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

• 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
• ISSN: 0002-9637; 1476-1645
• DOI: 10.4269/ajtmh.17-0462

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.