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

Porter, Kimberly A., Cole, Stephen R., Eron, Joseph J., Jr., 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. and Meshnicka, Steven R. (2012) HIV-1 protease inhibitors and clinical malaria: A secondary analysis of the AIDS Clinical Trials Group A5208 study. Antimicrobial Agents and Chemotherapy, 56 2: 995-1000. doi:10.1128/AAC.05322-11

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Author Porter, Kimberly A.
Cole, Stephen R.
Eron, Joseph J., Jr.
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.
Title HIV-1 protease inhibitors and clinical malaria: A secondary analysis of the AIDS Clinical Trials Group A5208 study
Journal name Antimicrobial Agents and Chemotherapy   Check publisher's open access policy
ISSN 0066-4804
Publication date 2012-02
Year available 2011
Sub-type Article (original research)
DOI 10.1128/AAC.05322-11
Open Access Status File (Publisher version)
Volume 56
Issue 2
Start page 995
End page 1000
Total pages 6
Place of publication Washington, DC, United States
Publisher American Society for Microbiology
Collection year 2012
Language eng
Formatted 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 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 HIV-infected 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.
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes First published November 2011

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2012 Collection
School of Medicine Publications
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Created: Tue, 06 Mar 2012, 09:04:33 EST by System User