UP ART

Children living with HIV need safe, effective and long-lasting treatment to stay healthy and thrive. Dolutegravir (DTG)-based treatment has changed the landscape and positively impacted their viral suppression rates. However, data about the long-term impact of DTG, particularly in real-world settings, is still lacking.

The UP ART study plays a crucial role in filling this gap by generating long-term data on DTG that can guide improvements in HIV treatment and care strategies for children and adolescents living with HIV in Uganda.

The Ugandan Paediatric Anti-Retroviral Treatment (UP ART) study is an observational study tracking the medium- and long-term outcomes of children and adolescents living with HIV under 20 years old who are receiving HIV care in Uganda. The study collects detailed individual-level data to better understand treatment outcomes over time.

The initial phase of UP ART lasted 2 years (2021-2023), and a total of 1,496 children and adolescents where recruited. UP ART is currently implementing the second phase and aims at recruiting a total of 3,000 children and adolescents living with HIV for longitudinal follow-up.

UP ART is also implementing two sub-studies: one on medium and long-term outcomes of dolutegravir, funded by GlaxoSmithKline Research & Development Limited and coordinated by Penta, and one on Advanced HIV Disease (AHD), funded by UNITAID.

Since 2021, Uganda has quickly rolled out dolutegravir (DTG)-based HIV treatment for children, including an easy-to-take dispersible tablet for younger ones. This has helped more children on treatment achieve viral suppression, but 10-20% still struggle to reach that goal.

There’s limited information on how well DTG works over time, especially in real-world settings in sub-Saharan Africa. Additionally, Uganda is also implementing the STOP AIDS Package to reduce AIDS related deaths among children and adolescents living with HIV. However, there is a lack of data in the country on the effectiveness of the package in reducing HIV-related mortality.

The UP ART study will show how children and adolescents living with HIV in Uganda respond to DTG over the years, and assess the effectiveness of the STOP AIDS Package in reducing HIV-related mortality. It will describe patient characteristics at the start of DTG treatment and assess the drug’s medium- to long-term effectiveness by monitoring viral load, treatment success and failure rates.

The study will also investigate the reasons for treatment discontinuation, and potential side effects. This information is key to improving HIV care for children in Uganda and around the world.

The long-term ambition for the study is to contribute data to global research efforts through the European Pregnancy and Paediatric Cohort Collaboration (EPPICC).