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Immunological, Virological, Parasitic and Biological Profile of Malaria/HIV Co-Infection in 18 Years Old and Above Patients in Lubumbashi (DR Congo)

DOI: 10.4236/oalib.1102647, PP. 1-7

Subject Areas: Infectious Diseases, HIV

Keywords: Malaria/HIV Co-Infection, CD4, Viral Load, Parasite Density, Haemoglobin

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Abstract

Introduction: Malaria infection and HIV infection are major public health issues in several parts of the world. Together they have caused more than a million deaths per year. Africa, and Sub-Saharan in particular are the most affected. Our study objective is to determine the prevalence of Malaria/HIV co-infection and describe its immunological, virological, parasitic and biological characteristics. Methodology: This is a descriptive, transversal and multi centric study done on 18 years old and above HIV positive patients, for a period extending from December 2008 to October 2009 in 5 different HIV treatment centres. Parameters studied were gender, age, CD4 count, viral load, parasite density and haemoglobin level. The HIV diagnosis was made according to the AIDS National Program and malaria according to the Malaria National Program. Statistic analyses were done using Epi Info 7 software and the Yates corrected Chi Square test or the Fischer Exact test (when recommended) was used to check any link between different parameters studied. Statistical significance was fixed at <0.05. Results: 405 HIV seropositive patients were compiled. The malaria prevalence in these patients was 6.9%. Majority of co-infected patients were aged between 26 and 49 years (67.9%), and had a CD4 count <200 μl (67.9%), a parasitic density <10,000 trophozoites/μl (75%) and an Hb level <11 g/dl. With regards to correlations between co-infected patients parasitic density and the CD4 count, viral load and Hb level, none of the studied parameters showed any statistic significance difference. Conclusion: A prevalence of 6.9% among HIV/malaria co-infected patients and 67.7% of these patients had a CD4 count less than 200 cells/μl. Thus, both national programs must promote an early testing for HIV infected patients and reinforce preventive measures in the management of malaria.

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Kakisingi, C. , Mukuku, O. , Manika, M. , Mutombo, A. , Kasamba, E. , Tshikuluila, B. , Mawaw, P. , Mwamba, C. and Luboya, O. (2016). Immunological, Virological, Parasitic and Biological Profile of Malaria/HIV Co-Infection in 18 Years Old and Above Patients in Lubumbashi (DR Congo). Open Access Library Journal, 3, e2647. doi: http://dx.doi.org/10.4236/oalib.1102647.

