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Active, not recruitingNCT04648280Updated Mar 5, 2026

Safety and Pharmacokinetics Evaluation of Fostemsavir + (OBT) in HIV-1 Infected Children and Adolescents Who Are Failing Their cART and Have Dual- or Triple-class Antiretroviral Resistance

A Phase 1/2 interventional study of Fostemsavir in HIV Infections With Multi Drug Resistant Virus, sponsored by PENTA Foundation. Active, not recruiting at 8 sites in 3 countries. Open to participants aged 6 Years to 17 Years. Per ClinicalTrials.gov, last updated 2026-03-05.

Sponsored by PENTA Foundation · Phase 1/2, Interventional, and Treatment

Phase
Phase 1/2
Study type
Interventional
Enrollment
60
Allocation
Not applicable
Ages
6 Years to 17 Years
Sex
All
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Study summary

In the SHIELD study, the study sponsor seeks to assess safety, PK and antiviral activity for children and adolescents with dual or triple class resistance. It will also assess the acceptability and swallowability of formulation among the pediatric population. The dose selection of FTR for children and adolescents ≥20kg utilized a population pharmacokinetic (POP PK) model-based approach to achieve similar adult TMR exposures following FTR 600mg BID administration with combination therapy that was demonstrated to be safe and effective in the FTR Phase 3 BRIGHTE study in HTE patients.

02

Conditions studied

  • HIV Infections With Multi Drug Resistant Virus

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03

In context

HIV Infections

4,734 studies on the registry are indexed under HIV Infections; 244 are open to participants now.

This study's planned enrollment of 60 is below the median of 80 across 3,489 interventional studies indexed under HIV Infections.

Browse HIV Infections studies →

Lead sponsor

PENTA Foundation is the lead sponsor of 22 studies on the registry; 3 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
6 Years to 17 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Male and female -1 infected paediatric participants from 6 years old and weighing at least 20 kg to less than 18 years of age.
  • Antiretroviral-experienced with documented historical or baseline resistance to one or more agents in at least two classes. All resistance has to be properly documented.
  • Failing current antiretroviral regimen with a confirmed plasma HIV-1 RNA ≥ 1000 c/mL (first value from Investigator within 6 months of screening visit, with the second value obtained from Screening labs, without a decline greater than 1 log10, and no value \<1000 in between).
  • Documented resistance to at least one component of the current failing regimen per screening resistance testing.
  • Must have at least 1 fully active and available agent in 2 or more ARV classes, based on current and/or documented historical resistance testing, taking into account tolerability, and other safety concerns. At least two fully active agents must be a part of the initial OBT to be paired with FTR.
  • Girls who have reached menarche must have a negative pregnancy test at screening, not be breastfeeding, and be willing to adhere to effective methods of if sexually active. All participants (male or female) have to agree with recommendations for effective contraception.

Exclusion criteria

Exclusion Criteria:

Medical History and Concurrent Diseases:

  • Unable to comply with dosing requirements (to swallow solid pharmaceutical form of the medicinal product)
  • Unable to comply with study visits
  • Presence of a malabsorption syndrome or other gastrointestinal dysfunction which might interfere with drug absorption or render the participant unable to take oral medication.
  • Any clinical condition (including but not limited to recreational drug use) or prior therapy that, in the opinion of the Investigator, would make the participant unsuitable for the study
  • Pregnancy and breastfeeding

Physical and Laboratory Test Findings:

  • Chronic untreated virus (HBV) (however, participants with chronic treated HBV or spontaneously remitted HBV are eligible)
  • -2 infection
  • (ALT) ≥5 times the (ULN), OR ALT ≥3xULN and ≥1.5xULN (with>35% direct bilirubin)
  • History of unstable liver disease, decompensated cirrhosis, or known biliary disorder
  • History of congestive heart failure, or congenital/acquired prolonged syndrome/other cardiac diseases predisposing to prolonged QTc
  • \< 8.0 g/dL
  • \< 50,000 cells/mm3
  • Confirmed QTcF value > 450 msec, regardless of sex, at Screening or Day 1
  • Current (defined as taking the medication within 14 days of Day 1) or anticipated treatment with medication considered prohibited or restricted as per Appendix II. Certain medication will be carefully evaluated as acceptable, see Appendix II.
  • Participation in an experimental drug and/or HIV-1 vaccine trial(s) within the previous 30 days
  • Child in governmental care, e.g. child is a ward of the state. Note: This criterion does not apply if the child is officially adopted by a family/guardian.
Terms in these criteria, in plain language(10)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

QT and QTc

On an ECG, the QT interval is the time the heart’s lower chambers take to activate electrically and recover in each beat. QTc is that time adjusted for heart rate (QTcF by Fridericia’s formula, QTcB by Bazett’s). Some medicines lengthen it, and a long QTc can raise the risk of a dangerous heart rhythm.

