Effects of malaria intermittent preventive treatment with dihydroartemisinin-piperaquine on antiretroviral drug concentrations in African pregnant women living with HIV
Intermittent preventive treatment during pregnancy (IPTp) for malaria prevention with sulfadoxine-pyrimethamine is contraindicated in pregnant women living with HIV receiving cotrimoxazole prophylaxis. A recent clinical trial showed that dihydroartemisinin-piperaquine (DHA-PPQ) for IPTp is a safe and effective option for malaria prevention in this population. The present study evaluated the impact of monthly IPTp with DHA-PPQ on antiretroviral (ARV) drug concentrations in 105 participants recruited in the aforementioned trial in Mozambique and Gabon between January and November 2021. ARV serum concentrations from maternal venous and cord blood collected at the first antenatal care visit and at the end of pregnancy were measured by ultra-high-performance liquid chromatography-tandem mass spectrometry. At the end of pregnancy, median concentrations of dolutegravir were 835.1 ng/mL (248.1-1,687.6) in maternal and 1,204.2 ng/mL (456.4-1,883.3) in cord blood. For lamivudine (3TC), median concentrations were 108.3 ng/mL (28.8-246.1) in maternal and 186.5 ng/mL (81.9-427.6) in cord blood. No significant differences in ARV concentrations were found between the antimalarial treatment arm and the placebo arm. Furthermore, in multivariate exploratory analysis, no independent associations were found between ARV concentrations and participant characteristics. Our study found similar ARV concentrations in both treatment groups, suggesting that DHA-PPQ for monthly IPTp does not affect ARV concentrations in maternal and cord blood in women living with HIV.CLINICAL TRIALSThis study is registered with ClinicalTrials.gov as NCT03671109.
Authors
- Michael Ramharter (ORCID: https://orcid.org/0000-0002-9259-1885)
- Tacilta Nhampossa (ORCID: https://orcid.org/0000-0002-4616-8752)
- Rella Zoleko‐Manego (ORCID: https://orcid.org/0000-0001-7425-2794)
- Merçè Brunet (ORCID: https://orcid.org/0000-0002-7154-916X)
- M Ramírez Piqueras
- Anete Mendes
- Esperança Sevene (ORCID: https://orcid.org/0000-0001-9025-4052)
- Ghyslain Mombo‐Ngoma (ORCID: https://orcid.org/0000-0003-2658-8706)
- Clara Menéndez (ORCID: https://orcid.org/0000-0002-2641-6907)
- Lia Betty Dimessa Mbadinga
- Raquel González (ORCID: https://orcid.org/0000-0001-5487-801X)
- Francisco Saúte (ORCID: https://orcid.org/0000-0002-9107-8094)
- Wilfrid Ndzebe Ndoumba (ORCID: https://orcid.org/0000-0002-8213-4912)
- Meral Esen (ORCID: https://orcid.org/0000-0001-8638-4719)
- Antía Figueroa-Romero (ORCID: https://orcid.org/0000-0003-4682-1421)
- Sara Gamberini
- Susana Méndez (ORCID: https://orcid.org/0000-0002-7497-4014)
- Myriam El Gaaloul (ORCID: https://orcid.org/0009-0000-5671-5302)
- Dolors Soy (ORCID: https://orcid.org/0000-0001-8128-345X)
- André-Marie Tchouatieu (ORCID: https://orcid.org/0000-0003-0527-1515)
- Johannes Mischlinger (ORCID: https://orcid.org/0000-0002-2012-6327)
- Heimo Lagler (ORCID: https://orcid.org/0000-0003-3240-7385)
- Sebastian G. Wicha (ORCID: https://orcid.org/0000-0002-8773-4845)
- Sergi Sanz (ORCID: https://orcid.org/0000-0001-5010-4527)
- Bertrand Lell (ORCID: https://orcid.org/0000-0003-1427-3002)
- Núria Botella (ORCID: https://orcid.org/0000-0003-1941-4310)
- Linda Stöger (ORCID: https://orcid.org/0000-0003-3629-2378)
- on behalf of the MAMAH Study Group
Institutions
- Universität Hamburg (DE)
- Instituto de Salud Carlos III (ES)
- Departament de Salut (ES)
- Centre de Recherche Médicales de Lambaréné (GA)
- University Medical Center Hamburg-Eppendorf (DE)
- Hospital Clínic de Barcelona (ES)
- German Center for Infection Research (DE)
- Manhiça Health Research Centre (MZ)
- Instituto Nacional de Saúde (MZ)
- Barcelona Institute for Global Health (ES)
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (ES)
- Medicines for Malaria Venture (CH)
- Universitat de Barcelona (ES)
- Medical University of Vienna (AT)
- University of Tübingen (DE)
- Bernhard Nocht Institute for Tropical Medicine (DE)
Publication Details
- Journal
- Antimicrobial Agents and Chemotherapy
- Published
- 2026-06-12
- DOI
- https://doi.org/10.1128/aac.00337-26
- Primary Topic
- Malaria Research and Control
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- Medicines for Malaria Venture
- European and Developing Countries Clinical Trials Partnership