Effect of Nevirapine-based Antiretroviral Therapy on the Treatment Outcome of Uncomplicated Malaria with Artemether-Lumefantrine among HIV-infected children

Main Article Content

Lawal M. Saheed
Oreagba A. Ibrahim
Akinyede A. Akinwumi
Oshikoya A. Kazeem
Busari A. Abdulwasiu
Akinleye O. Moshood
Adewole B. Afeez
Ogungbire D. Opeyemi
Bamiro S. Babajide
Temiye O. Edamisan
Akanmu A. Sulaiman

Abstract

Background: The geographical overlap of malaria and HIV in sub-Saharan Africa posed a major public health challenge, which is further worsened by the potential interactions between antimalarial and antiretroviral drugs when co-administered. This study aimed to compare the responses to artemether/lumefantrine (AL) treatment among HIV-infected children on nevirapine based highly active antiretroviral therapy (HAART) and HIV-non-infected children that were positive for Plasmodium falciparummalaria parasites.


Methods: This is a multi-centered, prospective, non-randomized, open-labelled study with two arms consisting of HIV- infected children on nevirapine-based HAART (NVP-arm; n=32) and HIV-non infected children (control-arm; n=40). Both groups of patients were treated with ALafter microscopic confirmation of P. falciparum and were actively monitored for 28 days for efficacy and safety. Primary outcome was Adequate Clinical and Parasitological Response (ACPR) after treatment with ALby day


Results: Day 28 ACPR was lower in the NVP-arm (90%) compared to the control-arm (100%) of the study. In the NVP- arm of the study, 5% of cases had early treatment failure and 5% had late parasitological failure. The cumulative risk of developing recurrent malaria in NVP-arm was not statistically significantly higher than in the control-arm (P= 0.07). The reported potential adverse reactions to ALwere mild and included cough, pyrexia, anorexia, and abdominal pain. The cumulative risk of developing cough, pyrexia, anorexia and abdominal pain between NVP-arm compared to the control-arm was not statistically significant (Hazard ratio [HR], 0.51, 0.79 and 0.37 [95% confifidence interval {CI}, 0.04–5.26, 0.07-9.32, and 0.04- 3.56]; P= 1.000, 1.000, and 0.637) respectively.


Conclusion: Treatment of uncomplicated malaria with AL was safe and effffective after 28 days of follow-up in HIV- infected children on NVP. Nevirapine based HAARTmay, however, lead to delayed parasite clearance in children treated with AL.

Article Details

How to Cite
M. Saheed, L. ., A. Ibrahim, O. ., A. Akinwumi, . A. ., A. Kazeem, O. ., A. Abdulwasiu, B. ., O. Moshood, A. ., B. Afeez, . A. ., D. Opeyemi, O. ., S. Babajide, B. ., O. Edamisan, . T. ., & A. Sulaiman, A. . (2022). Effect of Nevirapine-based Antiretroviral Therapy on the Treatment Outcome of Uncomplicated Malaria with Artemether-Lumefantrine among HIV-infected children. The Nigerian Journal of Pharmacy, 56(1), 30–38 | https://doi.org/10.51412/psnnjp.2022.3. Retrieved from https://www.psnnjp.org/index.php/home/article/view/105
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Articles
Author Biographies

Lawal M. Saheed, Dept. of Pharmacology

Therapeutics and Toxicology, Faculty of Basic Medical Science, College of Medicine,

University of Lagos

Oreagba A. Ibrahim, Dept. of Pharmacology,

Therapeutics and Toxicology, Faculty of Basic Medical Science, College of Medicine,

University of Lagos

Akinyede A. Akinwumi, Dept. of Pharmacology,

Therapeutics and Toxicology, Faculty of Basic Medical Science, College of Medicine, University of Lagos

Oshikoya A. Kazeem, Dept. of Pharmacology,

Therapeutics and Toxicology, Lagos State University College of Medicine, Ikeja.

Busari A. Abdulwasiu, Dept. of Pharmacology,

Therapeutics and Toxicology, Faculty of Basic Medical Science, College of Medicine,

University of Lagos

Akinleye O. Moshood, Dept. of Pharmaceutical Chemistry,

Faculty of Pharmacy, University of Lagos

Adewole B. Afeez, Dept. of Pharmacology,

Therapeutics and Toxicology, Faculty of Basic Medical Science, College of Medicine,

University of Lagos

Ogungbire D. Opeyemi, Dept. of Pharmacology,

Therapeutics and Toxicology, Faculty of Basic Medical Science, College of Medicine, University of Lagos

Bamiro S. Babajide, Teaching and Research Laboratory,

 Department of Obstetrics and Gynecology, Faculty of Clinical Science,

College of Medicine, University of Lagos

Temiye O. Edamisan, Department of Pediatrics,

Faculty of Clinical Sciences, College of Medicine, University of Lagos

Akanmu A. Sulaiman, Department of Hematology and Blood Transfusion,

Faculty of Clinical Sciences, College of Medicine, University of Lagos

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