References

[1]  Asante, P.K., et al. (2011) Malaria Epidemiology in the Ahafo Area of Ghana. Malaria Journal, 10, 211.
http://dx.doi.org/10.1186/1475-2875-10-211
[2]  Murray, C.J., Briet, O.J.T., Hardy, D., Chitnis, N., Maire, N., Di Pasquale, A. and Smith, T.A. (2012) Global Malaria Mortality between 1980 and 2010: A Systematic Analysis. The Lancet, 379, 413-431.
http://dx.doi.org/10.1016/S0140-6736(12)60034-8
[3]  WHO (2011) World Malaria Report 2011. World Health Organization, Geneva.
[4]  WHO (2008) World Malaria Report 2008. WHO Press, Geneva.
[5]  Crowell, V., Briet, O.J., Hardy, D., Chitnis, N., Maire, N., Di, P.A., et al. (2013) Modelling the Cost-Effectiveness of Mass Screening and Treatment for Reducing Plasmodium Falciparum Malaria Burden. Malaria Journal, 12, 4.
http://dx.doi.org/10.1016/S0140-6736(12)60034-8
[6]  Martin-Blondel, G., et al. (2007) Impact de l’infection VIH sur l’infection palustre chez l’adulte. Medicine et Maladies Infectieuses, 37, 629-636.
http://dx.doi.org/10.1016/j.medmal.2007.03.018
[7]  UNAIDS (2014) The Gap Report. United Nations, Geneva.
[8]  Chalwe, V., et al. (2009) Increased Risk for Severe Malaria in HIV-1-Infected Adults, Zambia. Emerging Infectious Diseases, 15, 749-755.
http://dx.doi.org/10.3201/eid1505.081009
[9]  Martin-Blondel, G., et al. (2009) Impact du paludisme sur l’infection par le VIH. Médecine et Maladies Infectieuses, 40, 256-267.
http://dx.doi.org/10.1016/j.medmal.2009.10.008
[10]  Hobbs, V.C., et al. (2009) HIV Protease Inhibitors Inhibit the Development of Preerythrocytic-Stage Plasmodium Parasites. The Journal of Infectious Diseases, 199, 134-141.
http://dx.doi.org/10.1086/594369
[11]  Collaboration TATC (2009) Prognosis of Patients Treated with cART from 36 Months after Initiation, According to Current and Previous CD4 Cell Count and Plasma HIV-1 RNA Measurements. AIDS, 23, 2199-2208.
http://dx.doi.org/10.1097/QAD.0b013e3283305a00
[12]  Birku, Y., Mekonnen, E., Bjorkman, A. and Wolday, D. (2002) Delayed Clearance of Plasmodium falciparum in Patients with Human Immunodeficiency Virus Co-Infection Treated with Artemisinin. Ethiopian Medical Journal, 40, 17-26.
[13]  Whitworth, J., Morgan, D., Quigley, M., Smith, A., Mayanja, B., Eotu, H., et al. (2000) Effect of HIV-1 and Increasing Immunosuppression on Malaria Parasitaemia and Clinical Episodes in Adults in Rural Uganda: A Cohort Study. Lancet, 356, 1051-1056.
http://dx.doi.org/10.1016/S0140-6736(00)02727-6
[14]  French, N., Nakiyingi, J., Lugada, E., Watera, C., Whitworth, J.A. and Gilks, C.F. (2001) Increasing Rates of Malarial Fever with Deteriorating Immune Status in HIV-1-Infected Ugandan Adults. AIDS, 15, 899-906.
http://dx.doi.org/10.1097/00002030-200105040-00010
[15]  Centers for Disease Control and Prevention (2009) Guidelines for Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents. mMWR, 58, 94-98.
[16]  Wumba, D.R., Zanga, J., Aloni, M.N., Mbanzulu, K., Kahindo, A., Mandina, M.N., et al. (2015) Interactions between Malaria and HIV Infections in Pregnant Women: A First Report of the Magnitude, Clinical and Laboratory Features, and Predictive Factors in Kinshasa, the Democratic Republic of Congo. Malaria Journal, 14, 82.
http://dx.doi.org/10.1186/s12936-015-0598-2
[17]  European Guidelines. Accessed January 2016.
http://eacsociety.org/Guidelines.aspx
[18]  EDS-RDC II 2013-2014 (2014) Deuxième enquête démographique et de santé. Kinshasa.
[19]  Tay, S.C.K., Badu, K., Mensah, A.A. and Gbedema, S.Y. (2015) The Prevalence of Malaria among HIV Seropositive Individuals and the Impact of the Co-Infection on Their Hemoglobin Levels. Annals of Clinical Microbiology and Antimicrobials, 14, 10.
