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HIV SeropositivityPhase 1/2DOLPHIN MomsNCT05122026

Safety and Tolerability of 1 Month Daily (1HP) and 3 Months Weekly (3HP) Isoniazid and Rifapentine With Pharmacokinetics of Dolutegravir (DTG) in Pregnant People With HIV

A Phase 1/2 study testing Rifapentine and Isoniazid in people with HIV Seropositivity and Pregnancy, run by The Aurum Institute NPC at 3 sites in South Africa.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

Open-label, two-arm, randomized multicenter study to investigate the safety, tolerability, and pharmacokinetics (PK), and potential interactions between dolutegravir (DTG) and rifapentine (RPT) during pregnancy in people with HIV when RPT is given with isoniazid (INH) daily for 4 weeks (1HP) or weekly for 3 months… Read more about this study

Who is it for?
Ages 18 years and older, women only
What is being tested?
Rifapentine and Isoniazid
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
252 participants
Where
3 sitesSouth Africa
Study dates
17 Jan 2024to 31 Dec 2025
Phase
Phase 1/2
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • Women only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age > 18 years
  • Weight > 50 kg
  • Documented HIV infection
  • At least 4 weeks of ART and virally suppressed on dolutegravir plus two NRTIs
  • Undetectable HIV-1 viral load
  • Pregnancy at 20-34 weeks as confirmed by ultrasound
  • Singleton pregnancy

Who cannot join

  • Confirmed or suspected TB disease
  • Likely to move from the study area during the study period
  • Known exposure to pulmonary TB cases with known or suspected resistance to isoniazid or rifampicin in the source case
  • TB treatment within the past year
  • TB preventive therapy within the last year
  • Sensitivity or intolerance to isoniazid or rifamycins
Show all 15Show fewer
  • On nevirapine, etravirine, rilpivirine, PI-based, or raltegravir-containing ART regimens
  • Suspected acute hepatitis or known chronic liver disease; HBsAg positivity; severe hepatic impairment
  • Alanine aminotransferase (ALT) ≥ 3 times the upper limit of normal (ULN)
  • Total bilirubin ≥ 2.5 times the ULN
  • Absolute neutrophil count (ANC) < 750 cells/mm3
  • Creatinine clearance < 50 ml/min
  • Self-reported alcohol use exceeding 21 units per week
  • Karnofsky status < 80
  • On prohibited medications e.g. dofetilide

Trial locations and contacts

3 sites in 1 country.

South Africa3 sites
  • FAMily Centre for Research with Ubuntu (FAMCRU)

    Cape Town, Cape Town, 7505

  • Peri Natal HIV Research Unit - Klerksdorp Tshepong Hospital

    Klerksdorp, North West, 2571

  • The Aurum Institute: Tembisa Clinical Research Centre

    Tembisa, Gauteng, 1632

Other trials in South Africa

About this study

Open-label, two-arm, randomized multicenter study to investigate the safety, tolerability, and pharmacokinetics (PK), and potential interactions between dolutegravir (DTG) and rifapentine (RPT) during pregnancy in people with HIV when RPT is given with isoniazid (INH) daily for 4 weeks (1HP) or weekly for 3 months (3HP) as part of tuberculosis (TB) preventive therapy (TPT). Adults (age ≥18) who are pregnant with a singleton pregnancy (confirmed by ultrasound) at a gestational age of 20-34 weeks and virally suppressed on an existing DTG-based plus two nucleoside reverse transcriptase inhibitors (NRTI) antiretroviral (ART) regimen for at least four weeks may participate.

Read the detailed description

Enrolled participants will be randomized 1:1 to Arms 1 and 2.

Arm 1: 1HP (n=126):

Participants will start twice-daily DTG on Day 0, and will receive once-daily HP for 28 total doses, starting on Day 1. HIV viral load (VL) will be measured at baseline (screening), week 3 (Day 17), at delivery, and post-partum week 12. Safety labs: complete blood count (CBC), urea and electrolytes (U\&E), creatinine, prothrombin time and international normalized ratio (PT/INR), and liver function tests (LFT) will be obtained at screening for everyone and at follow-up visits, if clinically indicated; CBCs and LFTs will be checked at delivery in all participants.

