Pharmaceutical interactions between antiretroviral and antimalarial drugs used in chemoprophylaxis

• Published in: Acta tropica Vol. 179; pp. 25 - 35
• Main Authors: Zautner, Andreas Erich, Herchenröder, Ottmar, Moussi, Awatef El, Schwarz, Norbert Georg, Wiemer, Dorothea Franziska, Groß, Uwe, Frickmann, Hagen
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.03.2018
• Subjects: Drug interactions; HIV; Malaria; Prophylaxis; Resistance; Therapy; Tropics; Resistance; Therapy; HIV; Malaria; Drug interactions; Prophylaxis; Tropics
• ISSN: 0001-706X; 1873-6254
• DOI: 10.1016/j.actatropica.2017.12.021

Human immunodeficiency virus (HIV) is the causative agent of the Acquired Immunodeficiency Syndrome (AIDS). The pandemic is believed to have originated within the Northern Congo basin covering large parts of the Democratic Republic of Congo, the Republic of Congo, the Central African Republic, Cameroon and Gabon. Although over decades, HIV-1 has spread throughout the World leaving no country unaffected, sub-Saharan Africa remains the region with more than 80% of all infected individuals. The HIV-2 epidemic has largely remained restricted to West Africa along the Upper Guinean forests. Co-incident with these regions of highest HIV distribution is a part of the malaria belt and therefore, co-infections are common. In this review we carve out the consequences of HIV transmission prevention and synchronous malaria prophylaxis during occupational or leisure travelling activities within this World region. In particular, we elaborate on considering pre-existing drug resistances of both, the malaria parasites and the immunodeficiency viruses, when determining a combination for prophylactic and, if necessary, post-expositional measures with a focus on the compatibility of both medications. •Antiretroviral therapy without or with insufficient laboratory control has led to considerable HIV resistance.•Ongoing migration facilitates the spread of HIV-subtypes and resistant strains.•Resistance patterns of locally prevalent HIV-strains have to be considered for PEP or PrEP.•The chosen antiretroviral medication for PEP or PrEP has to be compatible with antimalarial drugs.•Local resistance patterns can make the identification of optimum choices challenging.