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  • HIV-1 protease inhibitors and clinical malaria: a secondary analysis of the AIDS Clinical Trials Group A5208 study

    Author(s)
    Porter, Kimberly A
    Cole, Stephen R
    Eron, Joseph J
    Zheng, Yu
    Hughes, Michael D
    Lockman, Shahin
    Poole, Charles
    Skinner-Adams, Tina S
    Hosseinipour, Mina
    Shaffer, Doug
    D'Amico, Ronald
    Sawe, Frederick K
    Siika, Abraham
    Stringer, Elizabeth
    Currier, Judith S
    Chipato, Tsungai
    Salata, Robert
    McCarthy, James S
    Meshnicka, Steven R
    Griffith University Author(s)
    Skinner-Adams, Tina
    Year published
    2012
    Metadata
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    Abstract
    HIV-1 protease inhibitors (PIs) have antimalarial activity in vitro and in murine models. The potential beneficial effect of HIV-1 PIs on malaria has not been studied in clinical settings. We used data from Adult AIDS Clinical Trials Group A5208 sites where malaria is endemic to compare the incidence of clinically diagnosed malaria among HIV-infected adult women randomized to either lopinavir/ritonavir (LPV/r)-based antiretroviral therapy (ART) or to nevirapine (NVP)-based ART. We calculated hazard ratios and 95% confidence intervals. We conducted a recurrent events analysis that included both first and second clinical ...
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    HIV-1 protease inhibitors (PIs) have antimalarial activity in vitro and in murine models. The potential beneficial effect of HIV-1 PIs on malaria has not been studied in clinical settings. We used data from Adult AIDS Clinical Trials Group A5208 sites where malaria is endemic to compare the incidence of clinically diagnosed malaria among HIV-infected adult women randomized to either lopinavir/ritonavir (LPV/r)-based antiretroviral therapy (ART) or to nevirapine (NVP)-based ART. We calculated hazard ratios and 95% confidence intervals. We conducted a recurrent events analysis that included both first and second clinical malarial episodes and also conducted analyses to assess the sensitivity of results to outcome misclassification. Among the 445 women in this analysis, 137 (31%) received a clinical diagnosis of malaria at least once during follow-up. Of these 137, 72 (53%) were randomized to LPV/r-based ART. Assignment to the LPV/r treatment group (n 226) was not consistent with a large decrease in the hazard of first clinical malarial episode (hazard ratio 1.11 [0.79 to 1.56]). The results were similar in the recurrent events analysis. Sensitivity analyses indicated the results were robust to reasonable levels of outcome misclassification. In this study, the treatment with LPV/r compared to NVP had no apparent beneficial effect on the incidence of clinical malaria among HIVinfected adult women. Additional research concerning the effects of PI-based therapy on the incidence of malaria diagnosed by more specific criteria and among groups at a higher risk for severe disease is warranted.
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    Journal Title
    Antimicrobial Agents and Chemotherapy
    Volume
    56
    Issue
    2
    DOI
    https://doi.org/10.1128/AAC.05322-11
    Subject
    Medical Parasitology
    Microbiology
    Medical Microbiology
    Pharmacology and Pharmaceutical Sciences
    Publication URI
    http://hdl.handle.net/10072/53131
    Collection
    • Journal articles

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