Malawi Medical Journal

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Frequent malaria illness episodes in two Malawian patients on antiretroviral therapy soon after stopping cotrimoxazole preventive therapy

Wongani J.S. Nyangulu, Edson Mwinjiwa, Titus H. Divala, Randy G. Mungwira, Osward Nyirenda, Maxwell Kanjala, Gillian Mbambo, Jane Mallewa, Terrie E. Taylor, Matthew B. Laurens, Miriam K. Laufer, Joep J. van Oosterhout


We describe two Malawian adults on successful antiretroviral therapy who experienced frequent malaria episodes after stopping cotrimoxazole prophylaxis. We argue that, in addition to stopping cotrimoxazole, diminished malaria immunity and drug interactions between efavirenz and artemether–lumefantrine may have played a causative role in the recurrent malaria our patients experienced.
AJOL African Journals Online