HIV and Placental Infection Modulate the Appearance of Drug-Resistant Plasmodium falciparum in Pregnant Women who Receive Intermittent Preventive Treatment

Menéndez, Clara; Serra-Casas, Elisa; Scahill, Michael D.; Sanz, Sergi; Nhabomba, Augusto; Bardají, Azucena; Sigaùque, Betuel; Cisteró, Pau; Mandomando, Inácio; Dobaño, Carlota; Alonso, Pedro L.; Mayor, Alfredo

doi:10.1093/cid/ciq049

Cited by 31 publications

(30 citation statements)

References 32 publications

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“…40 New evidence suggests that malaria parasites are more likely to develop wildtype mutations following exposure to sulfadoxine-pyrimethamine as intermittent preventive treatment during pregnancy (IPTp) when administered to HIVpositive women. 41 The interaction between STIs/RTIs and HIV has been well established, although providing presumptive treatment for STIs/RTIs to pregnant women in Rakai, Uganda, has not shown protective effect against maternal to child transmission of HIV. 42 However, malaria chemoprophylaxis was not provided in this study; therefore, the potential modulating effect of malaria on maternal to child transmission in the presence of STIs/RTIs remains unknown.…”

Section: Commentmentioning

confidence: 99%

Prevalence of Malaria and Sexually Transmitted and Reproductive Tract Infections in Pregnancy in Sub-Saharan Africa

Chico¹,

Mayaud²,

Ariti³

et al. 2012

JAMA

168

129

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Section: Commentmentioning

confidence: 99%

Prevalence of Malaria and Sexually Transmitted and Reproductive Tract Infections in Pregnancy in Sub-Saharan Africa

Chico¹,

Mayaud²,

Ariti³

et al. 2012

JAMA

168

129

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“…Indeed, although IPTp-SP has been associated with the selection of mutations [10, 13–15], it has been shown that self-reported use of IPTp-SP did not increase the prevalence of resistant alleles [5, 16]. Moreover, conflicting results about the impact of mutant parasites on pregnancy outcomes such as parasite densities, maternal haemoglobin level, and anaemia have been reported [14, 15].…”

Section: Introductionmentioning

confidence: 99%

Recent uptake of intermittent preventive treatment during pregnancy with sulfadoxine–pyrimethamine is associated with increased prevalence of Pfdhfr mutations in Bobo-Dioulasso, Burkina Faso

Cissé

Awandare

Soulama

et al. 2017

Malar J

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BackgroundThe impact of sulfadoxine–pyrimethamine (SP) used as intermittent preventive treatment during pregnancy (IPTp-SP) on mutant parasite selection has been poorly documented in Burkina Faso. This study sought first to explore the relationship between IPTp-SP and the presence of mutant parasites. Second, to assess the relationship between the mutant parasites and adverse pregnancy outcomes.Methods From September to December 2010, dried blood spots (DBS) were collected during antenatal care visits and at delivery from 109 pregnant women with microscopically confirmed falciparum malaria infection. DBS were analysed by PCR–restriction fragment length polymorphism (PCR–RFLP) for the polymorphisms at codons 51, 59, 108, and 164 of the Pfdhfr gene and codons 437 and 540 in the Pfdhps gene.ResultsBoth the Pfdhfr and Pfdhps genes were successfully genotyped in 92.7% (101/109) of the samples. The prevalence of Pfdhfr mutations N51I, C59R and S108N was 71.3, 42.6 and 64.4%, respectively. Overall, 80.2% (81/101) of samples carried the Pfdhps A437G mutation. None of the samples had the Pfdhfr I164L and the Pfdhps K540E mutations. The prevalence of the triple mutation N51I + C59R + S108N was 25.7% (26/101). The use of IPTp-SP was associated with a threefold increased odds of Pfdhfr C59R mutation [crude OR 3.29; 95% CI (1.44–7.50)]. Pregnant women with recent uptake of IPTp-SP were at higher odds of both the Pfdhfr C59R mutation [adjusted OR 4.26; 95% CI (1.64–11.07)] and the Pfdhfr intermediate-to-high resistance, i.e., ≥ 2 Pfdhfr mutations [adjusted OR 3.45; 95% CI (1.18–10.07)]. There was no statistically significant association between the presence of the Pfdhfr intermediate-to-high resistance and parasite densities or both maternal haemoglobin level and anaemia.ConclusionThe data indicate that despite the possibility that IPTp-SP contributes to the selection of resistant parasites, it did not potentiate pregnancy-associated malaria morbidity, suggesting the continuation of SP use as IPTp in Burkina Faso.Electronic supplementary materialThe online version of this article (doi:10.1186/s12936-017-1695-1) contains supplementary material, which is available to authorized users.

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“…Indeed, an increased prevalence of resistant malaria parasites has been found in HIV-positive versus HIV-negative pregnant women [16]. The mechanisms promoting malaria drug resistance in HIV-coinfected hosts are expected to be similar to those promoting TB drug resistance in HIV–TB infections, but evidence is largely lacking.…”

Section: Immune Modulationmentioning

confidence: 99%

The potential impact of coinfection on antimicrobial chemotherapy and drug resistance

Birger

Kouyos

Cohen

et al. 2015

Trends in Microbiology

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Across a range of pathogens, resistance to chemotherapy is a growing problem in both public health and animal health. Despite the ubiquity of coinfection, and its potential effects on within-host biology, the role played by coinfecting pathogens on the evolution of resistance and efficacy of antimicrobial chemotherapy is rarely considered. In this review, we provide an overview of the mechanisms of interaction of coinfecting pathogens, ranging from immune modulation and resource modulation, to drug interactions. We discuss their potential implications for the evolution of resistance, providing evidence in the rare cases where it is available. Overall, our review indicates that the impact of coinfection has the potential to be considerable, suggesting that this should be taken into account when designing antimicrobial drug treatments.

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HIV and Placental Infection Modulate the Appearance of Drug-Resistant Plasmodium falciparum in Pregnant Women who Receive Intermittent Preventive Treatment

Cited by 31 publications

References 32 publications

Prevalence of Malaria and Sexually Transmitted and Reproductive Tract Infections in Pregnancy in Sub-Saharan Africa

Prevalence of Malaria and Sexually Transmitted and Reproductive Tract Infections in Pregnancy in Sub-Saharan Africa

Recent uptake of intermittent preventive treatment during pregnancy with sulfadoxine–pyrimethamine is associated with increased prevalence of Pfdhfr mutations in Bobo-Dioulasso, Burkina Faso

The potential impact of coinfection on antimicrobial chemotherapy and drug resistance

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