Assessment of the impact of malaria on CD4+ T Cells and haemoglobin levels of HIV-malaria co-infected patients

Abstract

Introduction: The human immunodeficiency virus (HIV) and malaria destroy important cells required for proper immunological and haematological functioning of the body. This research therefore aimed to assess the effect of malaria on CD4+ and haemoglobin (Hb) levels of HIV-malaria co-infected patients. Methodology: The study was performed by sampling 220 adult HIV patients on highly active anti retroviral therapy (HAART) who routinely visited the Tema General Hospital in Ghana. Blood samples were obtained for both blood film microscopy identification of malaria parasites and analysis using rapid diagnostic test kits. A BD Facscount Analyzer was used in the quantification of CD4+ levels. Results: Of the 220 patients sampled, 34 (15.5%) were HIV-malaria co-infected, all of whom (34; 100%) had CD4+ counts below the normal range, while 23 (12.9%) of the HIV mono-infected patients had normal CD4+ counts. Almost all HIV-malaria co-infected patients (33; 97.1%) had low Hb levels, whereas 79 (42.5%) of the HIV mono-infected patients had normal Hb. Malaria infection strongly correlated positively and significantly with both low CD4+ count (χ2 = 0.828, P = 0.003) and Hb (χ2 = 0.817, P = 0.004) levels. Conclusion: Malaria co-infection with HIV decreases CD4+ T cells and Hb levels in patients. It is therefore recommended that HIV patients in malaria endemic areas should adhere to malaria preventive measures.

Effect of HIV and malaria parasites co-infection on immune-hematological profiles among patients attending anti-retroviral treatment (ART) clinic in Infectious Disease Hospital Kano, Nigeria

“…The prevalence of anemia in our study was moderate and similar to lower hemoglobin concentration recorded in a Ghana study as a result of HIV and malaria parasites co-infection [4]. This varied with a findings from Cameroon that reported higher prevalence of anaemia (97.1%) in HIV and malaria co-infection compared to HIV mono- infection (42.5%; p = 0.004) [18]. We also had findings similar to a Zimbabwe study which concluded that HIV-1 infection increases the incidence of Plasmodium falciparum parasitaemia and is associated with the development of severe malaria and mostly anemia [43].…”

“…Our reported prevalence was also higher than that reported in other Africa countries. For example, 15.5% [18] and 11.75% [4] in different Ghanaian studies and 10% in South Africa [20]. The prevalence of HIV and malaria co-infection observed between male and female participants in our study showed no significant difference as similarly observed by Tay and colleagues [4] and Sahle et al ., (2017) [38].…”

“…Hence high incidence of fever identified among immunosuppressed adults may lead to misclassification of illness episodes as malaria [17]. HIV and malaria both destroy important cells required for proper immunological and hematological functioning of the body [18]. Enhanced T-cell activation in HIV and malaria co-infected patients could worsen the immune response to both diseases [19].…”

Prevalence of malaria and HIV coinfection and influence of HIV infection on malaria disease severity in population residing in malaria endemic area along the Thai–Myanmar border

“…In one study conducted in 220 adult HIV patients on highly active antiretroviral therapy (HAART), only 1 (2.9%) malaria coinfected case had normal hemoglobin, whereas 79 (42.5%) of the HIV mono-infected cases had normal hemoglobin. None of the mono-infected cases had severe anemia compared with 6 (18.2%) of the HIV and malaria coinfected cases (Tagoe and Boachie, 2012). These results and others suggest future study of the association between anemia and malaria and HIV coinfection.…”

Haematological indices of malaria patients coinfected with HIV in Umuahia

“…Those changes include: anemia, thrombocytopenia and leucopenia have been documented as strong, independent predictors of morbidity and mortality in malaria co -infected HIV positive individuals than mono infected HIV positive individuals [8]. HIV and malaria both destroy important cells required for proper immunological and hematological functioning of the body [9,10].…”