http://dx.doi.org/10.1186/s12941-015-0064-6
[20]  ter Kuile, F.O., Parise, M.E., Verhoeff, F.H., Udhayakumar, V., Newman, R.D., van Eijk, A.M., 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. The American Journal of Tropical Medicine and Hygiene, 71, 41-54.
[21]  Adu-Gyasi, D., Fanello, C.I., Baiden, F., Porter, J.D.H., Korbel, D., Adjei, G., et al. (2013) Prevalence of Clinically Captured and Confirmed Malaria among HIV Seropositve Clinic Attendants in Five Hospitals in Ghana. Malaria Journal, 12, 382.
http://dx.doi.org/10.1186/1475-2875-12-382
[22]  Mermin, J., Ekwaru, J.P., Liechty, C.A., Were, W., Downing, R., Ransom, R., et al. (2006) Effect of Co-Trimoxazole Prophylaxis, Antiretroviral Therapy, and Insecticide-Treated Bed Nets on the Frequency of Malaria in HIV-1-Infected Adults in Uganda: A Prospective Cohort Study. Lancet, 367, 1256-1261.
http://dx.doi.org/10.1016/S0140-6736(06)68541-3
[23]  Browne, E.N.L., Frimpong, E., Sievertsen, J., Hagen, J., Hamelmann, C., Dietz, K., Horstmann, R.D. and Burchard, G.D. (2000) Malariometric Update for the Rainforest and Savannah of Ashanti Region, Ghana. Annals of Tropical Medicine and Parasitology, 94, 15-22.
http://dx.doi.org/10.1080/00034980057572
[24]  Sanyaolu, A.O., Fagbenro-Beyioku, A.F., Oyibo, W.A., Badaru, O.S., Onyeabor, O.S. and Nnaemeka, C.I. (2013) Malaria and HIV Co-Infection and Their Effect on Haemoglobin Levels from Three Healthcare Institutions in Lagos, Southwest Nigeria. African Health Sciences, 13, 295-300.
http://dx.doi.org/10.4314/ahs.v13i2.14
[25]  Cohen, C., Karstaedt, A., Frean, J., Thomas, J., Govender, N., Prentice, E., Dini, L., Galpin, J. and Crewe-Brown, H. (2005) Increased Prevalence of Severe Malaria in HIV-Infected Adults in South Africa. Clinical Infectious Diseases, 41, 1631-1637.
http://dx.doi.org/10.1086/498023
[26]  Onyenekwea, C.C., Ukibe, N., Meludu, S.C., Ilika, A., Aboh, N., Ofiaeli, N., Ezaeni, M. and Onochie, A. (2007) Prevalence of Malaria as Co-Infection in HIV-Infected Individuals in a Malaria Endemic Area of Southeastern Nigeria. Journal of Vector Borne Diseases, 44, 250-254.
[27]  Savage, E.J., Msyamboza, K., Gies, S., D’Alessandro, U. and Brabin, B.J. (2007) Maternal Anaemia as an Indicator for Monitoring Malaria Control in Pregnancy in Sub-Saharan Africa. BJOG: An International Journal of Obstetrics & Gynaecology, 114, 1222-1231.
http://dx.doi.org/10.1111/j.1471-0528.2007.01420.x
[28]  Rutto, E.K., Nyagol, J., Oyugi, J., Ndege, S., Onyango, N., Obala, A., et al. (2015) Effects of HIV-1 Infection on Malaria Parasitemia in Milo Sub-Location, Western Kenya. BMC Research Notes, 8, 303.
http://dx.doi.org/10.1186/s13104-015-1270-1
[29]  Bloland, P.B., Wirima, J.J., Steketee, R.W., Chilima, B., Hightower, A. and Breman, J.G. (1995) Maternal HIV Infection and Infant Mortality in Malawi: Evidence for Increased Mortality Due to Placental Malaria Infection. AIDS, 9, 721-726.
http://dx.doi.org/10.1097/00002030-199507000-00009
[30]  Cuadros, D.F., Branscum, A.J. and Crowley, P.H. (2011) Effects of Malaria on the Prevalence of HIV in East Sub-Saharan Africa. International Journal of Epidemiology, 40, 931-939.
http://dx.doi.org/10.1093/ije/dyq256
[31]  Mermin, J., Lule, J., Ekwaru, J.P., Malamba, S., Downing, R., Ransom, R., et al. (2004) Effect of Co-Trimoxazole Prophylaxis on Morbidity, Mortality, CD4-Cell Count, and Viral Load in HIV Infection in Rural Uganda. Lancet, 364, 1428-1434.
http://dx.doi.org/10.1016/S0140-6736(04)17225-5
