Study of Cobicistat-Boosted Atazanavir (ATV/co), Cobicistat-Boosted Darunavir (DRV/co) and Emtricitabine/Tenofovir Alafenamide (F/TAF) in Children With HIV

NCT ID: NCT02016924

Last Updated: 2025-06-26

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Clinical Phase

PHASE2/PHASE3

Total Enrollment

133 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-01-16

Study Completion Date

2027-03-31

Brief Summary

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The goal of this clinical study is to learn more about the safety and dosing of study drugs, cobicistat-boosted Atazanavir (ATV/co), cobicistat-boosted darunavir (DRV/co) and emtricitabine/tenofovir alafenamide (F/TAF), in children (age ≥ 4 weeks to \< 18 years) with HIV.

Detailed Description

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Conditions

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Acquired Immune Deficiency Syndrome (AIDS) HIV Infections

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Cohort 1: Part A and Part B

Participants ages 12 to \<18 years old will receive cobicistat 150 mg with either ATV or DRV plus background regimen (BR). The BR may contain additional antiretroviral agents except for the following disallowed agents: saquinavir, indinavir, nelfinavir, double protease inhibitor (PI) regimens, raltegravir, elvitegravir, efavirenz, nevirapine, delavirdine, maraviroc, etravirine, rilpivirine, dolutegravir, and investigational antiretroviral agents.

Group Type EXPERIMENTAL

ATV

Intervention Type DRUG

Capsules administered once daily according to dosing recommendations per product monograph

DRV

Intervention Type DRUG

Tablets administered once daily according to dosing recommendations per product monograph

Cobicistat

Intervention Type DRUG

Tablets administered orally once daily with food

BR

Intervention Type DRUG

Background Regimen (BR) include Food and Drug Administration (FDA)-approved nucleos(t)ide reverse transcriptase inhibitors (NRTIs) including zidovudine (ZDV), stavudine (d4T), didanosine (ddI), abacavir (ABC), tenofovir disoproxil fumarate (TDF), tenofovir alafenamide (TAF), lamivudine (3TC), and emtricitabine (FTC).

Cohort 2

Participants aged 6 to \<12 years old and ≥25 to \<40kg will receive cobicistat 150 mg and F/TAF 200/25 mg with either ATV or DRV.

Group Type EXPERIMENTAL

ATV

Intervention Type DRUG

Capsules administered once daily according to dosing recommendations per product monograph

DRV

Intervention Type DRUG

Tablets administered once daily according to dosing recommendations per product monograph

Cobicistat

Intervention Type DRUG

Tablets administered orally once daily with food

F/TAF

Intervention Type DRUG

Tablets administered orally once daily

Cohort 3

Participants age ≥ 2 years old will receive cobicistat 90 mg and F/TAF 120/15 mg with either ATV or DRV.

Group Type EXPERIMENTAL

ATV

Intervention Type DRUG

Capsules administered once daily according to dosing recommendations per product monograph

DRV

Intervention Type DRUG

Tablets administered once daily according to dosing recommendations per product monograph

Cobicistat

Intervention Type DRUG

Tablets administered orally once daily with food

F/TAF

Intervention Type DRUG

Tablets administered orally once daily

Cohort 4 (Group 1)

Participants age ≥ 4 weeks old weighing 14 to \< 25 kg will receive cobicistat tablet for oral suspension (TOS) 90 mg, once daily and F/TAF TOS 120/15 mg, once daily with either ATV or DRV or lopinavir boosted by ritonavir (LPV/r). Minimum age and weight for ATV is ≥ 3 months and ≥ 5 kg, minimum age and weight for DRV is ≥ 3 years and ≥ 15 kg; participants receiving LPV/r will not receive cobicistat TOS.

