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NCT06497465 | NOT YET RECRUITING | Tuberculosis


Dolutegravir/Lamivudine Dual Therapy for ART-naïve People With HIV and TB Receiving Rifampin-based TB Treatment
Sponsor:

Johns Hopkins University

Brief Summary:

This will be a Phase IIIb Clinical Trial, an international multicenter, randomized, three-arm, non-comparative trial of efficacy, safety, and tolerability of the dual therapy regimen dolutegravir plus lamivudine either twice daily or DTG/3TC ( Dovato) in the morning +dolutegravir (DTG) in the evening, versus standard of care (SOC) twice-daily dolutegravir plus 2 once-daily Nucleoside reverse-transcriptase inhibitors (NRTIs) tenofovir disoproxil fumarate /lamivudine (TDF/3TC), among antiretroviral therapy (ART)-nave individuals with HIV-1 receiving rifampin-based TB therapy

Condition or disease

Tuberculosis

HIV

Intervention/treatment

Dolutegravir 50mg Tab

Dolutegravir/Lamivudine 50 MG-300 MG Oral Tablet [DOVATO]

Dolutegravir plus Tenofovir disoproxil fumarate (TDF)/ lamivudine (3TC)

Phase

PHASE3

Detailed Description:

Tuberculosis (TB) is the most common cause of death in people with HIV worldwide. Among patients with HIV, the incidence of TB per year is about 5-10%. The two diseases are now always treated concurrently in co-infected individuals, as there is a survival benefit for starting antiretroviral therapy (ART) soon after TB treatment initiation. Current Brazilian guidelines suggest that for patients with a cluster of differentiation 4 (CD4) \< 50, ART should be started within 2 weeks of starting TB treatment; for patients with a CD4\>50, ART should be started within 2 months of starting TB treatment. World Health Organization guidelines suggest ART initiation within 2 weeks of TB diagnosis regardless of CD4 count (provided there are no signs of TB meningitis), but most programs defer ART until 6-8 weeks in patients with CD4 \>50 to reduce the risk of immune reconstitution inflammatory syndrome (IRIS). The option of dual therapy for HIV (i.e., complete regimens to treat HIV composed of only 2 drugs) is of increasing interest and can lower costs for patients, payors, and programs while lowering cumulative lifetime exposure to ART (with potential resultant lessened burden of cumulative toxicities) and maintaining high antiviral efficacy. Based on the GEMINI, TANGO, and SALSA clinical trials, a regimen of 50 milligram (mg) DTG combined with 300mg lamivudine (3TC) has been shown to be a highly effective stand-alone option for the treatment of HIV-1 in ART treatment-naïve or virologically suppressed individuals through 48 weeks (SALSA) and 144 weeks (GEMINI and TANGO).

Study Type : INTERVENTIONAL
Estimated Enrollment : 150 participants
Masking : NONE
Primary Purpose : TREATMENT
Official Title : Dolutegravir Plus Lamivudine (DTG/3TC) Dual Therapy Versus Dolutegravir With TDF-lamivudine (DTG + TDF/3TC) Among Antiretroviral naïve People With HIV and TB Receiving Rifampin-based TB Treatment
Actual Study Start Date : 2025-01-31
Estimated Primary Completion Date : 2028-01-31
Estimated Study Completion Date : 2029-01-31

Information not available for Arms and Intervention/treatment

Ages Eligible for Study: 15 Years to 99 Years
Sexes Eligible for Study: ALL
Accepts Healthy Volunteers:
Criteria
Inclusion Criteria
  • * Documentation of HIV-1 status: HIV-1 infection, documented by any licensed rapid HIV test or HIV-1 enzyme or chemiluminescence immunoassay (E/CIA) test kit at any time prior to entry and confirmed by a licensed Western blot or a second antibody test by a method other than the initial rapid HIV and/or E/CIA, or by HIV-1 antigen, or plasma HIV 1 RNA viral load. Two or more HIV-1 RNA viral loads of \>1,000 copies/mL are also acceptable as documentation of HIV-1 infection.
  • * CD4+ cell count ≥50 cells/mm3 obtained within 30 days prior to study entry
  • * HIV-1 viral load ≥1000 copies/mL
  • * ART-naïve.
  • * Documentation of pulmonary TB
Exclusion Criteria
  • * Pregnant, or plans to become pregnant.

Dolutegravir/Lamivudine Dual Therapy for ART-naïve People With HIV and TB Receiving Rifampin-based TB Treatment

Location Details

NCT06497465


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Locations


Not yet recruiting

Brazil, AM

Tropical Institute of Infectious Diseases Manaus

Manaus, AM, Brazil, 69040-000

Not yet recruiting

Brazil, BA

Federal University of Bahia

Salvador, BA, Brazil, 40110-160

Not yet recruiting

Brazil, RJ

FIOCruz

Rio de Janeiro, RJ, Brazil, 21040-360

Not yet recruiting

Brazil, RJ

Nova Iguaçu General Hospital

Rio de Janeiro, RJ, Brazil, 26210-190

Not yet recruiting

Brazil, RN

Federal University of Rio Grande do Norte

Natal, RN, Brazil, 59037-170

Not yet recruiting

Brazil, RS

University of Caxias do Sul Foundation

Caxias do Sul, RS, Brazil,

Not yet recruiting

Brazil, RS

Porto Alegre Clinical Hospital

Porto Alegre, RS, Brazil, 90035-903

Not yet recruiting

Brazil, SP

Faculty of Medicine of Botucatu/Unesp

Bottled, SP, Brazil, 18618-687

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