[32]  Asante, P.K., et al. (2011) Malaria Epidemiology in the Ahafo Area of Ghana. Malaria Journal, 10, 211.
http://dx.doi.org/10.1186/1475-2875-10-211
[33]  Murray, C.J., Bri?t, O.J.T., Hardy, D., Chitnis, N., Maire, N., Di Pasquale, A. and Smith, T.A. (2012) Global Malaria Mortality between 1980 and 2010: A Systematic Analysis. The Lancet, 379, 413-431.
http://dx.doi.org/10.1016/S0140-6736(12)60034-8
[34]  WHO (2011) World Malaria Report 2011. World Health Organization, Geneva.
[35]  WHO (2008) World Malaria Report 2008. WHO Press, Geneva.
[36]  Crowell, V., Briet, O.J., Hardy, D., Chitnis, N., Maire, N., Di, P.A., et al. (2013) Modelling the Cost-Effectiveness of Mass Screening and Treatment for Reducing Plasmodium Falciparum Malaria Burden. Malaria Journal, 12, 4.
http://dx.doi.org/10.1016/S0140-6736(12)60034-8
[37]  Martin-Blondel, G., et al. (2007) Impact de l’infection VIH sur l’infection palustre chez l’adulte. Medicine et Maladies Infectieuses, 37, 629-636.
http://dx.doi.org/10.1016/j.medmal.2007.03.018
[38]  UNAIDS (2014) The Gap Report. United Nations, Geneva.
[39]  Chalwe, V., et al. (2009) Increased Risk for Severe Malaria in HIV-1-Infected Adults, Zambia. Emerging Infectious Diseases, 15, 749-755.
http://dx.doi.org/10.3201/eid1505.081009
[40]  Martin-Blondel, G., et al. (2009) Impact du paludisme sur l’infection par le VIH. Médecine et Maladies Infectieuses, 40, 256-267.
http://dx.doi.org/10.1016/j.medmal.2009.10.008
[41]  Hobbs, V.C., et al. (2009) HIV Protease Inhibitors Inhibit the Development of Preerythrocytic-Stage Plasmodium Parasites. The Journal of Infectious Diseases, 199, 134-141.
http://dx.doi.org/10.1086/594369
[42]  Collaboration TATC (2009) Prognosis of Patients Treated with cART from 36 Months after Initiation, According to Current and Previous CD4 Cell Count and Plasma HIV-1 RNA Measurements. AIDS, 23, 2199-2208.
http://dx.doi.org/10.1097/QAD.0b013e3283305a00
[43]  Birku, Y., Mekonnen, E., Bj?rkman, A. and Wolday, D. (2002) Delayed Clearance of Plasmodium falciparum in Patients with Human Immunodeficiency Virus Co-Infection Treated with Artemisinin. Ethiopian Medical Journal, 40, 17-26.
[44]  Whitworth, J., Morgan, D., Quigley, M., Smith, A., Mayanja, B., Eotu, H., et al. (2000) Effect of HIV-1 and Increasing Immunosuppression on Malaria Parasitaemia and Clinical Episodes in Adults in Rural Uganda: A Cohort Study. Lancet, 356, 1051-1056.
http://dx.doi.org/10.1016/S0140-6736(00)02727-6
[45]  French, N., Nakiyingi, J., Lugada, E., Watera, C., Whitworth, J.A. and Gilks, C.F. (2001) Increasing Rates of Malarial Fever with Deteriorating Immune Status in HIV-1-Infected Ugandan Adults. AIDS, 15, 899-906.
http://dx.doi.org/10.1097/00002030-200105040-00010
[46]  Centers for Disease Control and Prevention (2009) Guidelines for Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents. mMWR, 58, 94-98.
[47]  Wumba, D.R., Zanga, J., Aloni, M.N., Mbanzulu, K., Kahindo, A., Mandina, M.N., et al. (2015) Interactions between Malaria and HIV Infections in Pregnant Women: A First Report of the Magnitude, Clinical and Laboratory Features, and Predictive Factors in Kinshasa, the Democratic Republic of Congo. Malaria Journal, 14, 82.
http://dx.doi.org/10.1186/s12936-015-0598-2
[48]  European Guidelines. Accessed January 2016.
http://eacsociety.org/Guidelines.aspx
[49]  EDS-RDC II 2013-2014 (2014) Deuxième enquête démographique et de santé. Kinshasa.
[50]  Tay, S.C.K., Badu, K., Mensah, A.A. and Gbedema, S.Y. (2015) The Prevalence of Malaria among HIV Seropositive Individuals and the Impact of the Co-Infection on Their Hemoglobin Levels. Annals of Clinical Microbiology and Antimicrobials, 14, 10.
