Malaria treatment efficacy among people living with HIV: the role of host and parasite factors.


Journal Article

Identification of an effect of HIV-associated immunosuppression on response to antimalarial therapy would help guide management of malaria infection in areas of high HIV prevalence. Therefore, we conducted an observational study of people living with HIV infection in Blantyre, Malawi. Participants who developed malaria were treated with sulfadoxine-pyrimethamine (SP) and followed for 28 days. Molecular markers for SP resistance were measured. One hundred seventy-eight episodes of malaria were assessed. The 28-day cumulative treatment failure rate was 29.1%. In univariate analysis, CD4 cell count was not associated with treatment failure (hazard ratio 0.6, 95% confidence interval 0.3-1.2). Among children, the risk of treatment failure increased with infection with SP-resistant parasites and anemia. Decreased CD4 cell count was not associated with impaired response to antimalarial therapy or diminished ability to clear SP-resistant parasites, suggesting that acquired immunity to malaria is retained in the face of HIV-associated immunosuppression.

Full Text

Cited Authors

  • Laufer, MK; van Oosterhout, JJG; Thesing, PC; Dzinjalamala, FK; Hsi, T; Beraho, L; Graham, SM; Taylor, TE; Plowe, CV

Published Date

  • October 2007

Published In

Volume / Issue

  • 77 / 4

Start / End Page

  • 627 - 632

PubMed ID

  • 17978061

Pubmed Central ID

  • 17978061

Electronic International Standard Serial Number (EISSN)

  • 1476-1645

International Standard Serial Number (ISSN)

  • 0002-9637

Digital Object Identifier (DOI)

  • 10.4269/ajtmh.2007.77.627


  • eng