Malaria in HIV-Infected Children Receiving HIV Protease-Inhibitor- Compared with Non-Nucleoside Reverse Transcriptase Inhibitor-Based Antiretroviral Therapy, IMPAACT P1068s, Substudy to P1060
Year: 2016
Type: article
Abstract: BACKGROUND: HIV and malaria geographically overlap. HIV protease inhibitors kill malaria parasites in vitro and in vivo, but further evaluation in clinical studies is needed. METHODS: Thirty-one children from Malawi aged 4-62 months were followed every 3 months and at intercurrent illness visits for ≤47 months (September 2009-December 2011). We compared malaria parasite carriage by blood smear microscopy (BS) and confirmed clinical malaria incidence (CCM, or positive BS with malaria symptoms) in children initiated on HIV antiretroviral therapy (ART) with zidovudine, lamivudine, and either nevirapine (NVP), a non-nucleoside reverse transcriptase inhibitor, or lopinavir-ritonavir (LPV-rtv), a protease inhibitor. RESULTS: We found an association between increased time to recurrent positive BS, but not CCM, when anti-malarial treatment and LPV-rtv based ART were used concurrently and when accounting for a LPV-rtv and antimalarial treatment interaction (adjusted HR 0.39; 95% CI (0.17,0.89); p = 0.03). CONCLUSIONS: LPV-rtv in combination with malaria treatment was associated with lower risk of recurrent positive BS, but not CCM, in HIV-infected children. Larger, randomized studies are needed to confirm these findings which may permit ART optimization for malaria-endemic settings. TRIAL REGISTRATION: ClinicalTrials.gov NCT00719602.
Source: PLoS ONE
Authors: Charlotte V. Hobbs, Erin E. Gabriel, Portia Kamthunzi, Gerald Tegha, Jean Tauzie, Elizabeth Petzold, Linda Barlow-Mosha, Benjamin H. Chi, Yonghua Li, Tiina Ilmet, Brian Kirmse, Jillian Neal, Sunil Parikh, Nagamah Deygoo, Patrick Jean Philippe, Lynne Mofenson, William Prescott, Jingyang Chen, Philippa Musoke, Paul Palumbo, Patrick E. Duffy, William Borkowsky, for the P1068s Study Team
Institutions: National Institutes of Health, University of Mississippi Medical Center, National Institute of Allergy and Infectious Diseases, New York University, University of North Carolina at Chapel Hill, Kamuzu Central Hospital, Duke Clinical Research Institute, MUJHU Research Collaboration, Weill Cornell Medicine, Yale University, Henry M. Jackson Foundation, Elizabeth Glaser Pediatric AIDS Foundation, University of Washington, Fred Hutch Cancer Center, Seattle Children's Research Institute, Makerere University, Dartmouth College
Language: English
Topic: Malaria Research and Control
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,382
Funders: Frederick National Laboratory for Cancer Research, Leidos, International Maternal Pediatric Adolescent AIDS Clinical Trials Network, National Institutes of Health, National Institute of Mental Health, National Institute of Allergy and Infectious Diseases, Eunice Kennedy Shriver National Institute of Child Health and Human Development
Awards: G3262353703, G3342746445, SDMC - IMPAACT Leadership Group, International Maternal, Adolescent and Pediatric Therapeutics Clinical Trials Network, The University of North Carolina Center for AIDS Research, University of North Carolina Global HIV Prevention and Treatment Clinical Trials Unit, The Johns Hopkins University - Uganda Clinical Trials Unit, IMPAACT Leadership Group
OpenAlex ID: W2560771963