http://dx.doi.org/10.1186/s12941-015-0064-6
[51]  ter Kuile, F.O., Parise, M.E., Verhoeff, F.H., Udhayakumar, V., Newman, R.D., van Eijk, A.M., 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. The American Journal of Tropical Medicine and Hygiene, 71, 41-54.
[52]  Adu-Gyasi, D., Fanello, C.I., Baiden, F., Porter, J.D.H., Korbel, D., Adjei, G., et al. (2013) Prevalence of Clinically Captured and Confirmed Malaria among HIV Seropositve Clinic Attendants in Five Hospitals in Ghana. Malaria Journal, 12, 382.
http://dx.doi.org/10.1186/1475-2875-12-382
[53]  Mermin, J., Ekwaru, J.P., Liechty, C.A., Were, W., Downing, R., Ransom, R., et al. (2006) Effect of Co-Trimoxazole Prophylaxis, Antiretroviral Therapy, and Insecticide-Treated Bed Nets on the Frequency of Malaria in HIV-1-Infected Adults in Uganda: A Prospective Cohort Study. Lancet, 367, 1256-1261.
http://dx.doi.org/10.1016/S0140-6736(06)68541-3
[54]  Browne, E.N.L., Frimpong, E., Sievertsen, J., Hagen, J., Hamelmann, C., Dietz, K., Horstmann, R.D. and Burchard, G.D. (2000) Malariometric Update for the Rainforest and Savannah of Ashanti Region, Ghana. Annals of Tropical Medicine and Parasitology, 94, 15-22.
http://dx.doi.org/10.1080/00034980057572
[55]  Sanyaolu, A.O., Fagbenro-Beyioku, A.F., Oyibo, W.A., Badaru, O.S., Onyeabor, O.S. and Nnaemeka, C.I. (2013) Malaria and HIV Co-Infection and Their Effect on Haemoglobin Levels from Three Healthcare Institutions in Lagos, Southwest Nigeria. African Health Sciences, 13, 295-300.
http://dx.doi.org/10.4314/ahs.v13i2.14
[56]  Cohen, C., Karstaedt, A., Frean, J., Thomas, J., Govender, N., Prentice, E., Dini, L., Galpin, J. and Crewe-Brown, H. (2005) Increased Prevalence of Severe Malaria in HIV-Infected Adults in South Africa. Clinical Infectious Diseases, 41, 1631-1637.
http://dx.doi.org/10.1086/498023
[57]  Onyenekwea, C.C., Ukibe, N., Meludu, S.C., Ilika, A., Aboh, N., Ofiaeli, N., Ezaeni, M. and Onochie, A. (2007) Prevalence of Malaria as Co-Infection in HIV-Infected Individuals in a Malaria Endemic Area of Southeastern Nigeria. Journal of Vector Borne Diseases, 44, 250-254.
[58]  Savage, E.J., Msyamboza, K., Gies, S., D’Alessandro, U. and Brabin, B.J. (2007) Maternal Anaemia as an Indicator for Monitoring Malaria Control in Pregnancy in Sub-Saharan Africa. BJOG: An International Journal of Obstetrics & Gynaecology, 114, 1222-1231.
http://dx.doi.org/10.1111/j.1471-0528.2007.01420.x
[59]  Rutto, E.K., Nyagol, J., Oyugi, J., Ndege, S., Onyango, N., Obala, A., et al. (2015) Effects of HIV-1 Infection on Malaria Parasitemia in Milo Sub-Location, Western Kenya. BMC Research Notes, 8, 303.
http://dx.doi.org/10.1186/s13104-015-1270-1
[60]  Bloland, P.B., Wirima, J.J., Steketee, R.W., Chilima, B., Hightower, A. and Breman, J.G. (1995) Maternal HIV Infection and Infant Mortality in Malawi: Evidence for Increased Mortality Due to Placental Malaria Infection. AIDS, 9, 721-726.
http://dx.doi.org/10.1097/00002030-199507000-00009
[61]  Cuadros, D.F., Branscum, A.J. and Crowley, P.H. (2011) Effects of Malaria on the Prevalence of HIV in East Sub-Saharan Africa. International Journal of Epidemiology, 40, 931-939.
http://dx.doi.org/10.1093/ije/dyq256
[62]  Mermin, J., Lule, J., Ekwaru, J.P., Malamba, S., Downing, R., Ransom, R., et al. (2004) Effect of Co-Trimoxazole Prophylaxis on Morbidity, Mortality, CD4-Cell Count, and Viral Load in HIV Infection in Rural Uganda. Lancet, 364, 1428-1434.
http://dx.doi.org/10.1016/S0140-6736(04)17225-5

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