1. CD4 T cell activation as a predictor for treatment failure in Ugandans with Plasmodium falciparum malaria.
- Author
-
Eggena MP, Hopkins H, Barugahare B, Okello M, Ssali F, Mugyenyi P, Rosenthal PJ, Cao H, and Dorsey G
- Subjects
- Adolescent, Adult, Age Factors, Animals, Body Temperature, CD8-Positive T-Lymphocytes physiology, Child, Child, Preschool, Chloroquine therapeutic use, Drug Combinations, Female, Humans, Male, Parasitemia, Plasmodium falciparum immunology, Pyrimethamine therapeutic use, Risk Factors, Sulfadoxine therapeutic use, Treatment Failure, Uganda, Antimalarials therapeutic use, CD4-Positive T-Lymphocytes immunology, Lymphocyte Activation, Malaria, Falciparum drug therapy, Malaria, Falciparum immunology
- Abstract
Host immunity plays an important role in response to antimalarial therapy but is poorly understood. To test whether T cell activation is a risk factor for antimalarial treatment failure, we studied CD4(+) and CD8(+) T cell activation in 31 human immunodeficiency virus-negative Ugandan patients 5-37 years of age who were treated for uncomplicated Plasmodium falciparum malaria. Increased CD4(+) T cell activation, as indicated by co-expression of HLA-DR and CD38, was an independent risk factor for treatment failure (hazard ratio = 2.45, 95% confidence interval = 1.02-5.89, P = 0.05) in multivariate analysis controlling for age, baseline temperature, and pre-treatment parasite density. The results provide insight into the role of cellular immunity in response to antimalarial therapy and underscore the need to investigate the mechanisms behind immune activation.
- Published
- 2006