Title: Effect of Plasmodium falciparum malaria on concentration of HIV-1-RNA in the blood of adults in rural Malawi: a prospective cohort study.

POPLINE Document Number: 277005

Author(s):

Kublin JG
Patnaik P
Jere CS
Miller WC
Hoffman IF

Source citation:

Lancet, 2005 Jan 15;365:233-240.

Abstract:

Background Raised HIV viral load in blood has been associated with accelerated disease progression and increased transmission of infection. To assess the effect of Plasmodium falciparum malaria on concentration of HIV in blood, we did a prospective cohort study in Malawi. Methods We recruited 367 HIV-1-infected adults. Among 334 people aparasitaemic at baseline, 148 had at least one malaria episode during follow-up and received antimalarial treatment. Of these, 77 had HIV-1-RNA measurements at baseline, during malaria, and post- malaria. We used linear regression with generalised estimating equations to assess effect of four definitions of malaria (any parasitaemia, parasite density =2000/µl, febrile parasitaemia, and febrile parasitaemia with parasite density =2000/µl) on changes in log HIV-1 RNA, overall and by baseline CD4 count. Finding With malaria defined as any parasitaemia, HIV-1-RNA concentration almost doubled between baseline (median 96 215 copies per mL) and malaria (168 901 copies per mL), a 0.25 (95% CI 0.11-0.39) log increase in mean RNA concentration. HIV-1-RNA concentration fell to median 82 058 copies per mL by about 8-9 weeks post-malaria. Increases in HIV-1-RNA were greatest for people with fever, parasite density 2000/µL or greater, and CD4 count more than 300 cells per µL, in whom concentrations rose from median 38 483 copies per mL at baseline to 196 098 copies per mL during malaria, a mean log increase of 0.82 (95% CI 0.55-1.10, p<0.0001), and fell to median 75 331 copies per mL post- malaria. People who remained aparisitaemic showed no changes in HIV-1-RNA concentration. Interpretation HIV-infected individuals with malaria have a significantly increased viral load, which might enhance HIV transmission and accelerate disease progression. (author's)

Keywords:

Malawi
Research Report
Clinical Research
Prospective Studies
Cohort Analysis
Estimation Technics
Rural Population
Adults
HIV Positive Persons
Malaria
Genetics
Fever
Blood
HIV Infections
Africa, Southern
Africa, Sub Saharan
Africa
Developing Countries
Research Methodology
Studies
Population Characteristics
Demographic Factors
Population
Age Factors
Viral Diseases
Diseases
Parasitic Diseases
Biology
Body Temperature
Physiology
Hemic System