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The interaction between malaria and human immunodeficiency virus infection in severely anaemic Malawian children: a prospective longitudinal study

Kyeyune, Francis X., Calis, Job C. J., Phiri, Kamija S., Faragher, Brian, Kachala, David, Brabin, Bernard and Boele van Hensbroek, Michael (2014) 'The interaction between malaria and human immunodeficiency virus infection in severely anaemic Malawian children: a prospective longitudinal study'. Tropical Medicine & International Health, Vol 19, Issue 6, pp. 698-705.

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Malaria and human immunodeficiency virus (HIV) infection are co-prevalent in sub-Saharan Africa and cause severe anaemia in children. Interactions between these infections occur in adults, although these are less clear in children. The aim of study was to determine their interaction in a cohort of severely anaemic children.


Severely anaemic Malawian children were enrolled, tested for HIV and malaria,transfused and followed for 18 months for malaria incidence. Antiretrovirals were not widely available in Malawi during the study period.


Of 381 children (haemoglobin <5 g/dl), 357 consented for HIV testing, 12.6% were HIVinfected,
and 59.5% had malaria parasitaemia. At enrolment, HIV-infected children had similar malaria parasitaemia prevalence (59.1% vs. 58.7%; P = 0.96) and parasite density (geometric mean [parasites/ll] 6903 vs. 12417; P = 0.18) as HIV-negative children. There were no differences in mean
CD4%, or prevalence of severe immunosuppression, between those with and without malaria parasitaemia. Plasma viral load correlated negatively with log parasitaemia (r = �0.78; P = 0.01). During follow-up, HIV-infected children did not experience more frequent parasitaemias or symptomatic malaria episodes. Adjusted risk estimates (95% CI) for malaria parasitaemia in HIVinfected children at 6 and 18 months follow-up were 0.39 (0.13–1.14) and 0.40 (0.11–1.51),respectively.


Severely anaemic HIV-infected children showed no increased susceptibility to asymptomatic or symptomatic malaria during or following their anaemic episode, although all experienced lower parasite prevalence during follow-up. This contrasts with data in adults and may relate to the malaria immunity of young children which is insufficiently developed to be impaired by HIV. The negative correlation between viral load and malaria parasitaemia remains unexplained.

Item Type: Article
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
WH Hemic and Lymphatic Systems > Hematologic Diseases. Immunologic Factors. Blood Banks > WH 155 Anemia
WS Pediatrics > WS 20 Research (General)
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI):
Depositing User: Julie Franco
Date Deposited: 22 Aug 2014 09:24
Last Modified: 11 May 2018 09:16


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