Group Type EXPERIMENTAL

ATV

Intervention Type DRUG

Capsules administered once daily according to dosing recommendations per product monograph

DRV

Intervention Type DRUG

Tablets administered once daily according to dosing recommendations per product monograph

LPV/r

Intervention Type DRUG

Solution administered orally

Cobicistat TOS

Intervention Type DRUG

Tablets for oral suspension

F/TAF TOS

Intervention Type DRUG

Tablets for oral suspension

Cohort 4 (Group 2)

Participants age ≥ 4 weeks old weighing 10 to \< 14 kg will receive cobicistat TOS 30 mg (twice daily) and F/TAF TOS 60/7.5 mg, once daily with either ATV or LPV/r. Minimum age and weight for ATV is ≥ 3 months and ≥ 5 kg, respectively; participants receiving LPV/r will not receive cobicistat TOS.

Group Type EXPERIMENTAL

ATV

Intervention Type DRUG

Capsules administered once daily according to dosing recommendations per product monograph

LPV/r

Intervention Type DRUG

Solution administered orally

Cobicistat TOS

Intervention Type DRUG

Tablets for oral suspension

F/TAF TOS

Intervention Type DRUG

Tablets for oral suspension

Cohort 4 (Group 3)

Participants age ≥ 4 weeks old weighing 6 to \< 10 kg will receive cobicistat TOS 30 mg (twice daily) and F/TAF TOS 30/3.75 mg, once daily with either ATV or LPV/r. Minimum age and weight for ATV is ≥ 3 months and ≥ 5 kg, respectively; participants receiving LPV/r will not receive cobicistat TOS.

Group Type EXPERIMENTAL

ATV

Intervention Type DRUG

Capsules administered once daily according to dosing recommendations per product monograph

LPV/r

Intervention Type DRUG

Solution administered orally

Cobicistat TOS

Intervention Type DRUG

Tablets for oral suspension

F/TAF TOS

Intervention Type DRUG

Tablets for oral suspension

Cohort 4 (Group 4)

Participants age ≥ 4 weeks old weighing 3 to \< 6 kg will receive cobicistat TOS 30 mg (twice daily) and F/TAF TOS 15/1.88 mg, once daily with either ATV or LPV/r. Minimum age and weight for ATV is ≥ 3 months and ≥ 5 kg, respectively; participants receiving LPV/r will not receive cobicistat TOS.

Group Type EXPERIMENTAL

ATV

Intervention Type DRUG

Capsules administered once daily according to dosing recommendations per product monograph

LPV/r

Intervention Type DRUG

Solution administered orally

Cobicistat TOS

Intervention Type DRUG

Tablets for oral suspension

F/TAF TOS

Intervention Type DRUG

Tablets for oral suspension

Cohort 5 (Group 1)

Participants ages ≥ 4 weeks old weighing ≥ 10 to \< 14 kg will receive F/TAF TOS 60/7.5 mg, once daily with the third unboosted drug.

Group Type EXPERIMENTAL

Third Unboosted Drug

Intervention Type DRUG

ATV (administered orally), DRV (administered orally), and LPV/r (administered orally) would be general list but unspecified for sites.

F/TAF TOS

Intervention Type DRUG

Tablets for oral suspension

Cohort 5 (Group 2)

Participants ages ≥ 4 weeks old weighing ≥ 6 to \< 10 kg will receive F/TAF TOS 30/3.75 mg, once daily with the third unboosted drug.

Group Type EXPERIMENTAL

Third Unboosted Drug

Intervention Type DRUG

ATV (administered orally), DRV (administered orally), and LPV/r (administered orally) would be general list but unspecified for sites.

F/TAF TOS

Intervention Type DRUG

Tablets for oral suspension

Cohort 5 (Group 3)

Participants ages ≥ 4 weeks old weighing ≥ 3 to \< 6 kg will receive F/TAF TOS 15/1.88 mg, once daily with the third unboosted drug.

Group Type EXPERIMENTAL

Third Unboosted Drug

Intervention Type DRUG

ATV (administered orally), DRV (administered orally), and LPV/r (administered orally) would be general list but unspecified for sites.

