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HIV-1 protease inhibitors (PIs) have antimalarial activity in vitro and in murine models. The potential beneficial effect of HIV-1 PIs on malaria has not been studied in clinical settings.
Exposure to malaria parasites will be assessed using light and exit traps followed by detection of Anopheles gambiae species and sporozoite infection. Study children will be surveyed at the end of each transmission season to estimate the prevalence of Plasmodium falciparum infection and the prevalence of anaemia.
The data from this study support the view that a multivalent vaccine involving different antigens is most likely to be more effective than a monovalent one.
Rapid cell-mediated immune responses, characterized by production of proinflammatory cytokines, such as IFN-{gamma}, can inhibit intraerythrocytic replication of malaria parasites and thereby prevent onset of clinical malaria.
Malaria is widely reported to suppress immune responses to heterologous antigens, including vaccines, but the evidence base for this assumption is patchy and confusing.
IPTi with long-acting regimens provide protection against clinical malaria for up to 8 weeks even in the presence of high ITN coverage, and that the prophylactic rather than the treatment effect of IPTi appears central to its protective efficacy.