The study may name a correction formula and a limit in milliseconds, often around 450–480.

Hemoglobin (Hb)

The protein in red blood cells that carries oxygen. A low level is anaemia, which can cause tiredness and breathlessness. Measured in g/dL or g/L (9 g/dL is 90 g/L).

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

05

Study design

Phase
Phase 1 / Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
60 participants (estimated)

Study arms

  • Experimental
    Fostemsavir

    Fostemsavir in combination with optimized background therapy (OBT) in HIV-1 infected children and adolescents who are failing their current combination antiretroviral therapy (cART) and have dual- or triple-class ARV resistance

    Drug: Fostemsavir

Interventions

  • fostemsavir in combination with optimized background therapy (OBT) in HIV-1 infected children and adolescents who are failing their current combination antiretroviral therapy (cART) and have dual- or triple-class ARV resistance

06

What researchers measure

Primary outcomes

  1. Occurrence of the following events through Week 24

    Time frame: 24 weeks

  2. AUC(0-tau)

    Time frame: at week 1, 4, 12, 24, 48

  3. Cmax

    Time frame: at week 1, 4, 12, 24, 48

  4. Ctau of temsavir across weight bands

    Time frame: at week 1, 4, 12, 24, 48

Secondary outcomes

  1. Proportion of patients with HIV-1 RNA <50 copies/mL

    To evaluate the antiviral activity of fostemsavir + OBT

    Time frame: at 24 weeks and 48 weeks

  2. Change in log10 HIV-1 RNA from baseline

    Time frame: at 24 weeks and 48 weeks

  3. Occurrence of: AEs, treatment-related AEs, AEs of Grade 3 or higher, serious AEs, and AEs leading to premature study treatment discontinuation.

    Time frame: at Week 48 and at the end of Study

  4. Occurrence of WHO 3 or 4 defining events, or death

    Time frame: up to 156 weeks

  5. efficacy of fostemsavir plus OBT

    changes from baseline in CD4+ T cell counts and the percentage of CD4 + T-cells

    Time frame: up to 156 weeks

  6. Emergence of genotypic or phenotypic resistance to Temsavir and components of OBT

    Time frame: up to 156 weeks

07

Study locations

8 sites
08

References and documents

Publications

  • Grasa C, Salvadori N, Nardone A, Than-In-At K, Koblansky A, Parry C, Thakkar N, Wang M, Giaquinto C, Rojo P, Cressey TR. SHIELD study: a multicenter, open-label, single-arm trial to evaluate the safety, pharmacokinetics and antiviral activity of fostemsavir in combination with optimized background therapy (OBT) in children and adolescents with HIV who are failing their current combination antiretroviral therapy (cART) and have dual- or triple-class antiretroviral (ARV) resistance. BMC Infect Dis. 2026 Feb 24;26(1):684. doi: 10.1186/s12879-026-12806-9. PubMed 41735855 ↗

Individual participant data

Plan to share: No

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Started Jun 2022 (actual). Primary completion is estimated for Dec 2028, 78 months after the start.

Of 35 non-industry phase 1/2 interventional studies under HIV Infections, half reached primary completion within 55 months of starting (the median), counting those still running; a quarter within 29 and three quarters within 73. This study's planned 78 months is above that.

Counting every sponsor, half of 42 studies reached it within 47 months; a quarter within 22 and three quarters within 73.

How these figures are worked out, and which studies are left out of them.

Registered
Nov 10, 2020
First posted
Dec 1, 2020
StartActual
Jun 30, 2022
Primary completionEst.
Dec 2028
CompletionEst.
Dec 2028
Last update
Mar 5, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Mar 5, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT04648280
Lead sponsor
PENTA Foundation
Collaborators
ViiV Healthcare, PHPT Foundation, Hospital Universitario 12 de Octubre, Cromsource
Responsible party
Sponsor
First posted
Dec 1, 2020
Start date
Jun 30, 2022
Primary completion
Dec 2028 (estimated)
Completion
Dec 2028 (estimated)
Last update
Mar 5, 2026

Oversight

Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is active, not recruiting, as verified in Mar 2026. You cannot join it, but the record below documents what was studied.

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Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

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Studies of the drug tested here: Fostemsavir

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