F/TAF TOS

Intervention Type DRUG

Tablets for oral suspension

Interventions

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ATV

Capsules administered once daily according to dosing recommendations per product monograph

Intervention Type DRUG

DRV

Tablets administered once daily according to dosing recommendations per product monograph

Intervention Type DRUG

Cobicistat

Tablets administered orally once daily with food

Intervention Type DRUG

BR

Background Regimen (BR) include Food and Drug Administration (FDA)-approved nucleos(t)ide reverse transcriptase inhibitors (NRTIs) including zidovudine (ZDV), stavudine (d4T), didanosine (ddI), abacavir (ABC), tenofovir disoproxil fumarate (TDF), tenofovir alafenamide (TAF), lamivudine (3TC), and emtricitabine (FTC).

Intervention Type DRUG

F/TAF

Tablets administered orally once daily

Intervention Type DRUG

LPV/r

Solution administered orally

Intervention Type DRUG

Third Unboosted Drug

ATV (administered orally), DRV (administered orally), and LPV/r (administered orally) would be general list but unspecified for sites.

Intervention Type DRUG

Cobicistat TOS

Tablets for oral suspension

Intervention Type DRUG

F/TAF TOS

Tablets for oral suspension

Intervention Type DRUG

Other Intervention Names

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Reyataz® Prezista® GS-9350 Tybost® Descovy® GS-9350 Tybost® Descovy®

Eligibility Criteria

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Inclusion Criteria

* HIV-1 infected, virologically suppressed males and females age ≥ 4 weeks to \< 18 years (according to requirements of enrolling Cohort).
* Body weight at screening ≥ 25 to \< 40 kg (Cohort 2); ≥ 14 to \< 25 kg (Cohort 3); ≥ 3 to \< 25 kg (Cohort 4); ≥ 3 to \< 14 kg (Cohort 5).
* Stable antiretroviral (ARV) regimen for a minimum of 3 months prior to the screening visit.

* Participants enrolled prior to implementation of Amendment 7: 2 nucleoside reverse transcriptase inhibitors (NRTIs) and ritonavir-boosted atazanavir (ATV/r) once daily or ritonavir-boosted darunavir (DRV/r) once daily or twice daily.
* Participants enrolled after the implementation of Amendment 9:

* Cohorts 2, 3 and 4 (Group 1): 2 NRTIs plus a third agent per local prescribing guidelines. Participants will switch from their current third agent to ATV or darunavir (DRV) at Day 1. Participants taking DRV must be on once-daily dosing or must switch to once daily at or prior to Day 1. Cohort 4 (Group 1), participants may also switch their current third agent to lopinavir boosted with ritonavir (LPV/r) at Day 1. Participants will switch their NRTI backbone to emtricitabine/tenofovir alafenamide (coformulated; Descovy®) (F/TAF).
* Cohort 4 (Groups 2 to 4) and Cohort 5 (Groups 1 to 3): 2 NRTIs plus a third agent per local prescribing guidelines or treatment naive. Participants on treatment will switch from their current third agent to ATV or LPV/r (Cohort 4 (Groups 2 to 4)), or to a third unboosted agent (Cohort 5 (Groups 1 to 3)). Participants will switch their NRTI backbone to F/TAF.
* Participants undergoing dose modifications to their ARV regimen for growth or switching medication formulations are considered to be on a stable ARV regimen.
* Documented plasma human immunodeficiency virus type 1 (HIV-1) ribonucleic acid (RNA) for ≥ 3 months preceding the screening visit:

* Participants enrolled after the implementation of Amendment 9:

