Increased risk for severe malaria in HIV-1-infected adults, Zambia.
To determine whether HIV-1 infection and HIV-1-related immunosuppression were risk factors for severe malaria in adults with some immunity to malaria, we conducted a case-control study in Luanshya, Zambia, during December 2005-March 2007. For each case-patient with severe malaria, we selected 2 matched controls (an adult with uncomplicated malaria and an adult without signs of disease). HIV-1 infection was present in 93% of case-patients, in 52% of controls with uncomplicated malaria, and in 45% of asymptomatic controls. HIV-1 infection was a highly significant risk factor for adults with severe malaria compared with controls with uncomplicated malaria (odds ratio [OR] 12.6, 95% confidence interval [CI] 2.0-78.8, p = 0.0005) and asymptomatic controls (OR 16.6, 95% CI 2.5-111.5, p = 0.0005). Persons with severe malaria were more likely to have a CD4 count <350/microL than were asymptomatic controls (OR 23.0, 95% CI 3.35-158.00, p<0.0001).
Chalwe
Victor
V
Tropical Diseases Research Centre, Ndola, Zambia.
Van geertruyden
Jean-Pierre
JP
Mukwamataba
Doreen
D
Menten
Joris
J
Kamalamba
John
J
Mulenga
Modest
M
D'Alessandro
Umberto
U
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000469:parasitology* / Q000503:physiopathology; D000293:Adolescent; D000328:Adult; D000818:Animals; D018791:CD4 Lymphocyte Count; D016022:Case-Control Studies; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology* / Q000276:immunology / Q000821:virology; D015497:HIV-1; D006801:Humans; D016778:Malaria, Falciparum / Q000175:diagnosis / Q000453:epidemiology* / Q000469:parasitology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010963:Plasmodium falciparum; D012307:Risk Factors; D012720:Severity of Illness Index; D055815:Young Adult; D015024:Zambia / Q000453:epidemiology