期刊
JOURNAL OF CLINICAL VIROLOGY
卷 77, 期 -, 页码 40-45出版社
ELSEVIER SCIENCE BV
DOI: 10.1016/j.jcv.2016.02.006
关键词
Cytomegalovirus; Malaria; Artemether-lumefantrine; Urine viral load
类别
资金
- Thrasher Foundation Career Development Grant
- Johns Hopkins Center for Child and Community Health Research BEAD Core
- National Institutes of Health [T32 AI052071, 1R01AI093701]
- Fogarty International Clinical Research Scholars and Fellows Program at Vanderbilt University [R24 TW007988]
- American Recovery and Reinvestment Act
Background: Artemisinins, commonly used to treat malaria, have shown activity against cytomegalovirus (CMV) in vitro, in an animal model, and in case reports; however, the in vivo anti-CMV activity has not been well investigated. Objectives: To evaluate whether artemisinins affect CMV shedding among subjects co-infected with CMV and malaria. Study design: A prospective observational study of children in Mali (6 month-10 year) presenting with fever. Urine samples were collected at day 0, 3, and 14 from children treated with artemether-lumefantrine (Coartem) for malaria and those who had other illnesses not treated with Coartem. CMV DNA was quantified using a real-time PCR. Resulting urine viral loads were compared between the groups at three time points. Results: 164 malaria cases and 143 non-malaria comparisons were enrolled. Eighty-one (49%) cases and 88 (62%) comparisons shed CMV at day 0. Day 0 and day 3 viral loads were similar, but at day 14 the median viral load of cases was lower than that of comparisons (360 vs 720 copies/mL or 2.56 vs 2.86 log(10)), p=0.059. A stratified analysis of day 0 high viral shedders (defined as >1000 copies/mL) showed significantly lower median viral load at day 14 among cases (490 copies/mL, 2.69 log(10)) vs comparisons (1200 copies/mL, 3.08 log(10)), p = 0.045. Conclusion: A high rate of urinary CMV shedding was found in a malaria-endemic area. Among high virus shedders artemether-lumefantrine decreased urine viral load, but the effect was not observed when analysis of both high and low shedders was performed. These results support additional studies of artemisinin dosing and duration in CMV infection. (C) 2016 Elsevier B.V. All rights reserved.
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