The first 25 participants enrolled to Arm 1 who consent to be in a PK substudy will participate in sparse PK blood collections for DTG. Sparse PK sampling for DTG will be performed on the morning of Day 1, before starting 1HP and before the morning dose of DTG. Additional sparse PK sampling for DTG will be performed prior to DTG dosing on Day 17 (to track with 72 hours after the 3rd dose of HP in Arm 2).

A plasma specimen for RPT PK will also be collected on Day 17.

Arm 2: 3HP (n=126):

Participants will start twice-daily DTG on Day 0, and will receive once-weekly HP for 12 total doses starting on Day 1. HIV VL will be measured at baseline (screening), week 3 (Day 17), at delivery, and at post-partum week 12. Safety labs: CBC, U\&E, creatinine, PT/INR, and LFTs will be obtained at screening for everyone and at follow-up visits, if clinically indicated; CBCs and LFTs will be drawn at delivery.

The first 25 participants enrolled to Arm 2 who consent to be in a PK substudy will participate in sparse PK blood collections for DTG. Sparse PK sampling for DTG will be performed on the morning of Day 1, before starting 3HP, and before the morning dose of DTG. Additional sparse PK sampling for DTG will be performed on Day 17 prior to DTG dosing (72 hours after the 3rd dose of HP) and on Day 52 prior to DTG dosing (72 hours after the 8th dose of HP).

There will not be plasma collection on Day 17 for RPT PK in Arm 2, because specimen collection would be 72 hours after the weekly HP dose and a RPT level will likely not be detectable.

Interim analysis will occur when 25 participants each from Arms 1 and 2 have completed the Week 3 (Day 17) sparse PK visit. Ongoing enrolment will not be paused during the interim analysis, which will assess DTG PK, safety, and VL data.

Enrollment will be paused if accrual to each arm reaches 101 participants before the interim analysis has been completed. Once results are available, then enrollment will restart with dosing (daily vs. BID) based on the DTG PK results.

Being tested
Rifapentine, Isoniazid
Keywords
Dolutegravir, 3HP, Rifapentine, pharmacokinetic, TB preventive treatment
Medical subject headings
HIV Seropositivity, Latent Tuberculosis

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • RifapentineDrug

    Also called Priftin

    As included in arm/group description

  • IsoniazidDrug

    Also called Winthrop Isoniazid

    As included in arm/group description

Study groups in NCT05122026
Study groupRoleWhat they receive
Arm 1: One month of daily isoniazid and rifapentine (4 weeks)Experimental* DTG 50 mg orally BID * DTG 50 mg + 2 NRTI each morning (non-study) * 2nd dose: DTG 50 mg each evening (during 1HP) * 1HP: INH 300 mg + RPT 600 mg each morning for 4 weeks
Receives: Drug: Rifapentine; Drug: Isoniazid
Arm 2: Three months of once-weekly isoniazid and rifapentine (12 weeks)Experimental* DTG 50 mg orally BID * DTG 50 mg + 2 NRTI each morning (non-study) * 2nd dose: DTG 50 mg each evening (during 3HP) * 3HP: INH 900 mg + RPT 900 mg each week for 12 weeks
Receives: Drug: Rifapentine; Drug: Isoniazid

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Mortality

    Maternal all-cause mortality (both groups)

    Measured: from study entry at Week 0 through post partum Week 24, to be reported at end of trial

  2. Targeted serious adverse events (SAEs)

    Premature discontinuation for toxicity or intolerance, Grade 3 or higher maternal bleeding, peripheral neuropathy, elevated LFTs), targeted pregnancy outcomes (fetal demise, stillbirth, preterm delivery (PTD) <32 weeks, birthweight (BW) <1500g, neonatal death <28 days of age), or permanent discontinuation due to toxicity (both groups)

    Measured: from study entry at Week 0 through post partum Week 12, to be reported at end of trial

  3. PK sampling of Dolutegravir - Cl/F parameter

    Oral clearance in the presence or absence of 1HP or 3HP (both groups)

    Measured: PK sampling at Week 1 (Day 1) and Week 3 (Day 17) for both groups, and at Week 8 (Day 52) for Group 2 (3HP arm), to be reported at end of trial

  4. PK sampling of Dolutegravir - AUC parameter

    Area under the plasma drug concentration-time curve (AUC) in the presence or absence of 1HP or 3HP (both groups)

