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The burden of co-infection with human immunodeficiency virus type 1 and malaria in pregnant women in sub-Saharan Africa

terKuile, Feiko ORCID:, Parise, M. E., Verhoeff, Francine H., Udhayakumar, V., Newman, R. D., van Eijk, Anna, Rogerson, S. J. and Steketee, R. W. (2004) 'The burden of co-infection with human immunodeficiency virus type 1 and malaria in pregnant women in sub-Saharan Africa'. American Journal of Tropical Medicine and Hygiene, Vol 71, Issue Sup. 2, pp. 41-54.

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In sub-Saharan Africa, human immunodeficiency virus (HIV) and malaria are among the leading causes of morbidity during pregnancy. We reviewed available information collected since the first report 15 years ago that HIV impaired the ability of pregnant women to control malaria parasitemia. Results from 11 studies showed that HIV-infected women experienced consistently more peripheral and placental malaria (summary relative risk = 1.58 and 1.66, respectively), higher parasite densities, and more febrile illnesses, severe anemia, and adverse birth outcomes than HIV-uninfected women, particularly in multigravidae. Thus, HIV alters the typical gravidity-specific pattern of malaria risk by shifting the burden from primarily primigravidae and secundigravidae to all pregnant women. The proportional increase of malaria during pregnancy attributable to HIV was estimated to be 5.5% and 18.8% for populations with HIV prevalences of 10% and 40%, respectively. Maternal malaria was associated with a two-fold higher HIV-1 viral concentrations. Three studies investigating whether placental malaria increased mother-to-child HIV-1 transmission showed conflicting results, possibly reflecting a complex balance between placental malarial immune responses and stimulation of HIV-1 viral replication. Further investigations of interactions between antiretroviral drugs, prophylaxis with cotrimoxazole, and antimalarial drugs in pregnant women are urgently needed. Although much has been learned in the past 15 years about the interaction between malaria and HIV-1 during pregnancy, many issues still require further information to improve our understanding. There is a clear need to strengthen the deployment of existing malaria and HIV prevention and intervention measures for pregnant women.

Item Type: Article
Uncontrolled Keywords: plasmodium-falciparum malaria to-child transmission toxic epidermal necrolysis intermittent sulfadoxine-pyrimethamine pneumocystis-carinii-pneumonia perinatal hiv transmission macrophage-tropic hiv-1 placental malaria rural malawi risk-factors
Subjects: WC Communicable Diseases > Virus Diseases > Acquired Immunodeficiency Syndrome. HIV Infections > WC 503 Acquired immunodeficiency syndrome. HIV infections
WC Communicable Diseases > Tropical and Parasitic Diseases > WC 750 Malaria
WQ Obstetrics > Pregnancy Complications > WQ 240 Pregnancy complications (General)
WQ Obstetrics > Pregnancy Complications > WQ 256 Infectious diseases
Depositing User: Martin Chapman
Date Deposited: 18 Apr 2012 16:07
Last Modified: 07 Jun 2018 14:49


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