A Phase 1/2 interventional study of ART and VRC01LS in HIV Infection, sponsored by National Institute of Allergy and Infectious Diseases (NIAID). Completed at 2 sites in Botswana. Open to participants aged 96 Weeks to 7 Years. Per ClinicalTrials.gov, last updated 2026-05-04.
Sponsored by National Institute of Allergy and Infectious Diseases (NIAID) · Phase 1/2, Interventional, and Treatment
The purpose of this study is to evaluate the impact of two broadly neutralizing antibodies, VRC01LS and 10-1074, on the maintenance of HIV suppression in a cohort of early-treated children in Botswana.
This study will evaluate the impact of two broadly neutralizing antibodies, VRC01LS and 10-1074, on the maintenance of HIV suppression in a cohort of early-treated children in Botswana.
The primary objectives are as follows:
The study includes 4 steps: the pharmacokinetics (PK) Step, Step 1, Step 2, and Step 3. In the PK Step, antiretroviral treatment (ART) is continued and 12 study participants will undergo safety and PK testing, 6 for each bNAb used in the study (10-1074 and VRC01LS). In Step 1, ART is continued and dual bNAb treatment occurs, with PK confirmation of dual bNAb dosing for the first 6 participants in Step 1. In Step 2, ART is withdrawn and dual bNAb maintenance treatment occurs. In Step 3, dual bNAbs will be discontinued and participants will be re-started on ART.
Participants will be in the study for a minimum of 56 weeks, and a maximum of 98 weeks for those who start in the PK step and continue through the study.
Willingness to provide signed informed consent (by the parent/guardian)
Inclusion Criteria for Entry into Step 1 (followed by participation in Steps 2-3):
Exclusion Criteria:
In the PK Step, participants will continue ART and receive VRC01LS at Weeks 0, 4, and 8 as a single intravenous (IV) dose (30 mg/kg load then 10 mg/kg maintenance).
Drug: ART · Biological: VRC01LS
In the PK Step, participants will continue ART and receive 10-1074 at Weeks 0, 4, and 8 as a single IV dose (30 mg/kg).
Drug: ART · Biological: 10-1074
In Step 1, eligible participants will continue to receive ART and will receive both 10-1074 and VRC01LS at Weeks 0, 4, and 8. Following a recommendation from the study team and Safety Monitoring Committee (SMC) to increase the maintenance dosing based on the PK Step, a VRC01LS loading dose of 30 mg/kg will be given at the start of Step 1, followed by 15 mg/kg dosing at each 4-weekly visit, and 10-1074 dosing will be at 30 mg/kg at each 4-weekly visit. In Step 2, participants with ongoing viral suppression throughout Step 1 will undergo withdrawal of ART and will continue maintenance 10-1074 (30 mg/kg) and VRC01LS (15 mg/kg) treatment for up to 24 weeks. In Step 3, both 10-1074 and VRC01LS will be discontinued and ART will be re-started.
Drug: ART · Biological: VRC01LS · Biological: 10-1074
ART will not be provided by the study. Participants will continue to receive their ART regimen they were receiving prior to enrolling in the study.
Administered by intravenous (IV) infusion
Administered by intravenous (IV) infusion
Frequency of Treatment-associated Adverse Events (AEs) [Number of Participants With Treatment-associated Adverse Event(s) of Any Grade]
Time frame: Measured until 30 days after study completion for each participant
Severity of Treatment-associated AEs (Number of Participants With Grade 3 or Higher Related AEs)
Graded according to the Division of AIDS Table for Grading the Severity of Adult and Pediatric Adverse Events (DAIDS AE Grading Table). The DAIDS grading table provides an AE severity grading scale ranging from grades 1 to 5 with Grade 1 indicating a mild event, Grade 2 indicating a moderate event, Grade 3 indicating a severe event, Grade 4 indicating a potentially life-threatening event, and Grade 5 indicating death.
