# Optimizing ACT use for African children in the setting of HIV and malnutrition

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2021 · $47,014

## Abstract

Abstract
Dihydroartemisinin-piperaquine (DP), an artemisinin-based combination therapy, is one of the most important
drugs for the treatment of uncomplicated malaria, yet fundamental questions remain for assuring its optimal
use in our most vulnerable populations, especially for children, and in the context of interacting antiretroviral
therapies. Dolutegravir (DTG), now a first-line HIV treatment option per the updated HIV treatment guidelines,
has never been studied in children in the setting of concomitant DP and its impact on DP pharmacokinetics is
unknown, while lopinavir/ritonavir (LPV/r, another HIV treatment), is known to increase maximum piperaquine
concentrations but the magnitude and associated risk of cardiotoxicity in children is still unclear. We plan to
expand our current grant to allow us to study potential interactions between DTG and DP and to also more
carefully, and safely, evaluate the potentially detrimental interaction between LPV/r and DP. This administrative
supplement is requesting support to allow the study of DTG as one of three antiretrovirals that will be under
evaluation. Specifically we are requesting support for the expansion of control children to include a broader
age range which is necessary to age-match children who are managed on DTG. Additionally, this supplement
is requesting support to permit a two phase study design that will allow us to complete a safe evaluation of the
likely interaction between LPV/r / and DP (i.e. LPV/r is expected to increase piperaquine concentrations which
has been associated with QTc prolongation). These two requests are to provide infrastructure support in
Uganda. In summary, the results of our study has the potential to significantly impact treatment guidelines for
HIV and malaria in children through this definitive study of pharmacokinetics and pharmacodynamics of DP in
the setting of these antiretroviral therapies. Our overaching goal is to inform optimized DP dosing strategies for
children.

## Key facts

- **NIH application ID:** 10440222
- **Project number:** 3R01HD068174-10S1
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** FRANCESCA T. AWEEKA
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $47,014
- **Award type:** 3
- **Project period:** 2021-07-01 → 2021-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10440222

## Citation

> US National Institutes of Health, RePORTER application 10440222, Optimizing ACT use for African children in the setting of HIV and malnutrition (3R01HD068174-10S1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10440222. Licensed CC0.

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