HIV treatments reduce malaria liver stage burden in a non-human primate model of malaria infection at clinically relevant concentrations in vivo

PLoS One. 2014 Jul 2;9(7):e100138. doi: 10.1371/journal.pone.0100138. eCollection 2014.

Abstract

We have previously shown that the HIV protease inhibitor lopinavir-ritonavir (LPV-RTV) and the antibiotic trimethoprim sulfamethoxazole (TMP-SMX) inhibit Plasmodium liver stages in rodent malarias and in vitro in P. falciparum. Since clinically relevant levels are better achieved in the non-human-primate model, and since Plasmodium knowlesi is an accepted animal model for the study of liver stages of malaria as a surrogate for P. falciparum infection, we investigated the antimalarial activity of these drugs on Plasmodium knowlesi liver stages in rhesus macaques. We demonstrate that TMP-SMX and TMP-SMX+LPV-RTV (in combination), but not LPV-RTV alone, inhibit liver stage parasite development. Because drugs that inhibit the clinically silent liver stages target parasites when they are present in lower numbers, these results may have implications for eradication efforts.

Publication types

  • Research Support, N.I.H., Intramural

MeSH terms

  • Animals
  • Antimalarials / pharmacology*
  • Disease Models, Animal
  • Drug Combinations
  • HIV Protease Inhibitors / pharmacology*
  • Liver / metabolism
  • Liver / parasitology
  • Liver / pathology
  • Lopinavir / pharmacology*
  • Macaca mulatta
  • Malaria, Falciparum / drug therapy*
  • Malaria, Falciparum / metabolism
  • Malaria, Falciparum / pathology
  • Plasmodium falciparum*
  • Ritonavir / pharmacology*
  • Sulfadoxine / pharmacology*
  • Trimethoprim / pharmacology*

Substances

  • Antimalarials
  • Drug Combinations
  • HIV Protease Inhibitors
  • lopinavir-ritonavir drug combination
  • Lopinavir
  • trimethoprim, sulfadoxine drug combination
  • Sulfadoxine
  • Trimethoprim
  • Ritonavir