HIV and malaria: interactions and implications.
OBJECTIVE
This review summarizes accumulating evidence of interactions between HIV and malaria and implications related to prevention and treatment of coinfection.


RESULTS
HIV-infected persons are at increased risk for clinical malaria; the risk is greatest when immune suppression is advanced. Adults with advanced HIV may be at risk for failure of malaria treatment, especially with sulfa-based therapies. Malaria is associated with increases in HIV viral load that, while modest, may impact HIV progression or the risk of HIV transmission. Cotrimoxazole prophylaxis greatly reduces the risk of malaria in people with HIV; the risk can be further reduced with antiretroviral treatment and the use of insecticide treated mosquito nets. Increased numbers of doses of intermittent preventive treatment during pregnancy can reduce the risk of placental malaria in women with HIV.


CONCLUSIONS
Interactions between malaria and HIV have important public health implications. People with HIV should use cotrimoxazole and insecticide treated mosquito nets. Malaria prevention is particularly important for pregnant women with HIV, although more information is needed about the best combination of strategies for prevention. In people with HIV, malaria diagnoses should be confirmed, highly effective drugs should be used for treatment, and possible drug interactions should be considered.
Slutsker
Laurence
L
Malaria Branch, Division of Parasitic Diseases, National Center for Zoonotic, Vectorborne, and Enteric Diseases (proposed), Centers for Disease Control and Prevention, Department of Health and Human Services, Atlanta, Georgia 30341, USA. lslutsker@cdc.gov
Marston
Barbara J
BJ
D019380:Anti-HIV Agents / Q000627:therapeutic use*; D000962:Antimalarials / Q000627:therapeutic use*; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission; D006801:Humans; D008288:Malaria / Q000150:complications / Q000453:epidemiology* / Q000517:prevention & control; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000188:drug therapy / Q000453:epidemiology
D019380:Anti-HIV Agents; D000962:Antimalarials