HIV treatment reduces malaria recurrence risk in children

A recent National Institutes of Health study found that a combination of anti-HIV drugs reduced the risk of recurrent malaria by close to 50 percent among HIV-positive children.

The study showed that a combination of protease inhibitors ritonavir and lopinavir contributed to the overall rate of malaria reduction by 40 percent among a group of HIV-positive children up to six years old and infants in Uganda. The protease inhibitor combination appeared not to inhibit an initial bout of malaria but reduced the chances of its recurrence after successful treatment.

"It's possible that these protease inhibitors prevent antimalarial drugs from breaking down or have some other additive effect against the malarial parasite," Lynne Mofenson, the chief of the Pediatric, Adolescent and Maternal AIDS Branch at the Eunice Kennedy Shriver National Institute of Child Health and Human Development, said. "Laboratory studies also suggest that protease inhibitors can block the malaria parasite outright. Finding out why this drug combination is effective is an area for further study."

The protease inhibitor combination was compared with drug treatment using non-nucleoside reverse transcriptase inhibitors. Nevirapine, an NNRTI, is the first-line treatment for HIV recommended for children by the WHO.

"The finding that this protease inhibitor combination not only appears more effective at treating HIV than NNRTIs, but also protects against malaria recurrence, merits its consideration for children living in areas where malaria is rampant," Mofenson said.

The findings were recently reported in the New England Journal of Medicine.

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