Ensuring children have appropriate HIV treatment

What it is

Triomune Baby/Junior became the first fixed-dose combination medicine developed specifically for children with HIV and paved the way for additional improved combination therapies for first- and second-line HIV treatment in children.

Why it matters

While antiretroviral therapy (ART) is lifesaving against HIV, existing formulations are often unsuitable for babies and children. These innovations enhance the acceptability and use of ART in children, helping to save and improve their lives.

The story

HIV can be transmitted from mother to child during pregnancy, childbirth, or breastfeeding. An estimated 1.4 million children aged 0–14 are living with HIV, with 120,000 new infections each year.[1] While antiretroviral therapy (ART) is recommended for all people with HIV, only half of the affected children receive treatment,[2] leading to preventable illness, deaths, and the emergence of drug resistance. Without treatment, 50% of children with HIV die before the age of two and 80% before their fifth birthday. The limited availability of suitable paediatric HIV medicines drives this. Poor taste, complex preparation and administration (e.g., crushing pills or dissolving tablets), and frequent refills (sometimes every two weeks) disrupt school, impose travel costs on families, and severely undermine adherence to these lifesaving treatments.[3] Although children in sub-Saharan Africa are most impacted, these barriers hinder access to HIV treatment and prevention for children globally.[4]

For more than 20 years, EDCTP has advanced HIV research to address these challenges.[5] Launched in 2005, the CHAPAS project[6] compared and evaluated ART regimens to identify safer, more effective, and child-friendly options that are acceptable and accessible. This research bore fruit in 2007 with the registration of Triomune Baby/Junior, the first fixed-dose combination medicine for children with HIV. Although ultimately discontinued due to side effects, it paved the way for safer, more effective paediatric HIV treatments, including fixed-dose combinations and oral granule formulations.

Evidence from CHAPAS studies also informed WHO recommendations on updated treatment options[7] and in July 2025, the CHAPAS-4 consortium announced[8]a new ART regimen for children that improves viral suppression, is easier to administer, and offers sustained long-term health benefits compared to existing alternatives.

Global Health EDCTP3 remains committed to driving innovation to ensure children living with HIV have access to the best possible treatment and care[9] while also advancing the development of improved HIV medicines for all.[10]

Sources:

[1] Global HIV Programme

[2] HIV – Reported number of children receiving antiretroviral therapy

[3] Challenges with pediatric antiretroviral therapy administration: Qualitative perspectives from caregivers and HIV providers in Kenya - PMC

[4] Increasing Access to Antiretroviral Therapy for the Prevention and Treatment of HIV in Infants, Children, and Youth in the United States: Policy Statement | Pediatrics | American Academy of Pediatrics & Setback in the fight against pediatric HIV — Harvard Gazette

[5] World AIDS Day 2024: Supporting innovative research to end inequality - Global Health EDCTP3 JU & HIV & HIV-associated infections - EDCTP

[6] HIV treatment: CHAPAS Trials - EDCTP

[7] CHAPAS 4 - International partnerships against infectious diseases

[8] Revolutionary HIV treatment for children introduced by EDCTP-funded CHAPAS - Global Health EDCTP3 JU