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Effects of HIV-1 serostatus, HIV-1 RNA concentration, and CD4 cell count on the incidence of malaria infection in a cohort of adults in rural Malawi

Patnaik, P., Jere, C. S., Miller, W. C., Hoffman, I. F., Wirima, J., Pendame, R., Meshnick, S. R., Taylor, T. E., Molyneux, Malcolm E and Kublin, J. G. (2005) 'Effects of HIV-1 serostatus, HIV-1 RNA concentration, and CD4 cell count on the incidence of malaria infection in a cohort of adults in rural Malawi'. Journal of Infectious Disease, Vol 192, Issue 6, pp. 984-991.

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Abstract

Background. To assess the effects of human immunodeficiency virus (HIV) infection on susceptibility to malaria, we compared the incidence rates of malaria by HIV type 1 (HIV-1) serostatus, baseline blood HIV-1 RNA concentration, and baseline CD4 cell count, over the course of a malaria season.
Methods. We followed a cohort of 349 adults in Malawi. For the 224 HIV-1-seropositive adults (64% of the cohort), we measured HIV-1 RNA concentration (n = 187) and CD4 cell count (n = 184) at baseline. Parasitemia n=187 n=184 was defined as presence of asexual parasites on a thick film of blood and was treated with sulfadoxine/pyrimethamine (SP), in accordance with national policy. Hazard ratios (HRs) of parasitemia were estimated using Cox regression. Demographics were adjusted for.
Results. HIV-1 seropositivity was associated with parasitemia (adjusted HR, 1.8 [95% confidence interval {CI}, 1.2 - 2.7] for a first parasitemia episode; adjusted HR, 2.5 [95% CI, 1.5 - 4.2] for a second parasitemia episode [114 days after the first episode]; adjusted HR, 1.9 [95% CI, 1.4 - 2.6] for parasitemia overall). Treatment failure ( parasitemia <= 14 days after SP treatment) did not differ by HIV-1 serostatus ( risk ratio, 1.3 [95% CI, 0.5 - 3.2]). HIV-1 RNA concentrations and CD4 cell counts were moderately but inconsistently associated with parasitemia. A high parasite density with fever was associated with HIV-1 seropositivity and low CD4 cell count.
Conclusion. HIV-infected adults in malaria-endemic areas are at increased risk for malaria. Where possible, additional malaria prevention efforts should be targeted at this population.

Item Type: Article
Subjects: WC Communicable Diseases > Virus Diseases > Acquired Immunodeficiency Syndrome. HIV Infections > WC 503.5 Complications
WC Communicable Diseases > Tropical and Parasitic Diseases > WC 750 Malaria
Digital Object Identifer (DOI): https://doi.org/10.1086/432730
Depositing User: Ms Julia Martin
Date Deposited: 13 Sep 2011 09:31
Last Modified: 07 Dec 2018 10:11
URI: https://archive.lstmed.ac.uk/id/eprint/1922

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