Children living with HIV can now benefit from an adapted, simpler combination therapy. In combination therapy, two or three medicines are used simultaneously to inhibit HIV. One of those agents is dolutegravir. It is now clear that the use of one, widely available, pill of dolutegravir in children yields equally good treatment results as a combination of several, less readily available pills of that drug. Especially in countries where the number of infections is high and good care is less accessible, this makes it easier to treat children. These results are included in the World Health Organisation (WHO) treatment guidelines.
Approximately 1.7 million children worldwide are infected with HIV. However, it is estimated that in 2018, only 56 percent of HIV-infected children had access to proper medication. In addition, the effect in children and teenagers is less desirable than in adults.
It was already known that the drug dolutegravir, in combination with other drugs, is a good treatment for all HIV-infected adults, because it effectively inhibits virus growth and the virus doesn’t quickly develop resistance. Moreover, it is a safe and cheap tool, and widely available: from high to low income countries.
It is also known that treatment options for children often lag behind those for adults. In the case of HIV-inhibiting treatments, children over 12 years of age and 40 kg received the same dose of dolutegravir as adults (one 50 mg pill daily). But younger children, or those of a lower weight, had to take two or more pills a day, but of a lower amount (10mg and 25mg), a dosage not approved by all drug agencies.
This is a problem because these lower dosages are not easily available in most countries. The study focused on simplifying the dosage of dolutegravir that children could take every day. The results show that one 50 mg pill of dolutegravir per day, the same dose as adults, works well in the children and that their body responds to the medicine in the same way as the more difficult dose to give. This benefits the treatment of the children.
As a result of this study, the WHO amended the guidelines for treatment in HIV-positive children.