About DolPHIN 2

Vertical transmission of HIV is entirely preventable and we have a duty to ensure HIV is not handed down across generations - Professor Saye Khoo, Chief Investigator

Despite global prevention initiatives, vertical transmission remains a major route of HIV infection.

In sub-Saharan Africa, over 1 in 5 pregnant women living with HIV are diagnosed in late pregnancy each year, and represent the group most likely to for their infants to aquire HIV due to delayed initiation of combination antiretroviral therapy (cART).

Since risk of vertical transmission is directly related to maternal HIV viral load, HIV drugs which result in very fast rates of viral load decline may be more effective at preventing vertical transmission of HIV, and make the global goal of elimination of vertical transmission more likely to be achieved.Dolutegravir (DTG) is a new agent which results in significantly faster viral load declines than Efavirenz (EFV)-based therapy, which is the current first line in sub-Saharan Africa.

The DolPHIN 2 clinical trial assesses whether dolutegravir is superior to efavirenz in mothers initiating cART in the third trimester of pregnancy (third trimester) in achieving undetectable HIV viral load at delivery, which is the only validated proxy for reducing risk of vertical transmission of HIV.  The trial was designed to yield high-quality evidence on the efficacy and safety of dolutegravir to allow definitive recommendations, and operational guidance to be established for use of dolutegravir to reduce vertical transmission in this high-risk scenario.  The trial recruited 268 late presenting pregnant women living with HIV who were randomised 1:1 to DTG- or EFV-containing cART.

In addition to the trial, qualitative and pharmacoeconomic studies were undertaken to further support the implementation of dolutegravir.

Click on the videos to the right to learn more.