HIV and placental infection modulate the appearance of drug-resistant Plasmodium falciparum in pregnant women who receive intermittent preventive treatment

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
Clara MenendezAlfredo Mayor

Abstract

Factors involved in the development of resistance to sulphadoxine-pyrimethamine (SP) by Plasmodium falciparum, particularly in the context of intermittent preventive treatment during pregnancy (IPTp), are not well known. We aimed to determine the impact of IPTp and human immunodeficiency virus (HIV) infection on molecular markers of SP resistance and the clinical relevance of resistant infections. SP resistance alleles were determined in peripheral (n = 125) and placental (n = 145) P. falciparum isolates obtained from pregnant women enrolled in a randomized, placebo-controlled trial of IPTp in Manhiça, Mozambique. Prevalence of quintuple mutant infections was 12% (23 of 185 isolates) in pregnant women who received placebo and 24% (20 of 85 isolates) in those who received SP (P = .031). When the last IPTp dose was administered at late pregnancy, mutant infections at delivery were more prevalent in placental samples (7 [23%] of 30, samples) than in peripheral blood samples (2 [7%] of 30 samples; P = .025), more prevalent in women who received IPTp-SP than in those who received placebo (odds ratio [OR], 8.13; 95% confidence interval [CI], 1.69-39.08), and more prevalent in HIV-positive women than in HIV-negative women (OR, 5.17; 9...Continue Reading

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Citations

Aug 21, 2013·Trends in Parasitology·Meera VenkatesanChristopher V Plowe
Mar 24, 2012·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Steve M TaylorStephen J Rogerson
Mar 4, 2014·Malaria Journal·Raquel GonzálezClara Menéndez
Aug 21, 2015·The Journal of Infectious Diseases·Julie GutmanFeiko O Ter Kuile
Jun 2, 2015·Trends in Microbiology·Ruthie B BirgerC Jessica E Metcalf
Jul 11, 2012·Expert Opinion on Pharmacotherapy·Azucena BardajíClara Menéndez
Jul 3, 2013·FEMS Microbiology Reviews·Manu VanaerschotJean-Claude Dujardin
Nov 29, 2011·Infection, Genetics and Evolution : Journal of Molecular Epidemiology and Evolutionary Genetics in Infectious Diseases·Steve M TaylorSteven R Meshnick
Mar 22, 2018·The Cochrane Database of Systematic Reviews·Raquel GonzálezClara Menéndez
Oct 11, 2014·The Cochrane Database of Systematic Reviews·Denitsa Radeva-PetrovaPaul Garner
Nov 28, 2018·The Cochrane Database of Systematic Reviews·Raquel GonzálezClara Menéndez
Feb 22, 2012·Expert Review of Anti-infective Therapy·Raquel GonzálezAlfredo Mayor
Nov 5, 2019·The Journal of Infectious Diseases·Silvie HuijbenAlfredo Mayor

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