Dual Infection with HIV and Malaria Fuels the Spread of Both Diseases in Sub-Saharan Africa

Abstract

Mounting evidence has revealed pathological interactions between HIV and malaria in dually infected patients, but the public health implications of the interplay have remained unclear. A transient almost one-log elevation in HIV viral load occurs during febrile malaria episodes; in addition, susceptibility to malaria is enhanced in HIV-infected patients. A mathematical model applied to a setting in Kenya with an adult population of roughly 200,000 estimated that, since 1980, the disease interaction may have been responsible for 8,500 excess HIV infections and 980,000 excess malaria episodes. Co-infection might also have facilitated the geographic expansion of malaria in areas where HIV prevalence is high. Hence, transient and repeated increases in HIV viral load resulting from recurrent co-infection with malaria may be an important factor in promoting the spread of HIV in sub-Saharan Africa.

Health Cycles and Health Transitions

“…That captures more appropriately the complementarities across infectious diseases that simultaneously affect a population. For example, one study estimates that the interaction between malaria and HIV may have been responsible for 8,500 excess HIV infections and 980,000 excess malaria episodes in Kenya (Abu-Raddad et al, 2006). Such co-infection may have also made it easier for malaria to spread to areas with high HIV prevalence.…”

HIV Diagnostics: Challenges and Opportunities

“…[3,62,63]. It is estimated that there are over 500 million cases of malarial infection annually, mostly in Africa, and dual infection of HIV and malaria facilitates the geographical expansion of each [64]. HCV and HBV infections are also highly prevalent among the HIV population [65,66].…”

A Study of the Outcomes of 103 Pregnant Women Admitted with Malaria at Three District Hospitals in Mashonaland East Province and One Central Hospital in Harare Province in Zimbabwe

“…The situation is compounded by high prevalence of HIV in the same region. Immune deficiency due to HIV infection makes humans more susceptible to malaria infection, also malaria fever has been noted to increase viral load by up to ten times [3]. Malaria is a major contributing factor to maternal morbidity and mortality because human immunity against the disease is reduced in pregnancy.…”

“…Malaria infection during pregnancy results in severe illness with maternal complications such as severe anemia, thrombocytopenia, cerebral malaria, hemorrhage, renal failure and pulmonary edema. The disease is more severe and more fatal in pregnancy with 13% mortality against 6.5% in non-pregnant women [3].…”