title: The effect of Plasmodium falciparum malaria on HIV-1 RNA blood plasma concentration.
abstract: OBJECTIVE
  This study was undertaken to determine the relative effect of malaria infection on HIV concentration in blood plasma, and prospectively to monitor viral concentrations after antimalarial therapy.
  
  
  METHODS
  A prospective, double cohort study was designed to compare the blood HIV-1 RNA concentrations of HIV-positive individuals with and without acute malaria illness. Subjects were followed for 4 weeks after successful malaria therapy, or for 4 weeks from enrollment (controls).
  
  
  METHODS
  Malawian adults with symptomatic Plasmodium falciparum parasitemia (malaria group) and asymptomatic, aparasitemic blood donors (control group) were tested for HIV-1 antibodies to identify appropriate study groups. The malaria group received antimalarial chemotherapy only and were followed with sequential blood films. In both groups, blood plasma HIV-1 RNA viral concentrations were determined at enrollment and again at 1, 2 and 4 weeks.
  
  
  RESULTS
  Forty-seven malaria patients and 42 blood donors were enrolled. At enrollment blood plasma HIV-1 RNA concentrations were approximately sevenfold higher in patients with malaria than in blood donors (medians 15.1 x 10(4) and 2.24 x 10(4) copies/ml, respectively, P = 0.0001). No significant changes in median HIV-1 concentrations occurred in the 21 blood donors followed to week 4 (P = 0.68). In the 27 subjects successfully treated for malaria who were followed to week 4, a reduction in plasma HIV-1 RNA was observed from a median of 19.1 x 10(4) RNA copies/ml at enrollment, to 12.0 x 10(4) copies/ml at week 4, (P = 0.02). Plasma HIV-1 concentrations remained higher in malaria patients than controls (median 12.0 x 10(4) compared with 4.17 x 10(4) copies/ml, P = 0.086).
  
  
  CONCLUSIONS
  HIV-1 blood viral burden is higher in patients with P. falciparum malaria than in controls and this viral burden can, in some patients, be partly reduced with antimalarial therapy.
authors: University of North Carolina, Division of Infectious Diseases, Chapel Hill, USA. hoffmani@med.unc.edu
authors: I F
authors: IF
authors: Hoffman
authors: C S
authors: CS
authors: Jere
authors: T E
authors: TE
authors: Taylor
authors: P
authors: P
authors: Munthali
authors: J R
authors: JR
authors: Dyer
authors: J J
authors: JJ
authors: Wirima
authors: S J
authors: SJ
authors: Rogerson
authors: N
authors: N
authors: Kumwenda
authors: J J
authors: JJ
authors: Eron
authors: S A
authors: SA
authors: Fiscus
authors: H
authors: H
authors: Chakraborty
authors: T E
authors: TE
authors: Taha
authors: M S
authors: MS
authors: Cohen
authors: M E
authors: ME
authors: Molyneux
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy / Q000821:virology*; D000328:Adult; D000818:Animals; D005260:Female; D015497:HIV-1 / Q000235:genetics; D006801:Humans; D016778:Malaria, Falciparum / Q000188:drug therapy / Q000821:virology*; D008297:Male; D011446:Prospective Studies; D012367:RNA, Viral / Q000097:blood; D019562:Viral Load
chemical_list: D012367:RNA, Viral