Antiretroviral Agents and Prevention of Malaria in HIV-Infected Ugandan Children
December 5, 2012
A recent study found that certain antiretroviral drugs reduced the risk of recurring malaria in children with HIV infection. The researchers tested the hypothesis that the incidence of malaria in HIV-infected children would be lower among those who received lopinavir-ritonavir-based antiretroviral therapy (ART) than among those who received non-nucleoside reverse-transcriptase inhibitor (NNRTI)-based ART.
The researchers conducted an open-label randomized trial in Tororo, Uganda, an area of high-intensity malaria transmission. A total of 170 children aged two months to five years with confirmed HIV-infection participated in the study; 86 children were assigned to the NNRTI-based ART group, and 84 were in the lopinavir-ritonavir-based ART group. Each child received a long-lasting insecticide-treated bed net, a hygienic water-storage container, multivitamins, and trimethoprim-sulfamethoxazole to be taken daily. The children were followed for a median of 366 days.
The incidence of malaria was found to be lower among children receiving lopinavir-ritonavir-based drugs than among those receiving the NNRTI-based regimen (1.32 versus 2.25 episodes per person-year) and the risk of a recurrence of malaria after treatment was also lower. More serious side effects occurred in the lopinavir-ritonavir group than in the NNRTI group. The researchers concluded that lopinavir-ritonavir-based ART compared with NNRTI-based ART reduced incidence of malaria by 41 percent, with the lower incidence attributed to a significant reduction in the recurrence of malaria after treatment with artemether-lumefantrine.
New England Journal of Medicine
11.29.2012; Vol. 367; No. 22: P. 2110-2118; Jane Achan, Abel Kakuru, Gloriea Ikilezi, Theodore Ruel, Tamara D. Clark, Christian Nsanzabana, Edwin Charlebois, Francesca Aweeka, Grant Dorsey, Philip J. Rosenthal, Diane Havlir, Moses R. Kamya
Discontinuing Antibiotic Used to Prevent Opportunistic Infections Among HIV Patients Could Increase Risk of Malaria, Diarrhea
This article was provided by U.S. Centers for Disease Control and Prevention. It is a part of the publication CDC HIV/Hepatitis/STD/TB Prevention News Update. Visit the CDC's website to find out more about their activities, publications and services.
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