Prevalence of Asymptomatic Parasitemia and Gametocytemia in HIV-Infected Children on Differing Antiretroviral Therapy

Laboratory data and prior pediatric reports indicate that HIV protease inhibitor (PI)-based antiretroviral therapy (ARV) kills gametocytes and reduces rates of gametocytemia, but not asymptomatic parasitemia, in a high malaria-transmission area. To determine whether ARV regimen impacts these rates i...

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Bibliographic Details
Published in:The American journal of tropical medicine and hygiene 2018-01, Vol.98 (1), p.67-70
Main Authors: Hobbs, Charlotte V, Gabriel, Erin E, Kamthunzi, Portia, Tegha, Gerald, Tauzie, Jean, Li, Yonghua, Ilmet, Tiina, Artimovich, Elena, Neal, Jillian, Hall, Ted, Parikh, Sunil, Kirmse, Brian, Jean-Philippe, Patrick, Chen, Jingyang, Prescott, William R, Palumbo, Paul, Duffy, Patrick E, Borkowsky, William, For The P S Study Team
Format: Article
Language:English
Subjects:
Africa South of the Sahara - epidemiology
Anti-HIV Agents - therapeutic use
Antiretroviral drugs
Asymptomatic Infections - epidemiology
Child, Preschool
Coinfection - epidemiology
Coinfection - parasitology
Coinfection - virology
Drug therapy
Female
HIV Infections - complications
HIV Infections - drug therapy
HIV Infections - parasitology
Humans
Infant
Malaria
Malaria, Falciparum - complications
Malaria, Falciparum - epidemiology
Male
Microsatellite Repeats - genetics
Parasitemia - epidemiology
Plasmodium falciparum - genetics
Prevalence
Protease inhibitors
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Summary:Laboratory data and prior pediatric reports indicate that HIV protease inhibitor (PI)-based antiretroviral therapy (ARV) kills gametocytes and reduces rates of gametocytemia, but not asymptomatic parasitemia, in a high malaria-transmission area. To determine whether ARV regimen impacts these rates in areas with less-intense malaria transmission, we compared asymptomatic parasitemia and gametocytemia rates in HIV-infected children by ARV regimen in Lilongwe, Malawi, an area of low-to-moderate transmission intensity. HIV PI lopinavir-ritonavir (LPV-rtv) ARV- or non-nucleoside reverse transcriptase inhibitor nevirapine ARV-treated children did not differ in the rates of polymerase chain reaction-detected asymptomatic parasitemia (relative risk [RR] 0.43 95% confidence interval [CI] [0.16, 1.18], value 0.10) or microscopically detected gametocytemia with LPV-rtv ARV during symptomatic malaria (RR 0.48 95% CI [0.22,1.04] value 0.06). LPV-rtv ARV was not associated with reduced rates of asymptomatic parasitemia, or gametocytemia on days of symptomatic malaria episodes, in HIV-infected children. Larger studies should evaluate whether ARV impacts transmission.
ISSN:0002-9637
1476-1645
DOI:10.4269/ajtmh.17-0462