Last Updated: 17/02/2016
HIV-malaria co-infections: a significant source of antimalarial drug resistance?
Objectives
Using an evolutionary framework, this project aims to unravel the link between HIV infection and frequency of malaria drug resistance and the selective forces that drive this resistance to higher levels in HIV co-infected individuals.
First, a meta-analysis of published studies will be done to determine whether a correlation between prevalence of resistance and prevalence of HIV infection can be seen. In addition, using clinical samples of HIV-positive and HIV-negative pregnant women from five different countries in Sub-Saharan Africa who are currently enrolled in a clinical trial with the aim to test the efficacy of Intermittent Preventative Therapy, the project will (i) assess the frequency of resistance markers by direct sequencing, (ii) study the multiplicity of malaria infection using genetic barcoding and (iii) determine the densities of the transmission stages using stage-specific qPCR. These metrics will be evaluated at the start of the intervention, at time of delivery and, from a subset of women in an ancillary study, during the course of pregnancy.
The rise and spread of drug-resistant malaria parasites is one of the major challenges for malaria control and may soon prove to be one of the biggest obstacles to malaria eradication. Due to the extensive geographical overlap of HIV and malaria, the two most serious health problems in the world, co-infections are common in nature. These co-infections may increase the emergence and spread of malaria drug resistance, as a result of intervention strategies and weaker immune systems. However, evidence for this is lacking and discussion is speculative of nature.
This project has the potential to have a big impact on public health policy, increase our understanding of malaria parasite dynamics in as-of-yet much understudied pregnant women, and contribute critically to malaria eradication.
Jul 2014 — Jun 2016
$236,816
