The impact of HIV-associated immunosuppression on the Plasmodium falciparum chloroquine resistance transporter gene (PfCRT) of HIV patients in Akure, Nigeria

Abstract

Background The study evaluated the prevalence of malaria and Plasmodium falciparum chloroquine resistance transporter gene (PfCRT) in HIV patients attending Specialist Hospital, Akure. This study was carried out between April and June 2019. Three hundred and seventeen (317) patients attending the antiretroviral clinic (ART) were involved, out of which 89 (28.08%) were males and 228 (71.92%) were females. HIV test was done using the Unigold® HIV test kit, malaria test was done using thick and thin blood smear, CD4 test was done using the Partec® CD4 counter and PCR was used to detect the presence of plasmodium falciparum mutant gene. The data obtained from this analysis was subjected to Pearson’s Chi-square test. Results The overall result showed low prevalence of malaria (23.03%) in the sampled patients. Highest malaria prevalence (31.0%) was recorded in HIV patients with CD4 count between 200–500 cells/μl of blood, with the males recording 24.7% malaria prevalence. The age group 20–29 years recorded the highest prevalence of 27.3%. A higher prevalence 91.1% of PfCRT gene in HIV-positive and (40.0%) in HIV-negative patients was recorded with 100% prevalence in patients with CD4 count ≤ 200. This shows that the low prevalence of malaria recorded in this study could be credited to good health-seeking attitude of HIV patients and the upscale of HIV care and treatment centres. Conclusion The high prevalence of PfCRT gene shows that treatment of malaria with chloroquine is still being practised despite the availability of artemisinin-based combination therapy (ACTs) as the recommended regimen for malaria treatment.

Molecular analysis of Bio-makers of Chloroquine resistance in Plasmodium falciparum Isolate from Gombe Local Government Area, Gombe State, Nigeria

“…In this study, two variants K76T (80.7%) and C72S (8.8%) of the PCRT gene were reported as the molecular markers for chloroquine resistance. This result is lower than the 95.0% positive isolate for PCRT-gene from Akure in previous research [20]. The difference observed might be attributed to the differences in the drug pressure specifically chloroquine exerted by the parasite (P. falciparum) from the two study areas (Gombe and Akure).…”

“…In the absence of an effective vaccine, effective antimalarial drugs are the mainstay to effective malaria prevention, control and eradication [12,[16][17][18][19]. From the 1940s up to the 2000s, chloroquine was the most widely used drug for treating malaria fever [20], this is partly due to its high efficacy, safety and low cost [21]. Chloroquine is a synthetic product that was first produced in the year 1934 and accepted for clinical use in 1947 [22].…”

HIV and Malaria co-infection and the impact of viral load and HAART usage on the development of Plasmodium falciparum Artemisinin and Lumefantrine resistant genes in Nnewi, Anambra State, Nigeria

“…More so, a good number of the study participants were observed to be traders 61.39% with secondary education 47.1% as the highest level of education. This could be as a result of the geographical region of the study group who are predominantly traders [26].…”