Efficacy of artemisinin-based combination therapy (ACT) in people living with HIV (PLHIV) diagnosed with uncomplicated Plasmodium falciparum malaria in Africa: a WWARN systematic review

Takyi, Abena; Soma, Aboubakar; Przybylska, Marianna; Harriss, Eli; Barnes, Karen I.; Dahal, Prabin; Guérin, Philippe J.; Stepniewska, Kasia; Carrara, Verena I.

doi:10.1186/s12936-025-05393-8

Table 1 Summary of the 26 articles included in the review and their associated study (Study ID)

From: Efficacy of artemisinin-based combination therapy (ACT) in people living with HIV (PLHIV) diagnosed with uncomplicated Plasmodium falciparum malaria in Africa: a WWARN systematic review

Study ID	First author, date and PMID of all included articles	Study years	Country	Transmission intensity	Study design	Patients enrolled	Age (years)	Pregnancy included	HIV-uninfected Included	Malaria drug	HIV drug	Total malaria episodes in PLHIV	Total malaria episodes overall	Clinical study	PCR	PK parameters
1	Huang-2017; 29,065,172 [40]	2012–2014	Malawi Uganda	Not provided	Observational, non-randomized study	39	3.6–12	N/A	Yes (historical controls)	AL	NVP	15	35	No	N/A	Artemether DHA LUM
2	1. Maganda-2014; 24,885,714 [25] 2. Maganda-2015, 25,906,774 [38] 3. Maganda-2016; 25,963,334 [58]	2010–2012	Tanzania	Moderate	Open-label, parallel three-arm study	269	19–67	No	No	AL	EFV NVP None	269	269	Yes	No	LUM
3	Gasarira-2008; 18,444,813 [45]	2005–2006	Uganda	Moderate	Longitudinal, 2 prospective cohorts	293	1–10	N/A	Yes	ASAQ	TS + ART	35	293	Yes	Yes	No
4	Sambol-2015; 25,732,044 [39]	2008	Uganda	High	Part of longitudinal, open-label RCT	107	0.5–2	N/A	Yes	DP	TS + ART	12^c	218	No	N/A	PPQ
5	1. Arinaitwe-2009; 19,877,969 [59] 2. Verret-2011; 21,383,095 [29]	2007–2009	Uganda	High	Longitudinal, open-label RCT	292	0.33–3	N/A	Yes	AL DP	TS TS + ART	172	2013	Yes	Yes^a	No
6	1. Kakuru-2013; 23,382,157 [36] 2. Wanzira-2014; 24,825,870 [30]	2007–2011	Uganda	High	Longitudinal, open-label RCT	312	0.33–5	N/A	Yes	AL DP	TS + ART	44^d	5564	Yes	No	No
7	Muhindo-2014; 24,468,007 [35]	2011–2012	Uganda	High	Longitudinal, open-label RCT	202	4–5	N/A	Yes	AL DP	TS + ART	38	770	Yes	No	No
8	Kakuru-2014; 24,759,826 [31]	2009–2013 2007–2012	Uganda	High	Longitudinal, 2 open-label RCTs	166	0.12–6	N/A	No	AL DP	EFV NVP LPV/r None	938	938	Yes	No	No
9	Achan-2012; 23,190,222 [33]	2009–2011	Uganda	High	Longitudinal, open-label RCT	170	0.5–7	N/A	No	AL	EFV NVP LPV/r	281	281	Yes	No	LUM
10	Musoke-2012; ISSN: 1816–3319 [37]	2010–2011	Uganda	High	Open-label, parallel three-arm study	36	Adults	No	No	AL	TS TS + EFV	36	36	No	N/A	LUM
11	1. Kajubi-2016; 28,018,925 [34] 2. Parikh-2016; 27,143,666 [26]	2011–2014	Uganda	High	Longitudinal, prospective PK/PD study	252	1.1–8.6	N/A	Yes	AL	EFV NVP LPV/r	118	134	Yes	Yes	Artemether DHA LUM
12	1. Van Geertruyden-2006; 16,960,779 [24] 2. Van Geertruyden-2009; 19,922,664 [60]	2003–2005	Zambia	Moderate	RCT	970	Adults	No	Yes	AL SP	None	320	970	Yes	Yes	No
13	Usman-2021; 33,755,736 [61]	Not provided	Nigeria	Not provided	PK parallel study	20	Adults ≥ 18	No	Yes	AL	ATV/r	10	20	No	N/A	LUM
14	1. Adegbola-2018; 30,082,286 [62] 2. Adegbola-2020; 32,209,837 [63]	2016–2017	Nigeria	Unstable	PK parallel study	69	18–45	Yes	No	AL	EFV	52	52	No	N/A	LUM Desbutyl-Lum
15	Hugues-2020; 31,929,402 [28]	2012–2014	Uganda	High	PK parallel study	39	≥ 16	Yes, all	Yes	AL	EFV	39	39	Yes	No	Artemether DHA LUM
16	Usman-2020; 32,921,396 [54]	Not provided	Nigeria	Not provided	PK parallel study	40	≥ 18	No	Yes	AL	EFV NVP LPV/r	30	40	No	N/A	LUM
17	Banda-2019; 31,126,288 [64]	2014–2015	Zambia	Moderate-High	Single-arm interventional study	152	15–65	No	No	AL	EFV	152	152	Yes	Yes	No
18	Sevene-2019; 31,429,785 [32]	2013–2015	Malawi Mozambique	Moderate-High	Single-arm interventional study	221	15–65	No	No	DP	EFV NVP	221	221	Yes	Yes	No
19	Chijioke-Nwauche-2013; 23,774,430 [27]^b	2010–2011	Nigeria	Holoendemic	PK parallel study	167	16–65	Not provided	Yes	AL	EFV NVP	68	167	Yes	No	LUM

Study 8 combines a set of patients from Study 4 and an extension of Study 8 is reported in Study 9. Studies will be referred to in the text (i.e. ID 1) and the relevant article afferent to the study will be referenced
ACT artemisinin combination therapy, AL artemether-lumefantrine, ART antiretroviral therapy, ASAQ artesunate-amodiaquine, ATV/r atazanavir-ritonavir, Desbutyl-Lum desbutyl-lumefantrine, DHA dihydroartemisinin, DP dihydroartemisinin-piperaquine, EFV efavirenz, LUM lumefantrine, LPV/r lopinavir/ritonavir, N/A information not available, NVP nevirapine, PLHIV people living with HIV, PK pharmacokinetics parameters; PCR: polymerase chain reaction (adjusted treatment failure), PPQ piperaquine, SP sulfadoxine-pyrimethamine, TS trimethoprim-sulfamethoxazole prophylactic treatment
^aPCR done, but no PCR corrected results presented
^bAll malaria slides positive by microscopy, but 78.1% were aparasitaemic by nested-PCR
^c12 children were HIV-infected and had at least one malaria episode; total number of episodes not reported
^d44 children were HIV-infected and had at least one malaria episode; total number of episodes not reported

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Table 1 Summary of the 26 articles included in the review and their associated study (Study ID)

Malaria Journal

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