The multi-country, randomized ODYSSEY trial has already shown that dolutegravir (DTG) plus two nucleoside analogues have superior treatment efficacy compared to standard-of-care (SOC) in 707 children ≥14kg (median age 12 years) starting first- or second-line ART. 

An additional cohort of 85 children weighing <14kg, recruited from Uganda, Zimbabwe and South Africa, completed a 96 week follow-up in June 2021. In this cohort (median age 1.4 years), about 28% had treatment failure by 96 weeks in the DTG arm compared to 48% in the SOC arm. DTG-based regimen was found to be superior to SOC among young children starting first or second-line therapy. The treatment benefit in the <14kg group was in line with that seen in children weighing ≥14kg. At 96 weeks, 76% of children receiving DTG-based ART had VL <50 copies/mL compared to 50% of children receiving SOC. The corresponding figures with VL <400 copies/mL were 91% vs. 71%... (WHO, July 16, 2021)