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Predicting Optimal Dihydroartemisinin-Piperaquine Regimens to Prevent Malaria During Pregnancy for Human Immunodeficiency Virus-Infected Women Receiving Efavirenz
dc.creator | Wallender, Erika | |
dc.creator | Vučićević, Katarina | |
dc.creator | Jagannathan, Prasanna | |
dc.creator | Huang, Liusheng | |
dc.creator | Natureeba, Paul | |
dc.creator | Kakuru, Abel | |
dc.creator | Muhindo, Mary | |
dc.creator | Nakalembe, Mirium | |
dc.creator | Havlir, Diane | |
dc.creator | Kamya, Moses | |
dc.creator | Aweeka, Francesca | |
dc.creator | Dorsey, Grant | |
dc.creator | Rosenthal, Philip J. | |
dc.creator | Savić, Radojka M. | |
dc.date.accessioned | 2019-09-02T12:06:51Z | |
dc.date.available | 2019-09-02T12:06:51Z | |
dc.date.issued | 2018 | |
dc.identifier.issn | 0022-1899 | |
dc.identifier.uri | https://farfar.pharmacy.bg.ac.rs/handle/123456789/3177 | |
dc.description.abstract | Background. A monthly treatment course of dihydroartemisinin-piperaquine (DHA-PQ) effectively prevents malaria during pregnancy. However, a drug-drug interaction pharmacokinetic (PK) study found that pregnant human immunodeficiency virus (HIV)-infected women receiving efavirenz-based antiretroviral therapy (ART) had markedly reduced piperaquine (PQ) exposure. This suggests the need for alternative DHA-PQ chemoprevention regimens in this population. Methods. Eighty-three HIV-infected pregnant women who received monthly DHA-PQ and efavirenz contributed longitudinal PK and corrected QT interval (QTc) (n = 25) data. Population PK and PK-QTc models for PQ were developed to consider the benefits (protective PQ coverage) and risks (QTc prolongation) of alternative DHA-PQ chemoprevention regimens. Protective PQ coverage was defined as maintaining a concentration > 10 ng/mL for > 95% of the chemoprevention period. Results. PQ clearance was 4540 L/day. With monthly DHA-PQ (2880 mg PQ), lt 1% of women achieved defined protective PQ coverage. Weekly (960 mg PQ) or low-dose daily (320 or 160 mg PQ) regimens achieved protective PQ coverage for 34% and > 96% of women, respectively. All regimens were safe, with lt = 2% of women predicted to have >= 30 msec QTc increase. Conclusions. For HIV-infected pregnant women receiving efavirenz, low daily DHA-PQ dosing was predicted to improve protection against parasitemia and reduce risk of toxicity compared to monthly dosing. | en |
dc.publisher | Oxford Univ Press Inc, Cary | |
dc.relation | National Natural Science Foundation of China - 31372466 | |
dc.rights | openAccess | |
dc.source | Journal of Infectious Diseases | |
dc.subject | intermittent preventive treatment during pregnancy | en |
dc.subject | dihydroartemisinin-piperaquine | en |
dc.subject | HIV infection | en |
dc.subject | drug-drug interaction | en |
dc.title | Predicting Optimal Dihydroartemisinin-Piperaquine Regimens to Prevent Malaria During Pregnancy for Human Immunodeficiency Virus-Infected Women Receiving Efavirenz | en |
dc.type | article | |
dc.rights.license | ARR | |
dcterms.abstract | Awеека, Францесца; Камyа, Мосес; Хавлир, Диане; Накалембе, Мириум; Wаллендер, Ерика; Мухиндо, Марy; Какуру, Aбел; Јаганнатхан, Прасанна; Вучићевић, Катарина; Савић, Радојка М.; Дорсеy, Грант; Росентхал, Пхилип Ј.; Натурееба, Паул; Хуанг, Лиусхенг; | |
dc.citation.volume | 217 | |
dc.citation.issue | 6 | |
dc.citation.spage | 964 | |
dc.citation.epage | 972 | |
dc.citation.other | 217(6): 964-972 | |
dc.citation.rank | M21 | |
dc.identifier.wos | 000427131300015 | |
dc.identifier.doi | 10.1093/infdis/jix660 | |
dc.identifier.pmid | 29272443 | |
dc.identifier.scopus | 2-s2.0-85042947997 | |
dc.identifier.fulltext | https://farfar.pharmacy.bg.ac.rs//bitstream/id/1759/3175.pdf | |
dc.type.version | publishedVersion |