New: Antiretroviral PK/PD Study Group

Together, malaria and HIV are responsible for more than two million deaths across the world each year. The large geographical overlap where both diseases are prevalent has meant that co-infections are commonplace. Even small interactions between the two could have substantial effects on populations.

In regions where both diseases are prevalent, HIV increases the risk of malaria infection, especially in those with suppressed immune systems. Although previous studies suggest that co-infected patients are at higher risk of malaria treatment failure due to weakened immune systems, questions remain about the effect of antiretroviral-antimalarial drug-drug interactions and whether adjusting dose regimens could benefit patients.

WWARN’s latest study group is using a pooled analysis to investigate the effects of both antiretrovirals and HIV disease on a patient’s drug exposure to lumefantrine and treatment efficacy of artemether-lumefantrine, the most widely recommended malaria treatment.

“This is an exciting project for us as it has the potential to inform policy makers of the optimal malaria treatment and dose for the many HIV-infected patients with malaria,” says Professor Karen Barnes, Head of the WWARN Pharmacology Group.

Using the power of pooled data, the team is setting out to better define the pharmacokinetic-pharmacodynamic (PK/PD) impact of the interactions between these drugs. The questions this study group aims to resolve include:

• What are the effects of taking artemether-lumefantrine when using antiretrovirals?
• Should the dose of artemether-lumefantrine be adjusted when co-administered with an antiretroviral?
• What are the effects of the HIV disease on lumefantrine drug concentrations?

“It has always been a challenge to understand the effects antimalarial treatments can have on individuals with HIV,” says Dr Jane Achan, Lecturer and Paediatrician at Makerere University. “Pooled analysis is the most powerful way to best understand the risks and nuances associated with the interactions between the drugs needed to treat both diseases. This is a challenge, but understanding the best way to dose artemether-lumefantrine in HIV patients could really limit the morbidity and mortality associated with co-infection.”

The study group is currently inviting researchers to participate in this study group. If you have data relevant to the planned study that you would like to contribute, or if you would like some further information about the project, please contact Prof Karen Barnes and Lesley Workman by email at pharmacology@wwarn.org.

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