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[e-drug] HIV drug improves anti-malarial drug effectiveness

E-DRUG: HIV drug improves anti-malarial drug effectiveness

Source: ScienceNOW
21 March 2012 

An antiretroviral drug commonly given to HIV-infected children in Sub-Saharan 
Africa improves the effectiveness of a key malaria drug, according to a new 

Laboratory studies have long established that a class of HIV antiretrovirals 
known as protease inhibitors can cripple the malaria parasite Plasmodium, and 
researchers from Uganda and the United States wanted to better understand why.

They tested two antiretroviral 'cocktails' on 170 HIV-positive Ugandan children 
under the age of five. One of the cocktails contained two protease inhibitors, 
lopinavir and ritonavir.

Over the course of the two-year trial, children who received the cocktail 
containing the inhibitors had a 41 per cent drop in malaria cases compared with 
children who did not.

"The 41 per cent reduction in clinical malaria episodes is both statistically 
and clinically significant," Paula Brentlinger, a clinician at the University 
of Washington, Seattle, told ScienceNOW.  "The fact that it was achieved in one 
of the most malaria-vulnerable populations in the world is especially 

To their surprise, the researchers found that the two protease inhibitors had a 
limited impact on the malaria parasite itself. However they found one of the 
inhibitors ­ ritonavir ­ boosted the longevity in the body of a widely used 
anti-malarial drug, lumefantrine.

Children who received anti-retroviral cocktails containing ritonavir had five 
times as much lumefantrine in their bodies a week after receiving the 

"We think that these higher lumefantrine exposures were really what was driving 
the protection against recurrent episodes of malaria," said Jane Achan, a 
researcher at Makerere University, Uganda, who presented the results of the 
study earlier this month.

Carlos "Kent" Campbell, head of the Malaria Control Program at PATH, a US-based 
nonprofit organisation, said bednets remain the most critical prevention 
strategy and said most children at risk of malaria are not HIV-positive.

But he added that the "unanticipated positive consequences" of ritonavir may 
help reduce parasitemia, a leading malaria-related cause of anaemia in young 
African children.

S. Patrick Kachur, director of the Centre for Disease Control's malaria 
programme, also said the finding could benefit investigations into long-acting 
antimalarials for specific populations.

 to full article in 


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