose combination dispersible tablet.

Read the detailed description

Dolutegravir (DTG), Emtricitabine (FTC) and Tenofovir alafenamide (TAF) are anti-HIV medicines. DTG works very well, can be taken once-daily and has few side effects. In international treatment guidelines, DTG is one of the most recommended medicines for adults and young people. Emtricitabine is also one of the preferred medicines in anti-HIV treatment for adults and children. Tenofovir alafenamide (TAF) is not yet recommended in children <25 kg, however TAF could potentially be used safely and effectively in children.

Combining DTG, FTC and TAF in a specific dose ratio may offer treatment that is safe and effective. If so, a combination dispersible tablet containing these three medicines can be developed and this will allow the same HIV medicines to be used across children and adults.

This study will include 50 children aged 28 days to less than 10 years old who are living with HIV. All participants will receive the same treatment with DTG, FTC and TAF. Subjects will receive DTG 10 mg dispersible tablets and FTC/TAF 15/1.88 mg dispersible tablets or DTG 50 mg film coated tablets and FTC/TAF 200/25 mg film coated tablets depending on weight band. All children in the study will have clinical assessments. Blood tests will be performed to make sure that the medicines are safe and, at some visits, participants and carers will also be asked to answer some questions on taking medicine and how medicine tastes. All children will be followed up for 24 weeks.

Conditions
HIV Infection
Being tested
dolutegravir (DTG)/emtricitabine (FTC)/tenofovir alafenamide (TAF) regimen, Dolutegravir (DTG)/ Emtricitabine (FTC)/tenofovir alafenamide (TAF)
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 (DTG)/emtricitabine (FTC)/tenofovir alafenamide (TAF) regimenDrug

    Switch or start dolutegravir (DTG)/emtricitabine (FTC)/tenofovir alafenamide (TAF) regimen with a novel dose ratio for HIV treatment

  • Dolutegravir (DTG)/ Emtricitabine (FTC)/tenofovir alafenamide (TAF)Drug

    Single arm

Study groups in NCT05993767
Study groupRoleWhat they receive
dolutegravir (DTG)/emtricitabine (FTC)/tenofovir alafenamide (TAF) regimenExperimentalSwitch or start dolutegravir (DTG)/emtricitabine (FTC)/tenofovir alafenamide (TAF) regimen with a novel dose ratio for HIV treatment. Subjects will receive DTG 10 mg dispersible tablets and FTC/TAF 15/1.88 mg dispersible tablets or DTG 50 mg film coated tablets and FTC/TAF 200/25 mg film coated tablets depending on weight band
Receives: Drug: dolutegravir (DTG)/emtricitabine (FTC)/tenofovir alafenamide (TAF) regimen; Drug: Dolutegravir (DTG)/ Emtricitabine (FTC)/tenofovir alafenamide (TAF)

What is being measured

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

  1. Primary endpoints for DTG:

    • Geometric mean Ctrough concentration

    Measured: From enrollment to the end of treatment at 24 weeks

  2. Primary endpoints for DTG:

    Percentage of individual Ctrough concentrations below the 90% effective concentration (EC90) (0.32 mg/L)

    Measured: From enrollment to the end of treatment at 24 weeks

  3. Primary endpoints for DTG:

    • Geometric mean DTG Ctrough, Cmax, and AUC

    Measured: From enrollment to the end of treatment at 24 weeks

  4. Primary safety endpoints

    • Occurrence of serious adverse events

    Measured: From enrollment to the end of treatment at 24 weeks

  5. Primary safety endpoints

    • Occurrence of new clinical and laboratory grade 3 and 4 adverse events

    Measured: From enrollment to the end of treatment at 24 weeks

  6. Primary safety endpoints

    Occurrence of adverse events (of any grade) leading to treatment modification

    Measured: From enrollment to the end of treatment at 24 weeks

  7. Primary endpoints for FTC/TAF:

    • Geometric mean Ctrough, Cmax, and AUC

    Measured: From enrollment to the end of treatment at 24 weeks

  8. Primary endpoints for FTC/TAF:

    Intracellular tenofovir diphosphate (TDP) levels at 24 hours acquired through dried blood spot analysis

    Measured: From enrollment to the end of treatment at 24 weeks

Secondary outcomes (2)
  1. Efficacy endpoints

    • Viral load (VL) <400 c/ml at 24 weeks

    Measured: From enrollment to the end of treatment at 24 weeks

  2. Efficacy endpoints

    Occurrence of new or recurrent WHO clinical stage 3 or 4 event

    Measured: From enrollment to the end of treatment at 24 weeks

Timeline

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

  1. First posted15 Aug 2023
  2. Study start11 Dec 2024
  3. Primary completion30 Jun 2025
  4. Study completion20 Jan 2026

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
An interventional, phase I/II, multicenter, single-arm study
Masking
None (open label)
Enrolment
53 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05993767
Sponsor's protocol ID
UNIVERSAL1
Other IDs
RIA2019PD-2882
Acronym
UNIVERSAL1
Status last verified
Mar 2026
First submitted
1 Aug 2023
Last updated
4 Mar 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: IPD will be supporting a generic company dossier subject to FDA evaluation

Publications

  • Kamphuis AEM, Salvadori N, Mujuru HA, Bwakura-Dangarembizi M, Kisitu GP, Matovu F, Kaudha E, Mulindwa A, Jacobs TG, Than-In-At K, Cressey TR, Nardone A, Lallemant M, Colbers A, Burger DM; UNIVERSAL1 trial team. Expediting a UNIVERSAL first-line regimen of a dolutegravir-emtricitabine-tenofovir alafenamide fixed-dose ratio for children living with HIV older than 4 weeks: a 24-week, open-label, single-arm, phase 1-2, pharmacokinetic, safety, and antiviral activity trial. Lancet HIV. 2026 Sep 7:S2352-3018(26)00168-2. doi: 10.1016/S2352-3018(26)00168-2. Online ahead of print.

    PubMed 42705257

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing dolutegravir (DTG)/emtricitabine (FTC)/tenofovir alafenamide (TAF) regimen and Dolutegravir (DTG)/ Emtricitabine (FTC)/tenofovir alafenamide (TAF) in people with HIV Infection, run by PENTA Foundation at 3 sites in 2 countries.

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 8 inclusion and 15 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 4 Mar 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 3 sites in Uganda, Zimbabwe. 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?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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?

Primary endpoints for DTG: (time frame: From enrollment to the end of treatment at 24 weeks). The study lists 8 primary outcomes in all. 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 NCT05993767, 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 4 Mar 2026.

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