* For Cohorts 2, 3, and 4 (Group 1), virologically suppressed ≥ 3 months preceding the screening visit: HIV-1 RNA \< 50 copies/mL on a stable regimen (or undetectable HIV-1 RNA level according to the local assay being used if the limit of detection is ≥ 50 copies/mL).
* For Cohorts 4 (Groups 2 to 4) and Cohort 5 (Groups 1 to 3), on an ARV regimen irrespective of plasma HIV-1 RNA copies or treatment naive; a participant is considered treatment naive, if ARVs were given for prevention of mother-to-child transmission but not for HIV treatment.
* For virologically suppressed participants, unconfirmed virologic elevations of HIV-1 RNA ≥ 50 copies/mL (transient detectable viremia, or "blip") prior to screening are acceptable. If the lower limit of detection of the local HIV-1 RNA assay is \< 50 copies/mL (eg, \< 20 copies/mL), the plasma HIV-1 RNA level cannot exceed 50 copies/mL on 2 consecutive HIV-1 RNA tests.
* Adequate renal function: Estimated glomerular filtration rate (eGFR) ≥ 90 mL/min/1.73m2 using the Schwartz formula. If ≥ 1 year old, eGFR greater than or equal to the minimum normal value for age using the Schwartz formula. If \< 1 year old as follows:

* Age minimum value for eGFR (mL/min/1.73 m2) \> 28 days to ≤ 95 days is 30, ≥ 96 days to ≤ 6 months is 39, \> 6 to \< 12 months is 49.
* Participants must not have documented or suspected resistance to applicable study drugs including emtricitabine (Emtriva®) (FTC), TFV, ATV, DRV, or LPV. Participants \< 14 kg (Cohorts 4 (Groups 2 to 4) and 5 (Groups 1 to 3)) with M184V/I AND HIV-1 RNA \< 50 copies/mL will be allowed.
* Positive confirmatory HIV test (confirmatory nucleic acid-based testing if \< 18 months of age).
* Cohort 4 (Groups 2 to 4) and Cohort 5 (Groups 1 to 3): Last dose of nevirapine or efavirenz, if applicable, ≥ 14 days prior to enrollment.
Minimum Eligible Age

4 Weeks

Maximum Eligible Age

17 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Gilead Sciences

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Gilead Study Director

Role: STUDY_DIRECTOR

Gilead Sciences

Locations

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Pediatric Infectious Disease Associates

Long Beach, California, United States

Site Status

Peter Morton Medical Building

Los Angeles, California, United States

Site Status

University of Colorado Denver

Aurora, Colorado, United States

Site Status

The George Washington University

Washington D.C., District of Columbia, United States

Site Status

University of South Florida

Tampa, Florida, United States

Site Status

St. Jude Children's Research Hospital

Memphis, Tennessee, United States

Site Status

University of Texas Health Science Center of Houston

Houston, Texas, United States

Site Status

Hospital General de Agudos Cosme Argerich

Buenos Aires, , Argentina

Site Status

Helios Salud

Buenos Aires, , Argentina

Site Status

University of the Free State

Bloemfontein, , South Africa

Site Status

University of Stellenbosch

Cape Town, , South Africa

Site Status

King Edward VIII Hospital

Durban, , South Africa

Site Status

Rahima Clinical Trials, a Division of Wits Health Consortium (Pty) Ltd

Johannesburg, , South Africa

Site Status

The Aurum Institute: Pretoria Clinical Research Centre

Pretoria, , South Africa

Site Status

Perinatal HIV Research Unit

Soweto, , South Africa

Site Status

HIV-NAT

Bangkok, , Thailand

Site Status

Siriraj Hospital

Bangkok, , Thailand

Site Status

Srinagarind Hospital

Khon Kaen, , Thailand

Site Status

MU-JHU Research Collaboration/MU-JHU Care Ltd

Kampala, , Uganda

Site Status

SICRA-TASO Mulago National Referral Hospital

Kampala, , Uganda

Site Status

AMBSO Masaka Clinical Research Site

Masaka, , Uganda

Site Status

Imperial College Healthcare NHS Trust

London, , United Kingdom

Site Status

University of Zimbabwe Clinical Research Centre

Harare, , Zimbabwe

Site Status

Countries

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United States Argentina South Africa Thailand Uganda United Kingdom Zimbabwe

Related Links

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Other Identifiers

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2013-001402-28

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

IS000883

Identifier Type: OTHER

Identifier Source: secondary_id

GS-US-216-0128

Identifier Type: -

Identifier Source: org_study_id

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