Effects of malaria intermittent preventive treatment with dihydroartemisinin-piperaquine on antiretroviral drug concentrations in African pregnant women living with HIV
Year: 2026
Type: article
Abstract: Intermittent preventive treatment during pregnancy (IPTp) for malaria prevention with sulfadoxine-pyrimethamine is contraindicated in pregnant women living with HIV receiving cotrimoxazole prophylaxis. A recent clinical trial showed that dihydroartemisinin-piperaquine (DHA-PPQ) for IPTp is a safe and effective option for malaria prevention in this population. The present study evaluated the impact of monthly IPTp with DHA-PPQ on antiretroviral (ARV) drug concentrations in 105 participants recruited in the aforementioned trial in Mozambique and Gabon between January and November 2021. ARV serum concentrations from maternal venous and cord blood collected at the first antenatal care visit and at the end of pregnancy were measured by ultra-high-performance liquid chromatography-tandem mass spectrometry. At the end of pregnancy, median concentrations of dolutegravir were 835.1 ng/mL (248.1-1,687.6) in maternal and 1,204.2 ng/mL (456.4-1,883.3) in cord blood. For lamivudine (3TC), median concentrations were 108.3 ng/mL (28.8-246.1) in maternal and 186.5 ng/mL (81.9-427.6) in cord blood. No significant differences in ARV concentrations were found between the antimalarial treatment arm and the placebo arm. Furthermore, in multivariate exploratory analysis, no independent associations were found between ARV concentrations and participant characteristics. Our study found similar ARV concentrations in both treatment groups, suggesting that DHA-PPQ for monthly IPTp does not affect ARV concentrations in maternal and cord blood in women living with HIV.CLINICAL TRIALSThis study is registered with ClinicalTrials.gov as NCT03671109.
DOI: 10.1128/aac.00337-26
Authors: Linda Stöger, Johannes Mischlinger, Tacilta Nhampossa, Ghyslain Mombo-Ngoma, Meral Esen, André-Marie Tchouatieu, Mercè Brunet, Anete Mendes, Lia Betty Dimessa Mbadinga, Sara Gamberini, Wilfrid Ndzebe Ndoumba, Antía Figueroa-Romero, Bertrand Lell, Heimo Lagler, Rella Zoleko-Manego, Myriam El Gaaloul, Susana Méndez, Núria Botella, Sergi Sanz, Mireia Piqueras, Esperança Sevene, Francisco Saúte, Sebastian G. Wicha, Dolors Soy, Clara Menéndez, Michael Ramharter, Raquel González, on behalf of the MAMAH Study Group
Institutions: Instituto de Salud Carlos III, Barcelona Institute for Global Health, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Universitat de Barcelona, University Medical Center Hamburg-Eppendorf, German Center for Infection Research, Bernhard Nocht Institute for Tropical Medicine, Manhiça Health Research Centre, Instituto Nacional de Saúde, Centre de Recherche Médicales de Lambaréné, University of Tübingen, Medicines for Malaria Venture, Hospital Clínic de Barcelona, Medical University of Vienna, Universität Hamburg
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
Awards: G5993739516, G6591026299
OpenAlex ID: W7164536018