Time frame: Measured until 30 days after study completion for each participant
Proportion of Children Who Maintain HIV-1 Plasma RNA Less Than 400 Copies/mL, After Initiating VRC01LS and 10-1074 Infusions and Stopping ART
Based on laboratory evaluations
Time frame: Measured through Week 24 of Step 2
Proportion of Children Who Maintain HIV-1 Plasma RNA Less Than 40 Copies/mL, After Initiating VRC01LS and 10-1074 Infusions and Stopping ART
Based on laboratory evaluations
Time frame: Measured through Week 24 of Step 2
VRC01LS or 10-1074 Concentrations in Plasma
Median pre-dose trough (28 days post previous dose) based on laboratory evaluations
Time frame: Measured through Week 12 (PK Step)
Median Trough Concentration of VRC01LS or 10-1074 in Plasma 28 Days After the Third Dose
Based on laboratory evaluations
Time frame: Measured through Week 12 (PK Step)
VRC01LS and 10-1074 Concentrations in Plasma for Each Time Point
Based on laboratory evaluations
Time frame: Measured through Week 32 following Step 1 entry
Proportion of Children With Trough VRC01LS and 10-1074 Concentrations Below Defined Trough Ranges
Based on laboratory evaluations
Time frame: Measured through Week 32 following Step 1 entry
Height Z-scores of Virally Suppressed Children Receiving bNAbs
World Health Organization (WHO) standardized Z-scores will be evaluated for changes over time: WHO Length/height-for-age z-score (0-19 yrs), Change from Step 1, Day 0 to Step 3, Week 24. A z-score of 0 corresponds to the population mean. Scores above 0 indicate a participant's height is above the mean, while a score below 0 indicates a participant's height is below the mean. A positive change in z-score corresponds to a higher z-score at the second timepoint compared to the first.
Time frame: Measured through Week 24 (Step 3)
Weight Z-scores of Virally Suppressed Children Receiving bNAbs
WHO standardized Z-scores will be evaluated for changes over time: WHO Weight-for-age z-score (0-10 yrs), Change from Step 1, Day 0 to Step 3, Week 24. A z-score of 0 corresponds to the population mean. Scores above 0 indicate a participant's weight is above the mean, while a score below 0 indicates a participant's weight is below the mean. A positive change in z-score corresponds to a higher z-score at the second timepoint compared to the first.
Time frame: Measured through Week 24 (Step 3)
| Milestone | Group PK-A: ART + VRC01LS | Group PK-B: ART + 10-1074 | Steps 1-3 Participants (ART + 10-1074 + VRC01LS, Then 10-1074 + VRC01LS Only, Then ART Only) |
|---|---|---|---|
| Started | 6 | 6 | 0 |
| Completed | 6 | 6 | 0 |
| Not completed | 0 | 0 | 0 |
| Milestone | Group PK-A: ART + VRC01LS | Group PK-B: ART + 10-1074 | Steps 1-3 Participants (ART + 10-1074 + VRC01LS, Then 10-1074 + VRC01LS Only, Then ART Only) |
|---|---|---|---|
| Started | 0 | 0 | 28 |
| Completed | 0 | 0 | 25 |
| Not completed | 0 | 0 | 3 |
| Withdrew: Hiv-1 rna >40 copies/ml while receiving art + bnabs in step 1 | 0 | 0 | 3 |
| Milestone | Group PK-A: ART + VRC01LS | Group PK-B: ART + 10-1074 | Steps 1-3 Participants (ART + 10-1074 + VRC01LS, Then 10-1074 + VRC01LS Only, Then ART Only) |
|---|---|---|---|
| Started | 0 | 0 | 25 |
| Completed | 0 | 0 | 11 |
| Not completed | 0 | 0 | 14 |
| Withdrew: Hiv-1 rna >400 copies/ml while receiving bnabs alone in step 2 | 0 | 0 | 14 |
| Milestone | Group PK-A: ART + VRC01LS | Group PK-B: ART + 10-1074 | Steps 1-3 Participants (ART + 10-1074 + VRC01LS, Then 10-1074 + VRC01LS Only, Then ART Only) |
|---|---|---|---|
| Started | 0 | 0 | 28 |
| Completed | 0 | 0 | 28 |
| Not completed | 0 | 0 | 0 |
| Participants | Group PK-A: ART + VRC01LS | Group PK-B: ART + 10-1074 | Steps 1-3 Participants (ART + 10-1074 + VRC01LS) |
|---|---|---|---|
| Frequency of Treatment-associated Adverse Events (AEs) [Number of Participants With Treatment-associated Adverse Event(s) of Any Grade] | 4 | 1 | 19 |
Graded according to the Division of AIDS Table for Grading the Severity of Adult and Pediatric Adverse Events (DAIDS AE Grading Table). The DAIDS grading table provides an AE severity grading scale ranging from grades 1 to 5 with Grade 1 indicating a mild event, Grade 2 indicating a moderate event, Grade 3 indicating a severe event, Grade 4 indicating a potentially life-threatening event, and Grade 5 indicating death.
