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CDC HIV/AIDS/Viral Hepatitis/STD/TB Prevention News Update

UGANDA: Antiretroviral Agents and Prevention of Malaria in HIV-Infected Ugandan Children


New England Journal of Medicine Vol. 367; No. 22: P. 2110-2118. (11.29.12)

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


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Information in this article was accurate in December 5, 2012. The state of the art may have changed since the publication date. This material is designed to support, not replace, the relationship that exists between you and your doctor. Always discuss treatment options with a doctor who specializes in treating HIV.