[afro-nets] ARVs, Antibiotic, ITNs Could Reduce Malaria

General afro-nets
1

Combined Use Of Antiretrovirals, Antibiotic, ITNs Could Reduce
Malaria Incidence Among HIV-Positive People By 95%, Study Says
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20 Apr 2006 - Reprinted with permission from
http://www.kaisernetwork.org

The combined use of antiretroviral drugs, the antibiotic cotri-
moxazole and insecticide-treated nets could reduce the incidence
of malaria among HIV-positive people by up to 95%, according to
a study published in the April 15 issue of the journal Lancet,
Reuters reports. HIV-positive people are more susceptible to op-
portunistic diseases such as malaria, which also can be more se-
vere in people living with HIV. Jonathan Mermin of the Uganda
Virus Research Institute in Entebbe, Uganda, and colleagues
looked at how individual and combined treatments for malaria af-
fected about 1,000 HIV-positive people in Uganda. The research-
ers found that cotrimoxazole -- an antibiotic widely used among
HIV-positive people worldwide -- reduced malaria incidence among
the study participants by 76%. Cotrimoxazole taken with antiret-
roviral drugs reduced incidence by 92%, and the combination of
the two drugs cut incidence by up to 95% when patients also used
ITNs, the study finds. The researchers said the antiretrovirals
do not have any effect on the malaria parasite but strengthened
the participants' immune systems. "Although these interventions
work separately, the prime message is that together they are as-
sociated with [up to] a 95% reduction in malaria," Mermin said,
adding, "Malaria then becomes a rare event among this population
whereas before the interventions it was quite common" (Reaney,
Reuters, 4/14).

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2

ARVs, Antibiotic, ITNs Could Reduce Malaria (2)
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FYI, a comment on this malaria (the relationship between AIDS
and malaria in Africa) by a colleague, Dr. Donald Roberts, who
is an epidemiologist at the Uniformed Services University of the
Health Sciences (USA):

"Only a subpopulation of people with HIV infections have ma-
laria. Across most African populations only small subpopulations
of people have HIV infections. In many areas of Africa large
subpopulations of people have malaria infections and these in-
fections occur independent of the HIV infections. Basically re-
sults described in the paper are applicable to only a small sub-
population of those at risk of malaria infections. Malaria kills
mostly children and most children do not have AIDS. So, while
the paper reads as a new and exciting solution, it actually has
restricted application. Still, it is an interesting paper."

Philip Coticelli
mailto:pcoticelli@gmail.com