    Measured: PK sampling at Week 1 (Day 1) and Week 3 (Day 17) for both groups, and at Week 8 (Day 52) for Group 2 (3HP arm), to be reported at end of trial

  5. PK sampling of Dolutegravir - Ctau parameter

    Trough concentration (Ctau) in the presence or absence of 1HP or 3HP (both groups)

    Measured: PK sampling at Week 1 (Day 1) and Week 3 (Day 17) for both groups, and at Week 8 (Day 52) for Group 2 (3HP arm), to be reported at end of trial

Secondary outcomes (14)
  1. HIV-1 RNA viral load- maternal

    Maternal HIV-1 RNA viral load (copies/ml) (both groups)

    Measured: HIV viral load to be measured at Screening, Week 3, at Delivery, and post partum Week 12, to be reported at end of trial

  2. DTG Dose selection

    Dose options for DTG with 1HP or 3HP derived by simulation using nonlinear mixed effects models (both groups)

    Measured: Dose selection will be determined at the interim analysis to be conducted when 25 participants from Arms 1 and 2 respectively have completed the Week 3 PK visit. Based upon these results, new enrollees will receive DTG either once or twice daily.

  3. PK sampling of RPT - AUC parameter

    Area under curve (AUC) in participants taking 1HP (Group 1)

    Measured: PK sampling at Week 3 (Day 17 ) to be reported at end of trial

  4. PK sampling of RPT - Ctau parameter

    Trough concentration (Ctau) in participants taking 1HP (Group 1)

    Measured: PK sampling at Week 3 (Day 17 ) to be reported at end of trial

  5. Adverse Events- maternal

    Grade 3 or higher maternal adverse events (AE) (all groups)

    Measured: from study entry at Week 0 through post partum Week 12, to be reported at end of trial

  6. Adverse Events- pregnancy

    Grade 3 or higher pregnancy adverse events (AE) (all groups)

    Measured: from study entry at Week 0 through post partum Week 12, to be reported at end of trial

  7. Adverse Events- infant

    Grade 3 or higher infant adverse events (AE) (all groups)

    Measured: from Delivery through post partum Week 24, to be reported at end of trial

  8. HIV infection- infant

    Infant HIV infection (all groups)

    Measured: from Delivery through post partum Week 24, to be reported at end of trial

  9. Infant growth parameters- HAZ

    Height-for-age z-score (all groups)

    Measured: from Delivery through post partum Week 24, to be reported at end of trial

  10. Infant growth parameters- WAZ

    Weight-for-age z-score (WAZ) (all groups)

    Measured: from Delivery through post partum Week 24, to be reported at end of trial

  11. Infant growth parameters- HCAZ

    Head circumference-for-age z-score (HCAZ) (all groups)

    Measured: from Delivery through post partum Week 24, to be reported at end of trial

  12. TB disease-maternal

    confirmed maternal TB disease (all groups)

    Measured: from study entry at Week 0 through post partum Week 24, to be reported at end of trial

  13. TB disease-infant

    confirmed or suspected infant TB disease (all groups)

    Measured: from Delivery through post partum Week 24, to be reported at end of trial

  14. Treatment adherence- HP

    Proportion of doses taken for 1HP and 3HP regimens

    Measured: from study entry at Week 0 through up to 8 weeks of 1HP (Group 1) or up to 16 weeks of 3HP (Group 2) , to be reported at end of trial

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted16 Nov 2021
  2. Study start17 Jan 2024
  3. Primary completion24 Oct 2025
  4. Study completion31 Dec 2025 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 1/2
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Model description
Participants will be randomized 1:1 to receive either 1HP or 3HP
Masking
None (open label)
Enrolment
252 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05122026
Sponsor's protocol ID
IRB00299011
Other IDs
3HP-MOMS-AUR1-6-351
Acronym
DOLPHIN Moms
Status last verified
Dec 2025
First submitted
26 Oct 2021
Last updated
12 Dec 2025
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 1/2 study testing Rifapentine and Isoniazid in people with HIV Seropositivity and Pregnancy, run by The Aurum Institute NPC at 3 sites in South Africa.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 15 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: under way, not looking for participants, as of the sponsor's last update on 12 Dec 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 3 sites in South Africa. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this combined phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Mortality (time frame: from study entry at Week 0 through post partum Week 24, to be reported at end of trial). The study lists 5 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 12 Dec 2025.

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