title: The effect of Plasmodium falciparum malaria on peripheral and placental HIV-1 RNA concentrations in pregnant Malawian women.
abstract: OBJECTIVE
  To investigate the effect of placental Plasmodium falciparum malaria infection on peripheral and/or placental HIV-1 viral load.
  
  
  METHODS
  A cross-sectional study of HIV-infected pregnant women, with and without placental malaria, delivering at Queen Elizabeth Central Hospital in Malawi.
  
  
  METHODS
  Peripheral blood samples were collected from consenting women and tested for HIV. HIV-infected women received nevirapine at the onset of labor. At delivery, placental blood and tissue specimens were collected. HIV-1 RNA concentrations were measured in peripheral and placental plasma samples, and malaria infection was determined by placental histopathology.
  
  
  RESULTS
  Of the 480 HIV-infected women enrolled, 304 had placental histopathology performed, of whom 74 (24.3%) had placental malaria. Compared with women without placental malaria, those with placental malaria had a 2.5-fold higher geometric mean peripheral HIV-1 RNA concentration (62,359 versus 24 814 copies/ml; P = 0.0007) and a 2.4-fold higher geometric mean placental HIV-1 RNA concentration (11,733 versus 4919 copies/ml; P = 0.008). In multivariate analyses, after adjusting for CD4 cell count and other covariates, placental malaria was associated with a 1.7-fold increase in geometric mean peripheral HIV-1 RNA concentration (47,747 versus 27,317 copies/ml; P = 0.02) and a 2.0-fold increase in geometric mean placental HIV-1 RNA concentration (9670 versus 4874 copies/ml; P = 0.03).
  
  
  CONCLUSIONS
  Placental malaria infection is associated with an increase in peripheral and placental HIV-1 viral load, which might increase the risk of mother-to-child transmission of HIV.
authors.affiliation: Department of Community Health, College of Medicine, Blantyre, Malawi.
authors.forename: Victor
authors.initials: V
authors.lastname: Mwapasa
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Rogerson
authors.forename: Malcolm E
authors.initials: ME
authors.lastname: Molyneux
authors.forename: Elizabeth T
authors.initials: ET
authors.lastname: Abrams
authors.forename: Deborah D
authors.initials: DD
authors.lastname: Kamwendo
authors.forename: Valentino M
authors.initials: VM
authors.lastname: Lema
authors.forename: Eyob
authors.initials: E
authors.lastname: Tadesse
authors.forename: Ebbie
authors.initials: E
authors.lastname: Chaluluka
authors.forename: Paul E
authors.initials: PE
authors.lastname: Wilson
authors.forename: Steven R
authors.initials: SR
authors.lastname: Meshnick
mesh_terms: D000328:Adult; D018791:CD4 Lymphocyte Count; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000276:immunology / Q000635:transmission / Q000821:virology; D015497:HIV-1 / Q000302:isolation & purification*; D006801:Humans; D018445:Infectious Disease Transmission, Vertical; D016778:Malaria, Falciparum / Q000150:complications*; D018512:Parasitemia / Q000150:complications; D010920:Placenta / Q000821:virology*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000276:immunology / Q000821:virology*; D012367:RNA, Viral / Q000032:analysis; D019562:Viral Load
chemical_list: D012367:RNA, Viral