Prevalence of asymptomatic parasitemia and gametocytemia among HIV-infected Ugandan children randomized to receive different antiretroviral therapies.
In a recent randomized controlled trial, the use of protease inhibitor (PI)-based antiretroviral therapy (ART) was associated with a significantly lower incidence of malaria compared with non-nucleoside reverse transcriptase inhibitor-based ART in a cohort of human immunodeficiency virus-infected Ugandan children living in an area of high malaria transmission intensity. In this report, we compared the prevalence of asymptomatic parasitemia and gametocytemia using data from the same cohort. The prevalence of asymptomatic parasitemia did not differ between the two ART treatment arms. The PI-based arm was associated with a lower risk of gametocytemia at the time of diagnosis of malaria (6.6% versus 14.5%, P = 0.03) and during the 28 days after malaria diagnosis (3.4% versus 6.5%, P = 0.04). Thus, in addition to decreasing the incidence of malaria, the use of PI-based ART may lower transmission, as a result of a decrease in gametocytemia, in areas of high malaria transmission intensity.
Infectious Diseases Research Collaboration, Kampala, Uganda. gloria2k2@yahoo.co.uk
Gloria
G
Ikilezi
Jane
J
Achan
Abel
A
Kakuru
Theodore
T
Ruel
Edwin
E
Charlebois
Tamara D
TD
Clark
Philip J
PJ
Rosenthal
Diane
D
Havlir
Moses R
MR
Kamya
Grant
G
Dorsey
D002675:Child, Preschool; D015331:Cohort Studies; D015658:HIV Infections / Q000188:drug therapy* / Q000473:pathology / Q000821:virology; D017320:HIV Protease Inhibitors / Q000627:therapeutic use*; D006801:Humans; D015994:Incidence; D007223:Infant; D008288:Malaria / Q000175:diagnosis / Q000188:drug therapy*; D018512:Parasitemia / Q000188:drug therapy*; D010961:Plasmodium / Q000187:drug effects* / Q000472:pathogenicity; D015995:Prevalence; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D053058:Trophozoites / Q000187:drug effects*; D014454:Uganda
D017320:HIV Protease Inhibitors; D018894:Reverse Transcriptase Inhibitors