Effect of artemether-lumefantrine (Coartem) on cytomegalovirus urine viral load during and following treatment for malaria in children

Breanna Barger-Kamate, Michael Forman, Cheik Oumar Sangare, Aboubecrin Sedhigh A Haidara, Hamma Maiga, Dhananjay Vaidya, Abdoulaye Djimde, Ravit Boger

Research output: Contribution to journalArticle

Abstract

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 log10), 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 log10) vs comparisons (1200 copies/mL, 3.08 log10), 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.

Original languageEnglish (US)
Pages (from-to)40-45
Number of pages6
JournalJournal of Clinical Virology
Volume77
DOIs
StatePublished - Apr 1 2016

Fingerprint

Viral Load
Cytomegalovirus
Malaria
Urine
Artemisinins
Therapeutics
Mali
Cytomegalovirus Infections
artemether-lumefantrine combination
lumefantrine
artemether
Observational Studies
Real-Time Polymerase Chain Reaction
Fever
Animal Models
Prospective Studies
Viruses
DNA

Keywords

  • Artemether-lumefantrine
  • Cytomegalovirus
  • Malaria
  • Urine viral load

ASJC Scopus subject areas

  • Virology
  • Infectious Diseases

Cite this

Effect of artemether-lumefantrine (Coartem) on cytomegalovirus urine viral load during and following treatment for malaria in children. / Barger-Kamate, Breanna; Forman, Michael; Sangare, Cheik Oumar; Haidara, Aboubecrin Sedhigh A; Maiga, Hamma; Vaidya, Dhananjay; Djimde, Abdoulaye; Boger, Ravit.

In: Journal of Clinical Virology, Vol. 77, 01.04.2016, p. 40-45.

Research output: Contribution to journalArticle

Barger-Kamate, Breanna ; Forman, Michael ; Sangare, Cheik Oumar ; Haidara, Aboubecrin Sedhigh A ; Maiga, Hamma ; Vaidya, Dhananjay ; Djimde, Abdoulaye ; Boger, Ravit. / Effect of artemether-lumefantrine (Coartem) on cytomegalovirus urine viral load during and following treatment for malaria in children. In: Journal of Clinical Virology. 2016 ; Vol. 77. pp. 40-45.
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abstract = "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{\circledR}) 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 log10), 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 log10) vs comparisons (1200 copies/mL, 3.08 log10), 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.",
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AU - Barger-Kamate, Breanna

AU - Forman, Michael

AU - Sangare, Cheik Oumar

AU - Haidara, Aboubecrin Sedhigh A

AU - Maiga, Hamma

AU - Vaidya, Dhananjay

AU - Djimde, Abdoulaye

AU - Boger, Ravit

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AB - 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 log10), 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 log10) vs comparisons (1200 copies/mL, 3.08 log10), 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.

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