CV8, a new combination of dihydroartemisinin, piperaquine, trimethoprim and primaquine, compared with atovaquone–proguanil against falciparum malaria in Vietnam


Phan T. Giao, Peter J. de Vries (corresponding author), Le Q. Hung and Piet A. Kager, Division of Infectious Diseases, Tropical Medicine & AIDS, Academic Medical Center F4-217, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. E-mail:
Tran Q. Binh, Tropical Diseases Clinical Research Center, Cho Ray Hospital, 201 B Nguyen Chi Thanh, District 5, Ho Chi Minh City, Vietnam. E-mail:
Nguyen V. Nam, Binh Thuan Provincial Malaria Station, Phan Thiet, Binh Thuan Province, Vietnam. E-mail:


Objectives  To study a new combination, based on dihydroartemisinin and piperaquine (CV8) and atovaquone/proguanil (Malarone) for treatment of uncomplicated falciparum malaria in Vietnam.

Methods  Vietnamese adults with falciparum malaria were allocated randomly to treatment with dihydroartemisinin/piperaquine/trimethoprim/primaquine 256/2560/720/40 mg (CV8, n = 84) or Malarone 3000/1200 mg (n = 81), both over 3 days. Patients were followed-up for 28 days.

Results  All patients recovered rapidly. The mean (95% CI) parasite elimination half-life of CV8 was 6.8 h (6.2–7.4) and of Malarone 6.5 h (6.1–6.9) (P = 0.4). Complete parasite clearance time was 35 (31–39) and 34 h (31–38) (P = 0.9). The 28-day cure rate was 94% and 95%, respectively (odds ratio 0.84, 95% CI 0.18–3.81). No significant side-effects were found.

Conclusion  CV8 and Malarone are effective combinations against multi-drug resistant falciparum malaria. CV8 has the advantage of a low price.