| Participants | Group PK-A: ART + VRC01LS | Group PK-B: ART + 10-1074 | Steps 1-3 Participants (ART + 10-1074 + VRC01LS) |
|---|---|---|---|
| Number of participants with Grade 3 treatment-associated AEs | 0 | 0 | 1 |
| Number of participants with Grade 4 treatment-associated AEs | 0 | 0 | 0 |
| Number of participants with Grade 5 treatment-associated AEs | 0 | 0 | 0 |
Based on laboratory evaluations
| Participants | Steps 2 Participants (10-1074 + VRC01LS) |
|---|---|
| Proportion of Children Who Maintain HIV-1 Plasma RNA Less Than 400 Copies/mL, After Initiating VRC01LS and 10-1074 Infusions and Stopping ART | 11 |
Based on laboratory evaluations
| Participants | Steps 2 Participants (10-1074 + VRC01LS) |
|---|---|
| Proportion of Children Who Maintain HIV-1 Plasma RNA Less Than 40 Copies/mL, After Initiating VRC01LS and 10-1074 Infusions and Stopping ART | 10 |
Median pre-dose trough (28 days post previous dose) based on laboratory evaluations
| mcg/mL | Group PK-A: ART + VRC01LS | Group PK-B: ART + 10-1074 |
|---|---|---|
| Day 28 | 223.3 (157.9 to 253.3) | 155.2 (91.3 to 318.6) |
| Day 56 | 180.7 (164.9 to 227.1) | 232.0 (113.6 to 328.5) |
| Day 84 | 156.9 (125.8 to 201.4) | 258.3 (122.4 to 467.3) |
Based on laboratory evaluations
| mcg/mL | Group PK-A: ART + VRC01LS | Group PK-B: ART + 10-1074 |
|---|---|---|
| Median Trough Concentration of VRC01LS or 10-1074 in Plasma 28 Days After the Third Dose | 156.9 (125.8 to 201.4) | 258.3 (122.4 to 467.3) |
Based on laboratory evaluations
| mcg/mL | Steps 1-3 Participants (ART + 10-1074 + VRC01LS) |
|---|---|
| Step 1 Week 4 (10-1074) | 154.4 (83.7 to 257.2) |
| Step 1 Week 8 (10-1074) | 168.1 (95.5 to 264.7) |
| Step 2 Week 0 (10-1074) | 194.6 (120.1 to 417.7) |
| Step 2 Week 4 (10-1074) | 205.6 (125.3 to 404) |
| Step 2 Week 8 (10-1074) | 232.3 (120.3 to 323.2) |
| Step 2 Week 12 (10-1074) | 211.7 (111.2 to 371.5) |
| Step 2 Week 16 (10-1074) | 212.5 (183.6 to 381.6) |
| Step 2 Week 20 (10-1074) | 246.8 (163.5 to 345.8) |
| Step 2 Week 24 or Step 3 Entry (10-1074) | 268.1 (108.5 to 1724.1) |
| Step 1 Week 4 (VRC01LS) | 226.5 (139 to 426.3) |
| Step 1 Week 8 (VRC01LS) | 293.4 (208 to 329.9) |
| Step 2 Week 0 (VRC01LS) | 239.1 (142.7 to 377.4) |
| Step 2 Week 4 (VRC01LS) | 255.9 (124.8 to 370.7) |
| Step 2 Week 8 (VRC01LS) | 254.7 (104.7 to 497.8) |
| Step 2 Week 12 (VRC01LS) | 260.2 (141.8 to 595.3) |
| Step 2 Week 16 (VRC01LS) | 273.9 (141.2 to 673.2) |
| Step 2 Week 20 (VRC01LS) | 266.5 (154.2 to 663.9) |
| Step 2 Week 24 or Step 3 Entry (VRC01LS) | 295.3 (170.9 to 507.8) |
Based on laboratory evaluations
| Participants | Steps 1-3 Participants (ART + 10-1074 + VRC01LS) |
|---|---|
| Step 1 Week 4 (10-1074) | 0 |
| Step 1 Week 8 (10-1074) | 0 |
| Step 2 Week 0 (10-1074) | 0 |
