Sunday, April 1, 2012

Anti retrovirals help malaria drugs

Researchers revealed at the 19th Conference on Retroviruses and Opportunistic Infections clinical data showing anti-retroviral drugs coupled with standard anti-malaria treatment greatly improves the efficacy of the malaria treatment. The study was done by a team of researchers headed by Diane Havlir of the University of California, San Francisco (UCSF), and Moses Kamya of Makerere University College of Health Sciences in Uganda

The data, presented by Jane Achan, showed that treatment with protease inhibitors lopinavir and ritonavir (two anti-retrovirals) resulted in a 41% drop in malaria cases. Breaking the data down even further revealed a 29% reduction in first malaria cases, or cases in which the children had no previous malaria infection. When they isolated reinfections they found a 59% reduction. These drugs are mildly protective against an initial infection, but are very good at blocking a secondary infection. Why is that?

The common anti-malaria drug, Lumefantrine, can stay in the body for several weeks, extending the length of time the drug protects. Ritonavir is a protease inhibitor that has little effect on HIV, but instead prevents the body from breaking down other HIV drugs and improving the effectiveness of the treatment. It appears that it provides the same effect for anti-malaria drugs as it does for anti-retroviral drugs. When they looked in the blood of children in the treatment groups they found fivefold more lumefantrine in the group that also received the protease inhibitors.

"We think that these higher lumefantrine exposures were really what was driving the protection against recurrent episodes of malaria," Achan said.

It appears that once again, the HIV world has turned science dogma on its head.

"We always think of drug-drug interactions as something to be avoided, but HIV has taught us the opposite," says Paul Volberding, an HIV/AIDS clinician at UCSF.

These findings could alter how treatment occurs in areas with high incidence of both HIV and malaria. Additionally, the study could change how long term prophylactic malaria treatment is done.

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