Effect of cotrimoxazole prophylaxis on malaria occurrence among <scp>HIV</scp>‐infected adults in West Africa: the <scp>MALHIV</scp> Study

Eholié, Serge; Ello, F.; Coffie, Patrick A.; Hema, A.; Minta, D.K.; Sawadogo, Adrien

doi:10.1111/tmi.12919

Cited by 7 publications

(7 citation statements)

References 37 publications

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“…The absence of a statistical significance of these differences could be attributed to the small number of P. falciparum-infected patients, but also to the fact that the viral load which have been shown to be associated with the presence of malaria and/or anemia, were not recorded. However, the main findings of this study, the first reported in Gabon, are in accordance with those reported by other authors [14,24,42,44].…”

Section: Discussionsupporting

confidence: 94%

“…Age was known for 1106 participants; it ranged from 17 to 96 years. The median age was significantly higher among PLHIV (43 [35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52] years old) compared to the HIV uninfected individuals (27 years old) (p < 0.01). Indeed, almost half of the patients of this group were less than 25 years old while this age group represented only 4.8% of the PLHIV (Table 1).…”

Section: Resultsmentioning

confidence: 99%

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Burden of asymptomatic malaria, anemia and relationship with cotrimoxazole use and CD4 cell count among HIV1-infected adults living in Gabon, Central Africa

Akotet

Lengongo

Ondounda

et al. 2017

Pathogens and Global Health

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Section: Discussionsupporting

confidence: 94%

Section: Resultsmentioning

confidence: 99%

Burden of asymptomatic malaria, anemia and relationship with cotrimoxazole use and CD4 cell count among HIV1-infected adults living in Gabon, Central Africa

Akotet

Lengongo

Ondounda

et al. 2017

Pathogens and Global Health

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“…[116] However, cotrimoxazole prophylaxis has demonstrated a 69%-80% reduction in the risk of malaria in HIV+ adults. [116][117][118] HIV-infected pregnant women did not demonstrate reduced risk of placental or maternal malaria nor improved birth conditions with daily treatment of trimethoprim-sulfamethoxazole (TMP-SMX) compared to control. [119] Newborns of mothers co-infected with HIV and malaria are at high risk of congenital malaria when maternal CD4 count is <200 cells/μl.…”

Section: Comorbid Conditionsmentioning

confidence: 99%

Global HIV neurology

Thakur

Boubour

Saylor

et al. 2019

Aids

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: Neurological conditions associated with HIV remain major contributors to morbidity and mortality and are increasingly recognized in the aging population on long-standing combination antiretroviral therapy (cART). Importantly, growing evidence shows that the CNS may serve as a reservoir for viral replication, which has major implications for HIV eradication strategies. Though there has been major progress in the last decade in our understanding of the pathogenesis, burden, and impact of neurological conditions associated with HIV infection, significant scientific gaps remain. In many resource-limited settings, ARVs considered second or third line in the United States, which carry substantial neurotoxicity, remain mainstays of treatment, and patients continue to present with severe immunosuppression and central nervous system (CNS) opportunistic infections. Despite this, increased global access to cART has coincided with an aging HIV+ population with cognitive sequelae, cerebrovascular disease, and peripheral neuropathy. Further neurological research in low-income and middle-income countries (LMICs) is needed to address the burden of neurological complications in HIV+ patients, particularly regarding CNS viral reservoirs and their effects on eradication.

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“…According to the World Health Organization (WHO), by the end of 2016, 36.7 million people worldwide were HIV-infected and 25.5 million lived in sub-Saharan Africa [1]. Comorbidity due to both pathogens is not rare [2, 3]. Integrated care of patients with HIV infection and malaria in areas coendemic is now an international health challenge in order to control and reduce the burden of these infections.…”

Section: Introductionmentioning

confidence: 99%

“…Another sulfamide association, the cotrimoxazole (CTX, trimethoprim-sulfamethoxazole) is recommended for malaria prevention in endemic settings and opportunistic infections diseases such as pneumocystosis, toxoplasmosis, and isosporiasis among people living with HIV (PLHIV) [5]. Indeed, when used as a chemoprophylactic agent, CTX decreases by 90% the risk of malaria episodes and reduces the incidence of clinical malaria in PLHIV adults [2, 6–8]. IPTp-SP and CTX chemoprophylaxis coverage are high reaching 80% in Gabon [3, 9].…”

Section: Introductionmentioning

confidence: 99%

Increased Frequency of Pfdhps A581G Mutation in Plasmodium falciparum Isolates from Gabonese HIV-Infected Individuals

Lengongo

Ndiaye

Mbuyi

et al. 2019

Malaria Research and Treatment

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Background. Studying malaria parasites cross resistance to sulfadoxine-pyrimethamine (SP) and trimethoprim-sulfamethoxazole (cotrimoxazole, CTX) is necessary in areas coendemic for malaria and HIV. Polymorphism and frequency of drug resistance molecular markers, Pfdhfr and Pfdhps genes have been assessed in Plasmodium falciparum isolates from HIV-infected adults, in Gabon. Materiel and Methods. A cross-sectional study was conducted in three HIV care and treatment centers, at Libreville, the capital city of Gabon and at Oyem and Koulamoutou, two rural cities between March 2015 and June 2016. P. falciparum-infected HIV adults were selected. Analysis of Pfdhfr and Pfdhps genes was performed using high resolution melting (HRM) technique. Results. Pfdhps A581G mutation was found in 23.5% (8/34) of the isolates. Triple Pfdhfr mutation (51I-59R-108N) was predominant (29.4%; n=10) while 17.6% (n=6) of the isolates carried a quadruple mutation (Pfdhfr 51I-59R-108N + Pfdhps 437G; Pfdhfr 51I-108N + Pfdhps 437G-Pfdhps581G; Pfdhfr 51I-59R-108N + Pfdhps 581G). Highly resistant genotype was detected in around 10% (n=3) of the isolates. The quintuple mutation (triple Pfdhfr 51I-59R-108N and double Pfdhps437-581) was only found in isolates from two patients who did not use CTX. The most frequent haplotypes were those with a single mutation (NCNIAKA) (36%) and a quadruple mutation (NCIIGKG, NRIIGKA, and NRIIAKG). Mixed unknown genotypes were found at codon 164 in three isolates. Mixed genotypes were more frequent at codons 51 (23.5%; n=8) and 59 (20.5%; n=7) (p<0.01). Conclusion. Pfdhps A581G mutation as well as new combination of quintuple mutations is found for the first time in isolates from HIV-infected patients in Gabon in comparison to a previous study. The detection of these genotypes at a nonnegligible frequency underlines the need of a regular surveillance of antifolates drug resistance.

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Effect of cotrimoxazole prophylaxis on malaria occurrence among HIV‐infected adults in West Africa: the MALHIV Study

Abstract: Patients in the CTX group had an adjusted risk of malaria three times lower than those in the non-CTX group. The prolonged large-scale use of CTX did not blunt the efficacy of CTX to prevent malaria in this region.

Cited by 7 publications

References 37 publications

Burden of asymptomatic malaria, anemia and relationship with cotrimoxazole use and CD4 cell count among HIV1-infected adults living in Gabon, Central Africa

Burden of asymptomatic malaria, anemia and relationship with cotrimoxazole use and CD4 cell count among HIV1-infected adults living in Gabon, Central Africa

Global HIV neurology

Increased Frequency of Pfdhps A581G Mutation in Plasmodium falciparum Isolates from Gabonese HIV-Infected Individuals

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