Increased risk for severe malaria in HIV-1-infected adults, Zambia

Emerg Infect Dis. 2009 May;15(5):749; quiz 858. doi: 10.3201/eid1505.081009.

Abstract

To determine whether HIV-1 infection and HIV-1-related immunosuppression were risk factors for severe malaria in adults with some immunity to malaria, we conducted a case-control study in Luanshya, Zambia, during December 2005-March 2007. For each case-patient with severe malaria, we selected 2 matched controls (an adult with uncomplicated malaria and an adult without signs of disease). HIV-1 infection was present in 93% of case-patients, in 52% of controls with uncomplicated malaria, and in 45% of asymptomatic controls. HIV-1 infection was a highly significant risk factor for adults with severe malaria compared with controls with uncomplicated malaria (odds ratio [OR] 12.6, 95% confidence interval [CI] 2.0-78.8, p = 0.0005) and asymptomatic controls (OR 16.6, 95% CI 2.5-111.5, p = 0.0005). Persons with severe malaria were more likely to have a CD4 count <350/microL than were asymptomatic controls (OR 23.0, 95% CI 3.35-158.00, p<0.0001).

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • AIDS-Related Opportunistic Infections / diagnosis
  • AIDS-Related Opportunistic Infections / epidemiology*
  • AIDS-Related Opportunistic Infections / parasitology*
  • AIDS-Related Opportunistic Infections / physiopathology
  • Adolescent
  • Adult
  • Animals
  • CD4 Lymphocyte Count
  • Case-Control Studies
  • Female
  • HIV Infections / complications*
  • HIV Infections / epidemiology*
  • HIV Infections / immunology
  • HIV Infections / virology
  • HIV-1
  • Humans
  • Malaria, Falciparum / diagnosis
  • Malaria, Falciparum / epidemiology*
  • Malaria, Falciparum / parasitology
  • Malaria, Falciparum / physiopathology*
  • Male
  • Middle Aged
  • Plasmodium falciparum
  • Risk Factors
  • Severity of Illness Index*
  • Young Adult
  • Zambia / epidemiology