HIV and Malaria Co‐infection

Cunnington, Aubrey; Riley, Eleanor M.

doi:10.1002/9781118393321.ch19

Cited by 6 publications

(7 citation statements)

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“…Both pathogens (HIV and malaria) may be contributing factors in the modification of each other’s development, disease severity and disease progression rate [10]. The greatest burden of disease due to both HIV and malaria (predominantly Plasmodium falciparum ) occurs commonly in Sub-Saharan Africa [11]. The potential consequences of both diseases’ interaction, including understanding their reciprocal effects on host immune response and their combined effect on host response to other pathogens is important [11].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2017

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BackgroundHuman immunodeficiency virus (HIV) and malaria co-infection may present worse health outcomes in the tropics. Information on HIV/malaria co-infection effect on immune-hematological profiles is critical for patient care and there is a paucity of such data in Nigeria.ObjectiveTo evaluate immune-hematological profiles among HIV infected patients compared to HIV/malaria co-infected for ART management improvement.MethodsThis was a cross sectional study conducted at Infectious Disease Hospital, Kano. A total of 761 consenting adults attending ART clinic were randomly selected and recruited between June and December 2015. Participants’ characteristics and clinical details including two previous CD4 counts were collected. Venous blood sample (4ml) was collected in EDTA tube for malaria parasite diagnosis by rapid test and confirmed with microscopy. Hematological profiles were analyzed by Sysmex XP-300 and CD4 count by Cyflow cytometry. Data was analyzed with SPSS 22.0 using Chi-Square test for association between HIV/malaria parasites co-infection with age groups, gender, ART, cotrimoxazole and usage of treated bed nets. Mean hematological profiles by HIV/malaria co-infection and HIV only were compared using independent t-test and mean CD4 count tested by mixed design repeated measures ANOVA. Statistical significant difference at probability of <0.05 was considered for all variables.ResultsOf the 761 HIV infected, 64% were females, with a mean age of ± (SD) 37.30 (10.4) years. Prevalence of HIV/malaria co-infection was 27.7% with Plasmodium falciparum specie accounting for 99.1%. No statistical significant difference was observed between HIV/malaria co-infection in association to age (p = 0.498) and gender (p = 0.789). A significantly (p = 0.026) higher prevalence (35.2%) of co-infection was observed among non-ART patients compared to (26%) ART patients. Prevalence of co-infection was significantly lower (20.0%) among cotrimoxazole users compared to those not on cotrimoxazole (37%). The same significantly lower co-infection prevalence (22.5%) was observed among treated bed net users compared to those not using treated bed nets (42.9%) (p = 0.001). Out of 16 hematology profiles evaluated, six showed significant difference between the two groups (i) packed cell volume (p = <0.001), (ii) mean cell volume (p = 0.005), (iii) mean cell hemoglobin concentration (p = 0.011), (iv) absolute lymphocyte count (p = 0.022), (v) neutrophil percentage count (p = 0.020) and (vi) platelets distribution width (p = <0.001). Current mean CD4 count cell/μl (349±12) was significantly higher in HIV infected only compared to co-infected (306±17), (p = 0.035). A significantly lower mean CD4 count (234.6 ± 6.9) was observed among respondents on ART compared to non-ART (372.5 ± 13.2), p<0.001, mean difference = -137.9).ConclusionThe study revealed a high burden of HIV and malaria co-infection among the studied population. Co-infection was significantly lower among patients who use treated bed nets as well as cotrimoxazole chemotherapy and...

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Section: Introductionmentioning

confidence: 99%

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

et al. 2017

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“…In contrast, malarial fever can also exacerbate viral infections; herpesviruses, for example, respond to an increase of temperature with rapid reactivation and active viral gene transcription of latent virus (Grinde, 2013 ). Moreover, despite the temperature sensitivities of various Gram-negative bacteria species, malaria exacerbates their infections in individuals, suggesting that during malarial disease, the deleterious effects on the immune response far outweigh the salutary effects of fever, e.g., malarial infections are associated with increase of Gram-negative bacteremia (Cunnington and Riley, 2012 ).…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, antimalarial treatment may enhance responses to some types of vaccines (Cunnington and Riley, 2010 ). While it is still unclear how parasite-induced changes in the host immune response influence the clinical manifestations of Plasmodium infections, malaria is associated with poor antibody responses to chronic Epstein-Barr viremia and an increase in HIV viral load and bacteremia (Cunnington and Riley, 2012 ).…”

Section: The Very Complex Relationships Between Immunity and Malariamentioning

confidence: 99%

“…Several studies have suggested that people infected with HIV have more frequent and more severe episodes of malaria and vice versa . HIV and Plasmodium both interact with the host's immune system, resulting in a complex activation of immune cells leading to dysfunctional levels of antibody and cytokine production (Flateau et al, 2011 ; Cunnington and Riley, 2012 ; Alemu et al, 2013 ; Berg et al, 2014 ; Van Geertruyden, 2014 ). On the one hand, malaria has been reported to increase HIV replication in vitro and in vivo , and studies using murine models suggest that malarial infection enhances the sexual acquisition of HIV due to, among other factors, the upregulation of HIV co-receptor expression (Chege et al, 2014 ).…”

Section: Clinical Importance Of Malaria Co-infections With Other Disementioning

confidence: 99%

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Malarial pathocoenosis: beneficial and deleterious interactions between malaria and other human diseases

Faure

2014

Front. Physiol.

