title: Correlates of HIV and malaria co-infection in Southern India.
abstract: BACKGROUND
  Malaria and HIV co-infection adversely impact the outcome of both diseases and previous studies have mostly focused on falciparum malaria. Plasmodium vivax contributes to almost half of the malaria cases in India, but the disease burden of HIV and P. vivax co-infection is unclear.
  
  
  METHODS
  HIV-infected subjects (n=460) were randomly selected from the 4,611 individuals seen at a Voluntary Counseling and Testing Center in Chennai, India between Jan 2 to Dec 31 2008. Malaria testing was performed on stored plasma samples by nested PCR using both genus-specific and species-specific primers and immunochromatography-based rapid diagnostic test for detecting antibodies against Plasmodium falciparum and P. vivax.
  
  
  RESULTS
  Recent malaria co-infection, defined by the presence of antibodies, was detected in 9.8% (45/460) participants. Plasmodium vivax accounted for majority of the infections (60%) followed by P. falciparum (27%) and mixed infections (13%). Individuals with HIV and malaria co-infection were more likely to be men (p=0.01). Between those with and without malaria, there was no difference in age (p=0.14), CD4+ T-cell counts (p=0.19) or proportion CD4+ T-cell below 200/mL (p=0.51).
  
  
  CONCLUSIONS
  Retrospective testing of stored plasma samples for malaria antibodies can facilitate identification of populations with high rates of co-infection, and in this southern India HIV-infected cohort there was a considerable burden of malaria co-infection, predominantly due to P. vivax. However, the rate of P. falciparum infection was more than 6-fold higher among HIV-infected individuals than what would be expected in the general population in the region. Interestingly, individuals co-infected with malaria and HIV were not more likely to be immunosuppressed than individuals with HIV infection alone.
authors.affiliation: University of California San Diego, San Diego, CA, USA. abharti@ucsd.edu
authors.forename: Ajay R
authors.initials: AR
authors.lastname: Bharti
authors.forename: Shanmugam
authors.initials: S
authors.lastname: Saravanan
authors.forename: Vidya
authors.initials: V
authors.lastname: Madhavan
authors.forename: Davey M
authors.initials: DM
authors.lastname: Smith
authors.forename: Jabin
authors.initials: J
authors.lastname: Sharma
authors.forename: Pachamuthu
authors.initials: P
authors.lastname: Balakrishnan
authors.forename: Scott L
authors.initials: SL
authors.lastname: Letendre
authors.forename: Nagalingeswaran
authors.initials: N
authors.lastname: Kumarasamy
mesh_terms: D000328:Adult; D000368:Aged; D000913:Antibodies, Protozoan / Q000097:blood; D060085:Coinfection / Q000453:epidemiology*; D005260:Female; D015483:HIV Antibodies / Q000097:blood; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D007194:India / Q000453:epidemiology; D016778:Malaria, Falciparum / Q000453:epidemiology*; D016780:Malaria, Vivax / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016036:Seroepidemiologic Studies; D055815:Young Adult
chemical_list: D000913:Antibodies, Protozoan; D015483:HIV Antibodies