Abstract | OBJECTIVE: The objective of this study is to determine the epidemiological effectiveness of a first-line antiretroviral regimen with HIV protease inhibitor for preventing recurrent malaria in children under the range of HIV prevalence levels and malaria transmission intensities encountered in sub-Saharan Africa. DESIGN: METHODS: To evaluate the benefits of HIV protease inhibitors on the health burden of recurrent malaria among children, we constructed a dynamic model of malaria transmission to both HIV-positive and HIV-negative children, parameterized by data from a recent clinical trial. The model was then evaluated under varying malaria transmission and HIV prevalence settings to determine the health benefits of HIV protease inhibitors in the context of artemether-lumefantrine treatment of malaria in children. RESULTS: Comparing scenarios of low, intermediate and high newborn HIV prevalence, in a range of malaria transmission settings, our dynamic model predicts that artemether-lumefantrine with HIV protease inhibitor based regimens prevents 0.03-0.10, 5.2-13.0 and 25.5-65.8 annual incidences of malaria per 1000 children, respectively. In addition, HIV protease inhibitors save 0.002-0.006, 0.22-0.8, 1.04-4.3 disability-adjusted life-years per 1000 children annually. Considering only HIV-infected children, HIV protease inhibitors avert between 278 and 1043 annual incidences of malaria per 1000 children. CONCLUSION:
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Authors | Scott Greenhalgh, Martial Ndeffo, Alison P Galvani, Sunil Parikh |
Journal | AIDS (London, England)
(AIDS)
Vol. 29
Issue 4
Pg. 473-82
(Feb 20 2015)
ISSN: 1473-5571 [Electronic] England |
PMID | 25486414
(Publication Type: Journal Article, Research Support, N.I.H., Extramural)
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Chemical References |
- Antimalarials
- Artemether, Lumefantrine Drug Combination
- Artemisinins
- Drug Combinations
- Ethanolamines
- Fluorenes
- HIV Protease Inhibitors
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Topics |
- Africa South of the Sahara
(epidemiology)
- Animals
- Antimalarials
(therapeutic use)
- Artemether, Lumefantrine Drug Combination
- Artemisinins
(therapeutic use)
- Child
- Child, Preschool
- Drug Combinations
- Ethanolamines
(therapeutic use)
- Fluorenes
(therapeutic use)
- HIV Infections
(drug therapy, epidemiology, immunology)
- HIV Protease Inhibitors
(therapeutic use)
- Humans
- Malaria
(drug therapy, epidemiology, prevention & control)
- Recurrence
- Treatment Outcome
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