%0 Journal Article
%9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES
%A Denoeud Ndam, Lise
%A Clément, M. C.
%A Briand, Valérie
%A Akakpo, J.
%A Agossou, V. K.
%A Atadokpédé, F.
%A Dossou-Gbété, L.
%A Komongui, D. G.
%A Afangnihoun, A.
%A Girard, P. M.
%A Zannou, D. M.
%A Cot, Michel
%T Tolerability of mefloquine intermittent preventive treatment for malaria in HIV-infected pregnant women in Benin
%D 2012
%L fdi:010057157
%G ENG
%J Jaids-Journal of Acquired Immune Deficiency Syndromes
%@ 1525-4135
%K HIV ; malaria ; pregnancy ; mefloquine ; drug tolerance ; Benin
%M ISI:000308352000015
%N 1
%P 64-72
%R 10.1097/QAI.0b013e3182615a58
%U https://www.documentation.ird.fr/hor/fdi:010057157
%> https://www.documentation.ird.fr/intranet/publi/2012/09/010057157.pdf
%V 61
%W Horizon (IRD)
%X Objective: To investigate the tolerability of mefloquine intermittent preventive treatment (MQ IPTp) for malaria in HIV-infected pregnant women compared with HIV-negative women. Design: Prospective cohort study comparing samples of HIV-negative and HIV- infected pregnant women from 2 clinical trials conducted in Benin. Methods: One hundred and three HIV-infected women from the ongoing PACOME trial were compared with 421 HIV-negative women from a former trial, both trials aiming to evaluate the efficacy and tolerability of MQ IPTp, administered at the dose of 15 mg/kg. Descriptive analysis compared the proportion of women reporting at least 1 adverse reaction, according to HIV status. Multilevel logistic regression identified factors associated with the probability of reporting an adverse reaction for each MQ intake. Results: Dizziness and vomiting were the most frequent adverse reactions. Adverse reactions were less frequent in HIV-infected women (65% versus 78%, P = 0.009). In multilevel analysis, HIV infection [odds ratio (OR) = 0.23, 95% confidence interval (CI) = 0.08 to 0.61] decreased the risk for adverse reactions, whereas detectable viral load (OR = 2.46, 95% CI = 1.07 to 5.66), first intake (versus further intakes, OR = 5.26, 95% CI = 3.70 to 7.14), older age (OR = 1.62, 95% CI = 1.13 to 2.32), and higher education level (OR = 1.71, 95% CI = 1.12 to 2.61) increased the risk. Moderate and severe adverse reactions were more frequent when antiretrovirals were started concomitantly with a MQ intake. Conclusions: This study provides reassuring data on the use of MQ IPTp in HIV-infected pregnant women. However frequent, adverse reactions remained moderate and did not impair adherence to MQ IPTp. In this high-risk group, MQ might be an acceptable alternative in case sulfadoxine-pyrimethamine loses its efficacy for intermittent preventive treatment.
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