{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T17:12:32Z","timestamp":1784913152916,"version":"3.55.0"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2022,3,15]],"date-time":"2022-03-15T00:00:00Z","timestamp":1647302400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001713","name":"EDCTP","doi-asserted-by":"crossref","award":["TMA2017CDF-1897"],"award-info":[{"award-number":["TMA2017CDF-1897"]}],"id":[{"id":"10.13039\/501100001713","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100005627","name":"Thrasher Research Fund","doi-asserted-by":"crossref","award":["15567"],"award-info":[{"award-number":["15567"]}],"id":[{"id":"10.13039\/100005627","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,5,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>In sub-Saharan Africa, the burdens of malaria and HIV infections overlap. In settings with moderate-to-high malaria transmission intensity, pregnant women living with HIV (PLWH) require both ART and malaria intermittent preventive treatment (IPTp). Dihydroartemisinin\/piperaquine has been identified as a promising alternative to sulfadoxine\/pyrimethamine for IPTp. However, another antimalarial drug, artesunate\/amodiaquine, similar to dihydroartemisinin\/piperaquine, was previously shown to reduce dolutegravir exposure in non-pregnant adults.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To investigate the effect of dihydroartemisinin\/piperaquine on dolutegravir plasma exposure in pregnant women on dolutegravir-based ART.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted an open-label, non-randomized, fixed-sequence, pharmacokinetic study in PLWH in Malawi. Dolutegravir concentrations were measured over a 24\u2005h period, before and after the recommended 3\u2005day treatment dose of dihydroartemisinin\/piperaquine in 12 pregnant women in their second or third trimester. Non-compartmental analysis was performed, and geometric mean ratios (GMRs) and 90% CIs were generated to compare dolutegravir pharmacokinetic parameters between the two treatment periods.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Co-administration of dihydroartemisinin\/piperaquine and dolutegravir increased dolutegravir\u2019s overall exposure (AUC0\u201324) and Cmax by 30% (GMR 1.30; 90% CI 1.11\u20131.52) and 31% (GMR 1.31; 90% CI 1.13\u20131.51), respectively. The dolutegravir trough (C24) concentration increased by 42% (GMR 1.42; 90% CI 1.09\u20131.85). The combined treatments were well tolerated with no serious adverse events observed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Dihydroartemisinin\/piperaquine may be administered with dolutegravir-based ART in pregnant women as the modest increase in dolutegravir exposure, similar to pharmacokinetic parameter values published previously, ensures its efficacy without any clinically significant adverse events observed in this small study.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jac\/dkac081","type":"journal-article","created":{"date-parts":[[2022,3,7]],"date-time":"2022-03-07T12:07:23Z","timestamp":1646654843000},"page":"1733-1737","source":"Crossref","is-referenced-by-count":11,"title":["Effect of dihydroartemisinin\/piperaquine for malaria intermittent preventive treatment on dolutegravir exposure in pregnant women living with HIV"],"prefix":"10.1093","volume":"77","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0757-5259","authenticated-orcid":false,"given":"Clifford G.","family":"Banda","sequence":"first","affiliation":[{"name":"Malawi-Liverpool-Wellcome Trust Clinical Research Programme , Blantyre, Malawi"},{"name":"Division of Clinical Pharmacology, Department of Medicine, University of Cape Town , Cape Town, South Africa"},{"name":"Kamuzu University of Health Sciences , Blantyre, Malawi (formerly College of Medicine and Kamuzu College of Nursing, University of Malawi)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dumisile","family":"Nkosi","sequence":"additional","affiliation":[{"name":"Malawi-Liverpool-Wellcome Trust Clinical Research Programme , Blantyre, Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Allen","sequence":"additional","affiliation":[{"name":"Division of Clinical Pharmacology, Department of Medicine, University of Cape Town , Cape Town, South Africa"},{"name":"WorldWide Antimalarial Resistance Network (WWARN), Pharmacology Scientific Group, University of Cape Town , Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lesley","family":"Workman","sequence":"additional","affiliation":[{"name":"Division of Clinical Pharmacology, Department of Medicine, University of Cape Town , Cape Town, South Africa"},{"name":"WorldWide Antimalarial Resistance Network (WWARN), Pharmacology Scientific Group, University of Cape Town , Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mwayiwawo","family":"Madanitsa","sequence":"additional","affiliation":[{"name":"Training and Research Unit of Excellence , Blantyre, Malawi"},{"name":"Department of Clinical Sciences, Malawi University of Science and Technology , Limbe, Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marumbo","family":"Chirwa","sequence":"additional","affiliation":[{"name":"Malawi-Liverpool-Wellcome Trust Clinical Research Programme , Blantyre, Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mayamiko","family":"Kapulula","sequence":"additional","affiliation":[{"name":"Training and Research Unit of Excellence , Blantyre, Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon","family":"Muyaya","sequence":"additional","affiliation":[{"name":"Training and Research Unit of Excellence , Blantyre, Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Munharo","sequence":"additional","affiliation":[{"name":"Training and Research Unit of Excellence , Blantyre, Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9070-8699","authenticated-orcid":false,"given":"Lubbe","family":"Wiesner","sequence":"additional","affiliation":[{"name":"Division of Clinical Pharmacology, Department of Medicine, University of Cape Town , Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamija S.","family":"Phiri","sequence":"additional","affiliation":[{"name":"Kamuzu University of Health Sciences , Blantyre, Malawi (formerly College of Medicine and Kamuzu College of Nursing, University of Malawi)"},{"name":"Training and Research Unit of Excellence , Blantyre, Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Mwapasa","sequence":"additional","affiliation":[{"name":"Kamuzu University of Health Sciences , Blantyre, Malawi (formerly College of Medicine and Kamuzu College of Nursing, University of 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