The Effect of Malaria on Disease Progression of HIV/AIDS
|Study Design:||Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Participant, Investigator
Primary Purpose: Supportive Care
|Official Title:||The Effect of Malaria on Disease Progression of HIV/AIDS in Kumasi, Ghana|
- Measure the effects of antimalarials on CD4 cell count decline and HIV viral load increase in study patients [ Time Frame: 12 months ]
- Measure the effect of malaria prophylaxis on malaria parasitaemia and haemoglobin levels in study patients [ Time Frame: 12 months ]
|Study Start Date:||October 2007|
|Study Completion Date:||December 2009|
|Primary Completion Date:||October 2008 (Final data collection date for primary outcome measure)|
|Active Comparator: A||
250mg weekly PO for 6 months
|Placebo Comparator: B||
1 tablet weekly PO for 6 months
Malaria and HIV are among the most prevalent infectious diseases in sub-Saharan Africa and are major causes of morbidity and mortality in the sub region. Because of the wide-spread geographical overlap in HIV and malaria, the probability for co-infections and the potential for interactions between the two diseases are high. Even modest interactions may have substantial impact in populations.
It is now clear that there are interactions between the two infections. HIV associated immunosuppression erodes the malaria acquired immunity of the HIV patients. The risk of parasitaemia, high parasite density and malarial fever increases with decreasing CD4 T cell counts and increasing viral load of HIV patients. Plasmodium falciparum has been shown to stimulate HIV replication through the production of cytokines (including interleukin 6 and tumor necrosing factor α (TNF-α)) by activated lymphocytes. Malaria treatment in HIV patients with malaria resulted in significant reduction of the median HIV viral load concentration.
Although it is now clear that malaria causes transient rises in HIV-1 viral loads, could repeated episodes of malaria in areas of intense transmission lead to a cumulative effect on viral load and accelerate decline in CD4 counts thereby accelerating HIV disease progression? If so, could the decline in CD4 count in individuals who have not yet started on anti-retroviral drugs be slowed down by intermittent malaria treatment?
A controlled interventional study with mefloquine as malaria prophylaxis for 6 months will be used in HIV/AIDS patients who are not already on ARTs in KATH, and malaria parasitaemia and density, HIV viral load and CD4 cell count will be monitored in both arms.
Comparison: Malaria parasitaemia and density, HIV viral loads and CD4 cell counts will be compared between the intervention group and the control groups to determine the effect o malaria and malaria prophylaxis on HIV disease progression
Please refer to this study by its ClinicalTrials.gov identifier: NCT00499876
|Komfo Anokye Teaching Hospital|
|Kumasi, Ghana, 1934|
|Principal Investigator:||Ruby Martin-Peprah, MBChB, PhD||Komfo Anokye Teaching Hospital|