If artemisinin-combination therapy is combined with antiretroviral therapy what can potentially happen?

October 2024/PHARMABIOME

What is the issue?

Malaria-HIV coinfection

HIV patients are susceptible to malaria infection and as they get the infection, they take artemisinin combination therapy together with their antiretroviral drugs at the same time or different times.  

Observations

There is variable plasma artemether-lumefantrine drug profiles for persons infected with malaria only in comparison wirh persons living with HIV infected with malaria. This also affects the plasma concentrations of the antiretroviral drugs administered.  Lumefantrine stays in the body after administration for about 48-72 hours post dose in the blood stream and therefore can still interact with DTG-TDF-3TC.

From the lab

By Dr T

The PHARMABIOME project has been interested in seeing what happens to when a person living with HIV is also gets infected with plasmodium parasiyes leading to malaria. How will it affect treatment for HIV and malaria? There could be potential drug-drug interactions that can cause the therapeutic levels of the drugs to vary in an individual. In addition, the genetic make up of the person can affect the enzymes that break down ACT and ART. Observations of eleveated lumefantrine levels were commonly seen in malaria-HIV coinfections in our cohort in addition to DTG metabolites. This will affect parasite and viral clearance in that person which could cause drug resistance in time.