CD4 T cell activation as a predictor for treatment failure in Ugandans with Plasmodium falciparum malaria.

Mark P Eggena ; Heidi Hopkins ORCID logo ; Banson Barugahare ; Martin Okello ; Francis Ssali ; Peter Mugyenyi ; Philip J Rosenthal ; Huyen Cao ; Grant Dorsey ; (2006) CD4 T cell activation as a predictor for treatment failure in Ugandans with Plasmodium falciparum malaria. The American journal of tropical medicine and hygiene, 74 (1). pp. 41-43. ISSN 0002-9637 DOI: 10.4269/ajtmh.2006.74.41
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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.


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