| Step 2 Week 4 (10-1074) | 0 |
| Step 2 Week 8 (10-1074) | 0 |
| Step 2 Week 12 (10-1074) | 0 |
| Step 2 Week 16 (10-1074) | 0 |
| Step 2 Week 20 (10-1074) | 0 |
| Step 2 Week 24 or Step 3 entry (10-1074) | 0 |
| Step 1 Week 4 (VRC01LS) | 2 |
| Step 1 Week 8 (VRC01LS) | 0 |
| Step 2 Week 0 (VRC01LS) | 4 |
| Step 2 Week 4 (VRC01LS) | 1 |
| Step 2 Week 8 (VRC01LS) | 2 |
| Step 2 Week 12 (VRC01LS) | 2 |
| Step 2 Week 16 (VRC01LS) | 1 |
| Step 2 Week 20 (VRC01LS) | 1 |
| Step 2 Week 24 or Step 3 entry (VRC01LS) | 0 |
World Health Organization (WHO) standardized Z-scores will be evaluated for changes over time: WHO Length/height-for-age z-score (0-19 yrs), Change from Step 1, Day 0 to Step 3, Week 24. A z-score of 0 corresponds to the population mean. Scores above 0 indicate a participant's height is above the mean, while a score below 0 indicates a participant's height is below the mean. A positive change in z-score corresponds to a higher z-score at the second timepoint compared to the first.
| change in score on a scale | Steps 1-3 Participants (ART + 10-1074 + VRC01LS) |
|---|---|
| Height Z-scores of Virally Suppressed Children Receiving bNAbs | 0.18 (0.07 to 0.30) |
WHO standardized Z-scores will be evaluated for changes over time: WHO Weight-for-age z-score (0-10 yrs), Change from Step 1, Day 0 to Step 3, Week 24. A z-score of 0 corresponds to the population mean. Scores above 0 indicate a participant's weight is above the mean, while a score below 0 indicates a participant's weight is below the mean. A positive change in z-score corresponds to a higher z-score at the second timepoint compared to the first.
| change in score on a scale | Steps 1-3 Participants (ART + 10-1074 + VRC01LS) |
|---|---|
| Weight Z-scores of Virally Suppressed Children Receiving bNAbs | 0.09 (0.04 to 0.22) |
Collected over Measured until 30 days after study completion for each participant. Each column reports events occurring during that specific step.. Non-serious events are listed at a 0% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| PK Step (ART + VRC01LS) | 0/6 (0%) | 0/6 (0%) | 5/6 (83.3%) |
| PK Step (ART + 10-1074) | 0/6 (0%) | 0/6 (0%) | 6/6 (100%) |
| Step 1 (ART + VRC01LS + 10-1074) | 0/28 (0%) | 0/28 (0%) | 23/28 (82.1%) |
| Step 2 (VRC01LS + 10-1074 Only) | 0/25 (0%) | 1/25 (4%) | 18/25 (72%) |
| Step 3 (ART Only) | 0/28 (0%) | 0/28 (0%) | 26/28 (92.9%) |
| Event | PK Step (ART + VRC01LS) | PK Step (ART + 10-1074) | Step 1 (ART + VRC01LS + 10-1074) | Step 2 (VRC01LS + 10-1074 Only) | Step 3 (ART Only) |
|---|---|---|---|---|---|
| PneumoniaInfections and infestations | 0/6 | 0/6 | 0/28 | 1/25 | 0/28 |
| Event | PK Step (ART + VRC01LS) | PK Step (ART + 10-1074) | Step 1 (ART + VRC01LS + 10-1074) | Step 2 (VRC01LS + 10-1074 Only) | Step 3 (ART Only) |
