title: Impact of HIV-1 infection on the hematological recovery after clinical malaria.
abstract: BACKGROUND
  Anemia is the most frequent cytopenia in HIV-infected individuals and is often associated with malaria.
  
  
  OBJECTIVE
  To assess the impact of HIV-1 on the hematological recovery after a clinical malaria episode.
  
  
  METHODS
  In Ndola, Zambia, a region with high malaria and HIV prevalence, hemoglobin (Hb) was measured in 634 malaria patients 14 and 45 days after antimalarial treatment. Risk factors for hematological recovery were analyzed in a multivariate linear regression model.
  
  
  RESULTS
  At enrollment, HIV-1-infected malaria patients had lower Hb compared with HIV-1 uninfected (122.7 vs 136.0 g/L; P < 0.001). In both groups, mean Hb was significantly lower at day 14 posttreatment than day 0 (P < 0.0001) and significantly higher at day 45 than at day 14 (HIV-1 negative: P = 0.0001; HIV-1 infected: P = 0.005). HIV-1 was a risk factor for a larger Hb decrease until day 14 (P < 0.001) and slower recovery until day 45 (P = 0.048). When considering the whole 45-day follow-up period, mean Hb increased in the HIV-1-negative group (+3.54 g/L; 95% confidence interval: 1.37 to 5.70; P = 0.001) but not in the HIV-1-infected group (-0.72 g/L; 95% confidence interval: -3.85 to +2.40; P = 0.64). HIV-1 infection as such (P < 0.0001), not CD4 cell count (P = 0.46), was an independent risk factor for a slower hematological recovery.
  
  
  CONCLUSIONS
  HIV-1-infected malaria patients had a slower hematological recovery after successful parasite clearance. Malaria preventive measures should be targeted to this high-risk group.
authors.affiliation: Department of Parasitology, and Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium. jpvangeertruyden@itg.be
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Van Geertruyden
authors.forename: Modest
authors.initials: M
authors.lastname: Mulenga
authors.forename: Victor
authors.initials: V
authors.lastname: Chalwe
authors.forename: Nambozi
authors.initials: N
authors.lastname: Michael
authors.forename: Filip
authors.initials: F
authors.lastname: Moerman
authors.forename: Doreen
authors.initials: D
authors.lastname: Mukwamataba
authors.forename: Robert
authors.initials: R
authors.lastname: Colebunders
authors.forename: Umberto
authors.initials: U
authors.lastname: D'alessandro
mesh_terms: D000740:Anemia / Q000097:blood* / Q000469:parasitology; D000818:Animals; D000962:Antimalarials / Q000627:therapeutic use*; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000276:immunology / Q000821:virology; D015497:HIV-1; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D016778:Malaria, Falciparum / Q000150:complications* / Q000188:drug therapy* / Q000469:parasitology; D008297:Male; D015999:Multivariate Analysis; D010963:Plasmodium falciparum; D012307:Risk Factors; D016896:Treatment Outcome; D015024:Zambia
chemical_list: D000962:Antimalarials; D006454:Hemoglobins