Coinfection: Malaria and Hepatitis, a Case Report and a Review of the Literature

In Africa, Plasmodium falciparum malaria and hepatitis A virus (HAV) are common infections, although concomitant infections of these two human pathogens are apt to occur, the awareness of their prevalence and eventual significance remains low. Given that both pathogens target the hepatocyte as a host cell for intracellular replication (mosquito-borne malaria parasites silently replicate in suitable hepatocytes before invading red blood cells), direct or immunologically mediated interactions in concurrent infections could potentially intensify or inhibit the spread of both infections. We report the case of a patient aged 29-year-old who worked in the catering trade in Côte d’Ivoire, and who had a history of malaria two years before his hospitalization, which was treated with Artemether-Lumefantrine, who was hospitalized in the Infectious Diseases Department of the Mohamed VI University Hospital of Marrakech having a co-infection with P. falciparum malaria and acute HAV revealed by an acute fever associated with jaundice, vomiting and diarrhea evolving since one week after his return from Côte d’Ivoire. Considering a high hepatic cytolysis (8 × normal), hepatic serologies (A, B, C) were realized and revealed the presence of positive antibodies anti hepatitis A type IgM. The patient was treated with Artesunate injection at 2.4 mg/kg at H0 H12-H24 then relayed with oral Artemether-Lumefantrine (Coartem) 4 tablets twice a day for 3 days. The clinical course was characterized by apyrexia with regression of jaundice, vomiting, diarrhea and disappearance of confusion. Biologically: an improvement of the infectious balance.