title: Human immunodeficiency virus co-infection increases placental parasite density and transplacental malaria transmission in Western Kenya.
abstract: Plasmodium falciparum malaria and human immunodeficiency virus (HIV)-1 adversely interact in the context of pregnancy, however little is known regarding the influence of co-infection on the risk of congenital malaria. We aimed to determine the prevalence of placental and congenital malaria and impact of HIV co-infection on trans-placental malaria transmission in 157 parturient women and their infants by microscopy and by quantitative real-time polymerase chain reaction (PCR) in western Kenya. The prevalence of placental and cord blood infections were 17.2% and 0% by microscopy, and 33.1% and 10.8% by PCR. HIV co-infection was associated with a significant increase in placental parasite density (P < 0.05). Cord blood malaria prevalence was increased in co-infected women (odds ratio [OR] = 5.42; 95% confidence interval [CI] = 1.90-15.47) and correlated with placental parasite density (OR = 2.57; 95% CI = 1.80-3.67). A 1-log increase in placental monocyte count was associated with increased risk of congenital infection (P = 0.001) (OR = 48.15; 95% CI = 4.59-505.50). The HIV co-infected women have a significantly increased burden of placental malaria that increases the risk of congenital infection.
authors.affiliation: Tropical Disease Unit, Toronto General Hospital, Faculty of Medicine, University of Toronto Canada.
authors.forename: Steven D
authors.initials: SD
authors.lastname: Perrault
authors.forename: Jan
authors.initials: J
authors.lastname: Hajek
authors.forename: Kathleen
authors.initials: K
authors.lastname: Zhong
authors.forename: Simon O
authors.initials: SO
authors.lastname: Owino
authors.forename: Moses
authors.initials: M
authors.lastname: Sichangi
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Smith
authors.forename: Ya Ping
authors.initials: YP
authors.lastname: Shi
authors.forename: Julie M
authors.initials: JM
authors.lastname: Moore
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Kain
mesh_terms: D000328:Adult; D000818:Animals; D016054:DNA, Protozoan / Q000235:genetics / Q000302:isolation & purification; D005260:Female; D005312:Fetal Blood / Q000469:parasitology / Q000821:virology; D005434:Flow Cytometry; D020073:Gravidity; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D007630:Kenya / Q000453:epidemiology; D016778:Malaria, Falciparum / Q000453:epidemiology / Q000635:transmission*; D010920:Placenta / Q000469:parasitology / Q000821:virology*; D010963:Plasmodium falciparum; D016133:Polymerase Chain Reaction; D011247:Pregnancy; D011248:Pregnancy Complications / Q000469:parasitology*; D015995:Prevalence; D012424:Rural Population
chemical_list: D016054:DNA, Protozoan