Preeminence of Dolutegravir-Based Antiretroviral Therapy in Children and Adolescents

Dolutegravir (DTG) was designated by WHO as a preferred drug for first- and second-line ART in 2018 — and while HIV integrase strand-transfer inhibitors have proven superiority in adults, data in children and adolescents are more limited. Now, in an open-label, randomized noninferiority trial, investigators assessed the efficacy and safety of DTG-based ART compared with non–DTG-based ART in children and teens with HIV-1 infection who were starting therapy or switching to second-line therapy after treatment failure (median age, 12.2 years; median weight, 30.7 kg; 88% from three southern African countries). Among 707 participants in the final analysis (311 starting ART and 396 switching to second-line ART), 350 were randomized to DTG and 357 …