Effect of HIV-1 antiretroviral drugs on cytoadherence and phagocytic clearance of Plasmodium falciparum-parasitised erythrocytes.

In response to the HIV/AIDS pandemic, antiretroviral treatment is currently being implemented in sub-Saharan Africa, where malaria and HIV-1 co-infections are highly prevalent. The effectiveness and tolerability of antiretrovirals in patients with malaria and HIV-1 co-infection have not been investigated. Antiretrovirals decrease CD36 surface concentrations in vivo, which might impair receptor function and affect parasite-host interactions. Thus, we investigated the effects of these drugs on CD36-mediated cytoadherence and non-opsonic phagocytosis of Plasmodium falciparum parasitised erythrocytes in vitro. The protease-inhibitor class of antiretrovirals particularly impairs CD36-mediated cytoadherence and non-opsonic phagocytosis of parasitised erythrocytes by human macrophages. Such treatment might therefore contribute to altered malaria disease outcomes in co-infected patients.