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An anti-erythrocyte autoimmunization with anti-I specificity was shown in patients previously exposed to malaria (falciparum malaria in 98.7% of cases). An anti-I antibody was eluted from red cells in 14.6% of 41 patients with an acute P. falciparum infection. The frequency of the anti-I immunisation was found to be correlated to the rate of the antimalarial antibodies among the 152 patients without parasitaemia, coming from areas endemic for falciparum malaria: this frequency was 5.2% for a rate below 1/64, 9.7% for a rate between 1/64 and 1/256, and 34% for a rate above 1/1,024. Anti-I antibodies were more often noted in African patients coming from forest areas, considered as chronically infected with P. falciparum, and in other patients who have been in France for less than a month. No anti-I antibodies were found in the control group, composed of 52 Caucasian healthy subjects with no previous exposure to malaria. This anti-I immunisation was transitory and its disappearance was usually accompanied by a lowering of anti-malarial antibodies.

By using target cells that expressed only the regulatory NEF protein of the human immunodeficiency virus (HIV), we were able to identify specific cytolytic T cells (CTL) from most of the seropositive patients tested. This NEF-specific cytolytic activity was mediated by CD8+ lymphocytes. In two different donors, we identified a unique peptide in the NEF protein that could be recognized in association with two different HLA class I molecules. The definition of such a peptide should prove useful in evaluating vaccine strategies.

Halofantrine is a 9-phenanthrenemethanol which is effective against multi-drug resistant strains of Plasmodium falciparum. It has been shown to be highly effective and extremely well tolerated in the treatment of imported cases of falciparum malaria in France. A total of 1,500 mg administered in three 500 mg doses at six-hour intervals results in a 100% cure rate in semi-immune subjects. This dosage should be repeated after 14 days to obtain the same cure rate in non-immune patients. Minor clinical side effects included epigastric pains, nausea and, in one case, a skin rash.

Thirty-five patients with the acquired immunodeficiency syndrome (AIDS) and central nervous system toxoplasmosis, seen over a 30-month period, were treated with the combination pyrimethamine/sulfadiazine. All patients had clinical and computed tomographic scan findings consistent with active neurotoxoplasmosis. Mean duration of total therapy was six months. During the first two months of therapy, four patients died of acute neurotoxoplasmosis and 31 showed improvement. Of the 24 patients evaluable for long-term therapy, 14 (58 percent) achieved complete resolution and 10 had late clinical (n = 7) and/or computed tomographic scan (n = 6) sequelae. Six patients experienced 10 relapses, which occurred within six weeks of treatment discontinuation in seven of 10. Reintroduction of the combination led to complete resolution of the relapse in eight cases. These clinical results were correlated with brain anatomic findings in the 15 autopsied cases. Side effects, noted in 25 of 35, were mainly hematologic toxicity (n = 21) and cutaneous rash (n = 12). However, the combination had to be definitively stopped in only two cases and sulfadiazine alone had to be withdrawn in eight other cases. These data suggest that pyrimethamine/sulfadiazine is highly efficacious in neurotoxoplasmosis and that life-long therapy is needed to prevent relapses in patients with AIDS.

Albendazole, given as a 28 day course of 800 mg/day at 15 days intervals can be effective in the treatment of liver and lung hydatic cysts in adults of average weight. On average, six courses are required to obtain a satisfactory result (negative serological results, decrease in volume of scanner images). The treatment must be monitored and should only be prescribed in case of surgical contraindication or refusal by the patient to undergo surgery.