|---|---|---|---|---|---|
| CoughRespiratory, thoracic and mediastinal disorders | 5/6 | 3/6 | 7/28 | 11/25 | 11/28 |
| RhinorrhoeaRespiratory, thoracic and mediastinal disorders | 1/6 | 5/6 | 5/28 | 7/25 | 8/28 |
| Haemoglobin decreasedInvestigations | 4/6 | 2/6 | 8/28 | 7/25 | 14/28 |
| PyrexiaGeneral disorders | 2/6 | 3/6 | 1/28 | 6/25 | 1/28 |
| RhinitisInfections and infestations | 1/6 | 3/6 | 2/28 | 3/25 | 2/28 |
| Neutrophil count decreasedInvestigations | 1/6 | 1/6 | 10/28 | 4/25 | 8/28 |
| Abdominal painGastrointestinal disorders | 2/6 | 1/6 | 1/28 | 0/25 | 1/28 |
| Viral upper respiratory tract infectionInfections and infestations | 2/6 | 1/6 | 0/28 | 0/25 | 0/28 |
| Blood glucose decreasedInvestigations | 0/6 | 2/6 | 5/28 | 5/25 | 1/28 |
| Blood sodium decreasedInvestigations | 0/6 | 2/6 | 3/28 | 5/25 | 2/28 |
2 participants who entered the PK Step (a lead-in to the main study) in Group B did not proceed to Step 1 due to ineligibility for Step 1. Baseline characteristics of these 2 participants are reported separately. Baseline characteristics (at the time of study entry) for all 28 other participants (including those who entered the study in the PK Step and proceeded to Step 1) are shown in the Steps 1-3 group results.
| Age, Continuous(years) | Group PK-B: ART + 10-1074 | Steps 1-3 Participants (ART + 10-1074 + VRC01LS) | Total |
|---|---|---|---|
| Median | 3.12 (2.13 to 4.10) | 3.29 (2.80 to 3.98) | 3.29 (2.70 to 4.10) |
| Sex: Female, Male(Participants) | Group PK-B: ART + 10-1074 | Steps 1-3 Participants (ART + 10-1074 + VRC01LS) | Total |
|---|---|---|---|
| Female | 2 | 19 | 21 |
| Male | 0 | 9 | 9 |
| Race and Ethnicity Not Collected(Participants) | Group PK-B: ART + 10-1074 | Steps 1-3 Participants (ART + 10-1074 + VRC01LS) | Total |
|---|---|---|---|
| Count of participants | — | — | 0 |
| Region of Enrollment(participants) | Group PK-B: ART + 10-1074 | Steps 1-3 Participants (ART + 10-1074 + VRC01LS) | Total |
|---|---|---|---|
| Botswana | 2 | 28 | 30 |
| Weight(kg) | Group PK-B: ART + 10-1074 | Steps 1-3 Participants (ART + 10-1074 + VRC01LS) | Total |
|---|---|---|---|
| Median | 12.85 (10.30 to 15.40) | 12.55 (11.00 to 14.65) | 12.55 (10.90 to 15.20) |
| Height(cm) | Group PK-B: ART + 10-1074 | Steps 1-3 Participants (ART + 10-1074 + VRC01LS) | Total |
|---|---|---|---|
| Median | 94 (85 to 103) | 94 (87.5 to 101.5) | 94 (87 to 102) |
| CD4 cell count(cells/mm^3) | Group PK-B: ART + 10-1074 | Steps 1-3 Participants (ART + 10-1074 + VRC01LS) | Total |
|---|---|---|---|
| Median | 1173 (1131 to 1215) | 1106 (795 to 1539) | 1124 (833 to 1408) |
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National Institute of Allergy and Infectious Diseases (NIAID)