{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T15:46:14Z","timestamp":1787240774687,"version":"build-2736575974"},"reference-count":57,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T00:00:00Z","timestamp":1737676800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accp1.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Clinical Pharma"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Malaria and HIV co\u2010infection are prevalent in sub\u2010Saharan Africa causing significant drug interactions with co\u2010treatment. We previously reported a 30%\u201070% reduction in exposure to the standard 3\u2010day (6\u2010dose) artemether\u2010lumefantrine (AL) treatment for malaria when given with efavirenz\u2010based HIV therapy, impacting malaria reinfection risk. We conducted a prospective, randomized study comparing the 3\u2010day regimen to an extended 5\u2010day (10\u2010dose) regimen with pharmacokinetic sampling for artemether, dihydroartemisinin, lumefantrine, and desbutyl\u2010lumefantrine (DBL) over 42 days. The primary outcome was comparative pharmacokinetics between regimens compared among children with HIV and among children without HIV receiving a 3\u2010day regimen as controls (median age 5.3 years [range 1.4\u201013.9]; median weight 17.3 kg [range 8.7\u201039.1]). Children with HIV (n = 57; median age 10.8 years [range 3.4\u201017.1]; median weight 26.6 kg [range 14.6\u201054.5]) contributed 76 malaria episodes, with 71 included in the analysis. Another 97 children without HIV (median age 5.3 years [range 1.4\u201013.9]; median weight 17.3 kg [range 8.7\u201039.1]) contributed 114 episodes of malaria, with 109 included in the analysis. In the setting of efavirenz, artemether, dihydroartemisinin, lumefantrine, and DBL cumulative exposure was 2.09, 2.31, 1.90, and 1.65 fold higher with 5\u2010day versus 3\u2010day AL (all\n                    <jats:italic>P<\/jats:italic>\n                    &lt;\u00a0.001), and comparable to 3\u2010day AL in children without HIV. The extended regimen in children with HIV did not result in a statistically significant reduction in recurrence risk at 28 or 42 days. Extending the duration of AL to 5 days compensated for a clinically significant reduction in all components of AL in the context of EFV\u2010based antiretroviral therapy in young children.\n                  <\/jats:p>","DOI":"10.1002\/jcph.6193","type":"journal-article","created":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T05:27:53Z","timestamp":1737696473000},"page":"909-922","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Extended Treatment Duration of Artemether\u2010Lumefantrine in Ugandan Children with HIV on Efavirenz\u2010Based Antiretroviral Therapy: A Randomized Controlled Pharmacokinetic and Pharmacodynamic Trial"],"prefix":"10.1002","volume":"65","author":[{"given":"Meghan E.","family":"Whalen","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacy School of Pharmacy University of California\u2010San Francisco San Francisco General Hospital  San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Kajubi","sequence":"additional","affiliation":[{"name":"Infectious Disease Research Collaboration  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9767-1171","authenticated-orcid":false,"given":"Justin","family":"Goodwin","sequence":"additional","affiliation":[{"name":"Yale School of Public Health  New Haven CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francis","family":"Orukan","sequence":"additional","affiliation":[{"name":"Infectious Disease Research Collaboration  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"McKenzie","family":"Colt","sequence":"additional","affiliation":[{"name":"Yale School of Public Health  New Haven CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liusheng","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy School of Pharmacy University of California\u2010San Francisco San Francisco General Hospital  San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kacey","family":"Richards","sequence":"additional","affiliation":[{"name":"Yale School of Public Health  New Haven CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas J.","family":"Hoffmann","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics and Institute for Human Genetics University of California San Francisco  San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca T.","family":"Aweeka","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy School of Pharmacy University of California\u2010San Francisco San Francisco General Hospital  San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunil","family":"Parikh","sequence":"additional","affiliation":[{"name":"Yale School of Public Health  New Haven CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norah","family":"Mwebaza","sequence":"additional","affiliation":[{"name":"Infectious Disease Research Collaboration  Kampala Uganda"},{"name":"Makerere University College of Health Sciences  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,1,24]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"World Health Organization.WHO guidelines for malaria. 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