Volume 88, Issue 4
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



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%, = 0.03) and during the 28 days after malaria diagnosis (3.4% versus 6.5%, = 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.


Article metrics loading...

The graphs shown below represent data from March 2017
Loading full text...

Full text loading...



  1. Abu-Raddad LJ, Patnaik P, Kublin JG, , 2006. Dual infection with HIV and malaria fuels the spread of both diseases in sub-Saharan Africa. Science 314: 16031606.[Crossref] [Google Scholar]
  2. Otieno RO, Ouma C, Ong'echa JM, Keller CC, Were T, Waindi EN, Michaels MG, Day RD, Vulule JM, Perkins DJ, , 2006. Increased severe anemia in HIV-1-exposed and HIV-1-positive infants and children during acute malaria. AIDS 20: 275280.[Crossref] [Google Scholar]
  3. Whitworth J, Morgan D, Quigley M, Smith A, Mayanja B, Eotu H, Omoding N, Okongo M, Malamba S, Ojwiya A, , 2000. Effect of HIV-1 and increasing immunosuppression on malaria parasitemia and clinical episodes in adults in rural Uganda: a cohort study. Lancet 356: 10511056.[Crossref] [Google Scholar]
  4. Andrews KT, Fairlie DP, Madala PK, Ray J, Wyatt DM, Hilton PM, Melville LA, Beattie L, Gardiner DL, Reid RC, Stoermer MJ, Skinner-Adams T, Berry C, McCarthy JS, , 2006. Potencies of human immunodeficiency virus protease inhibitors in vitro against Plasmodium falciparum and in vivo against murine malaria. Antimicrob Agents Chemother 50: 639648.[Crossref] [Google Scholar]
  5. Nsanzabana C, Rosenthal PJ, , 2011. In vitro activity of antiretroviral drugs against Plasmodium falciparum . Antimicrob Agents Chemother 55: 50735077.[Crossref] [Google Scholar]
  6. Parikh S, Gut J, Istvan E, Goldberg DE, Havlir DV, Rosenthal PJ, , 2005. Antimalarial activity of human immunodeficiency virus type 1 protease inhibitors. Antimicrob Agents Chemother 49: 29832985.[Crossref] [Google Scholar]
  7. Skinner-Adams TS, McCarthy JS, Gardiner DL, Hilton PM, Andrews KT, , 2004. Antiretrovirals as antimalarial agents. J Infect Dis 190: 19982000.[Crossref] [Google Scholar]
  8. Peatey CL, Andrews KT, Eickel N, MacDonald T, Butterworth AS, Trenholme KR, Gardiner DL, McCarthy JS, Skinner-Adams TS, , 2010. Antimalarial asexual stage-specific and gametocytocidal activities of HIV protease inhibitors. Antimicrob Agents Chemother 54: 13341337.[Crossref] [Google Scholar]
  9. Achan J, Kakuru A, Ikilezi G, Ruel T, Clark TD, Nsanzabana C, Charlebois E, Aweeka F, Dorsey G, Rosenthal PJ, Havlir D, Kamya M, , 2012. Antiretroviral agents and prevention of malaria in HIV-infected Ugandan children. N Engl J Med 367: 21102118.[Crossref] [Google Scholar]
  10. Dorsey G, Staedke S, Clark TD, Njama-Meya D, Nzarubara B, Maiteki-Sebuguzi C, Dokomajilar C, Kamya MR, Rosenthal PJ, , 2007. Combination therapy for uncomplicated falciparum malaria in Ugandan children: a randomized trial. JAMA 297: 22102219.[Crossref] [Google Scholar]
  11. Nathoo S, Serghides L, Kain KC, , 2003. Effect of HIV-1 antiretroviral drugs on cytoadherence and phagocytic clearance of Plasmodium falciparum-parasitised erythrocytes. Lancet 362: 10391041.[Crossref] [Google Scholar]
  12. Redmond AM, Skinner-Adams T, Andrews KT, Gardiner DL, Ray J, Kelly M, McCarthy JS, , 2007. Antimalarial activity of sera from subjects taking HIV protease inhibitors. AIDS 21: 763765.[Crossref] [Google Scholar]
  13. Porter KA, Cole SR, Eron JJ, Jr Zheng Y, Hughes MD, Lockman S, Poole C, Skinner-Adams TS, Hosseinipour M, Shaffer D, D'Amico R, Sawe FK, Siika A, Stringer E, Currier JS, Chipato T, Salata R, McCarthy JS, Meshnick SR, , 2012. HIV-1 protease inhibitors and clinical malaria: a secondary analysis of the AIDS Clinical Trials Group A5208 study. Antimicrob Agents Chemother 56: 9951000.[Crossref] [Google Scholar]
  14. Skinner-Adams TS, Butterworth AS, Porter KA, D'Amico R, Sawe F, Shaffer D, Siika A, Hosseinipour MC, Stringer E, Currier JS, Chipato T, Salata R, Lockman S, Eron JJ, Meshnick SR, McCarthy JS, , 2012. The frequency of malaria is similar among women receiving either lopinavir/ritonavir or nevirapine-based antiretroviral treatment. PLoS ONE 7: e34399.[Crossref] [Google Scholar]
  15. Palumbo P, Lindsey JC, Hughes MD, Cotton MF, Bobat R, Meyers T, Bwakura-Dangarembizi M, Chi BH, Musoke P, Kamthunzi P, Schimana W, Purdue L, Eshleman SH, Abrams EJ, Millar L, Petzold E, Mofenson LM, Jean-Philippe P, Violari A, , 2010. Antiretroviral treatment for children with peripartum nevirapine exposure. N Engl J Med 363: 15101520.[Crossref] [Google Scholar]
  16. Violari A, Lindsey JC, Hughes MD, Mujuru HA, Barlow-Mosha L, Kamthunzi P, Chi BH, Cotton MF, Moultrie H, Khadse S, Schimana W, Bobat R, Purdue L, Eshleman SH, Abrams EJ, Millar L, Petzold E, Mofenson LM, Jean-Philippe P, Palumbo P, , 2012. Nevirapine versus ritonavir-boosted lopinavir for HIV-infected children. N Engl J Med 366: 23802389.[Crossref] [Google Scholar]

Data & Media loading...

  • Received : 25 Oct 2012
  • Accepted : 09 Jan 2013
  • Published online : 03 Apr 2013

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error