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In nature, organisms are commonly infected by an assemblage of different parasite species or by genetically distinct parasite strains that interact in complex ways. Linked to co-infections, pathocoenosis, a term proposed by M. Grmek in 1969, refers to a pathological state arising from the interactions of diseases within a population and to the temporal and spatial dynamics of all of the diseases. In the long run, malaria was certainly one of the most important component of past pathocoenoses. Today this disease, which affects hundreds of millions of individuals and results in approximately one million deaths each year, is always highly endemic in over 20% of the world and is thus co-endemic with many other diseases. Therefore, the incidences of co-infections and possible direct and indirect interactions with Plasmodium parasites are very high. Both positive and negative interactions between malaria and other diseases caused by parasites belonging to numerous taxa have been described and in some cases, malaria may modify the process of another disease without being affected itself. Interactions include those observed during voluntary malarial infections intended to cure neuro-syphilis or during the enhanced activations of bacterial gastro-intestinal diseases and HIV infections. Complex relationships with multiple effects should also be considered, such as those observed during helminth infections. Moreover, reports dating back over 2000 years suggested that co- and multiple infections have generally deleterious consequences and analyses of historical texts indicated that malaria might exacerbate both plague and cholera, among other diseases. Possible biases affecting the research of etiological agents caused by the protean manifestations of malaria are discussed. A better understanding of the manner by which pathogens, particularly Plasmodium, modulate immune responses is particularly important for the diagnosis, cure, and control of diseases in human populations.

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“…3 HIV prevalence among adults in Nigeria was about 2.9% with about 3.2 million persons living with HIV in 2016. 4 The greatest burden of disease due to both HIV and malaria (predominantly Plasmodium falciparum ) occurs commonly in sub-Saharan Africa 5 and the rates of co-infection make interaction between both diseases a global health focus. 5,6,7…”

Section: Introductionmentioning

confidence: 99%

Evaluation of standard diagnostic rapid test kits for malaria diagnosis among HIV patients in Kano, Nigeria

Mbah¹,

Jegede

Abdulrahman

et al. 2018

African Journal of Laboratory Medicine

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BackgroundMalaria diagnosis among HIV-positive patients is uncommon in Nigeria despite the high burden of both diseases.ObjectivesWe evaluated the performance of a malaria rapid diagnostic test (MRDT) against blood smear microscopy (BSM) among HIV-positive patients in relation to anti-retroviral treatment (ART) status, CD4+ count, fever, cotrimoxazole prophylaxis and malaria density count.MethodA cross-sectional study involving 1521 consenting randomly selected HIV-positive adults attending two ART clinics in Kano, Nigeria, between June 2015 and May 2016. Venous blood samples were collected for testing with MRDT, BSM, and CD4+ T cells count by cytometry. Biodata and other clinical details were extracted from patient folders into an Excel file, cleaned, validated, and exported for analysis into SPSS version 23.0. Sensitivity, specificity, predictive values of MRDT were compared with BSM with a 95% confidence interval.ResultsMalaria parasites were detected in 25.4% of enrollees by BSM and 16.4% by MRDT. Overall sensitivity of MRDT was 58% and specificity was 97%. Cotrimoxazole prophylaxis and fever status did not affect MRDT sensitivity and specificity. Unexpectedly, the sensitivity was highest at parasite density count of less than 500 cells/µL. At CD4+ T cells count over 500 cells/µL the sensitivity was higher (62.4%) compared to 56% at less than 500 cells/µL. In the non-ART group sensitivity was higher (65%) compared to those on ART (56%) but the specificity was similar. All differences were significant for all variables (p < 0.05).ConclusionAlthough the MRDT specificity was good, the sensitivity was poor, requiring further evaluation for use in malaria diagnosis among HIV-malaria co-infected persons in these settings.

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HIV and Malaria Co‐infection

Cited by 6 publications

References 15 publications

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

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

Malarial pathocoenosis: beneficial and deleterious interactions between malaria and other human diseases

Evaluation of standard diagnostic rapid test kits for malaria diagnosis among HIV patients in Kano, Nigeria

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