MAMAH, a clinical trial that seeks to improve the prevention of malaria among HIV-infected pregnant women, is launched

This month saw the official launching of MAMAH, an international project led by ISGlobal- an institution supported by the “la Caixa” Foundation- whose goal is to evaluate the safety and efficacy of the antimalarial drug dihydroartemisinin-piperaquine (DHA-PPQ) in preventing malaria among pregnant women infected with HIV. The results of the project, funded by the European & Developing Countries Clinical Trials Partnership(EDCTP), will contribute to reducing the burden of two major poverty-related diseases, HIV and malaria, in pregnant women.

For reasons that are not yet fully understood, pregnant women are particularly vulnerable to infection by Plasmodium. Because of this, the WHO recommends intermittent preventive treatment (IPTp) with sulphadoxin-pyrimethamine (SP) for pregnant women in malaria endemic regions. However, SP has adverse effects in HIV-seropositive women taking cotrimoxazole (CTXp), a prophylactic antibiotic that is given in combination with antiretroviral drugs (ARVs). Therefore, there is an urgent need to find alternative drugs to prevent malaria in this particularly vulnerable group (an estimated 12 million HIV-infected women live in malaria-endemic regions).

Given that DHA-PPQ has already proved to be effective in preventing malaria among seronegative pregnant women, this project will evaluate its security and efficacy in HIV-seropositive women taking daily CTXp and ARVs. The clinical trial will be performed in Gabon and Mozambique, two countries with a moderate to high prevalence of malaria and HIV.

“The MAMAH project represents a unique opportunity to improve malaria control in one of the most disease-susceptible populations, and paradoxically the less well protected: pregnant women infected with HIV” explains Raquel González, technical coordinator of the project. “In addition, MAMAH covers a R&D need regarding antimalarial and antiretroviral drug interactions, and the results will help guide future health care strategies in Sub-Saharan Africa”, she adds.

The other project partners are the Centre de Recherches Médicales de Lambaréné (CERMEL Gabon), the Health Research Centre of Manhiça (CISM Mozambique), the Medical University of Vienna (MedUni Wien, Austria), the Bernhard Nocht Institut für Tropenmedizin (BNITM, Germany), and the Eberhard Karls Universitaet Tuebingen (EKUT, Germany).