AEGiS-14IAC: Malaria infection elevates HIV-1 viral load.

14th International AIDS Conference

Barcelona, Spain - July 7-12, 2002

Malaria infection elevates HIV-1 viral load.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. WeOrC1375)

Kublin JG, Jere CS, Miller WC, Hoffman IF, Chimbiya N, Taylor TE, Molyneux ME
University of Maryland School of Medicine, Baltimore, United States

BACKGROUND: HIV infection increases malaria parasitemia and incidence of malarial fevers, and in one case-control study the mean HIV-1 viral load was higher in adults with malaria than in others. To assess the impact of malaria on HIV infection, we conducted a prospective cohort study in rural Malawi.

METHODS: We screened, identified and recruited HIV-1-positive adults (N=362) into the cohort. Participants were seen at routine visits every 2 months, at interim visits for any illness, and on designated days after each therapy for malaria. History, physical exam and blood-film microscopy were performed. We compared HIV-1 RNA levels (log) at the baseline visit to levels at the first visit positive for malaria parasitemia.

RESULTS: 161 HIV positive participants experienced at least one episode of P. falciparum parasitemia. Persons with parasitemia at baseline (N=32) or within the first 28 days after enrollment (N=10) were excluded from the HIV-1 RNA analysis. Among the remaining 119 persons, HIV RNA levels were available at baseline and during parasitemia for 73 persons. The mean RNA was 343757 copies/ml at the baseline visit and 500772/ml at the first episode of parasitemia. The mean paired (parasitemia - baseline) difference in RNA levels was 0.25 log (p = 0.0005). Among persons with subjective or measured fever and parasitemia, the difference was slightly greater, 0.35 log (p = 0.0003). The time to a parasitemia episode (mean = 89 days; median 75 days) did not correlate with the difference in HIV-1 RNA.

CONCLUSIONS: HIV RNA levels were significantly increased over baseline among persons with malaria. We are now studying viral loads in these individuals over several months after their malaria episode, and comparing the profiles with persons having no malaria. A malaria-associated increase in viral load, especially if sustained, could lead to increased transmission of HIV and more rapid disease progression, and thus have substantial public health implications.

Keywords: AEGIS, Viral Load, HIV-1, HIV Infections, Malaria, HIV Seropositivity, HIV, Parasitemia, Disease Progression, Malaria, Falciparum, HIV Protease Inhibitors, Anti-HIV Agents, HIV Seronegativity, Malaria, Vivax, Prospective Studies, Cohort Studies, Case-Control Studies, Malawi, Adult, immunology

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