title: Simultaneous diagnosis of severe imported Plasmodium falciparum malaria and HIV: report of three cases.
abstract: The increasing number of travellers to and from areas where considerable overlap between high malaria transmission and elevated prevalence of human immunodeficiency virus (HIV) infection exists, augment the probability that returning travellers to non-endemic countries might present with both infections. The presence of such co-infection can increase the severity of malaria episodes and also can change the progression of HIV infection. This article describes three travellers returning from malaria-endemic areas that had simultaneous diagnosis of severe Plasmodium falciparum malaria and HIV infection. Despite the severe forms of malaria and HIV co-infection, all patients responded successfully to anti-malarial treatment. Malaria and HIV interact with one another, with HIV infection increasing parasite burden, clinical severity and risk of complications of malaria; malaria seems to create an immunological interaction favourable to HIV spread and replication, with impact in progression to AIDS. The presence of malaria and HIV co-infection also poses other challenges related to treatment response, level of care and possible interactions of drugs. The authors recommend that all patients with fever returning from malaria endemic areas should be screened both for malaria and HIV infection.
authors.affiliation: Infectious Diseases Department of Sao Joao Hospital Centre, Faculty of Medicine of University of Porto, Alameda Prof. Hernâni Monteiro, 4200, Porto, Portugal. nunopereira85@gmail.com.|Nephrology Research and Development Unit, Instituto de Engenharia Biomédica, I3S, Instituto de Investigação e Inovação em Saúde, University of Porto, 4200-319, Porto, Portugal. nunopereira85@gmail.com.
authors.forename: Nuno Rocha
authors.initials: NR
authors.lastname: Pereira
authors.affiliation: Infectious Diseases Department of Sao Joao Hospital Centre, Faculty of Medicine of University of Porto, Alameda Prof. Hernâni Monteiro, 4200, Porto, Portugal. antonio.sarmento@hsjoao.min-saude.pt.|Nephrology Research and Development Unit, Instituto de Engenharia Biomédica, I3S, Instituto de Investigação e Inovação em Saúde, University of Porto, 4200-319, Porto, Portugal. antonio.sarmento@hsjoao.min-saude.pt.
authors.forename: António
authors.initials: A
authors.lastname: Sarmento
authors.affiliation: Infectious Diseases Department of Sao Joao Hospital Centre, Faculty of Medicine of University of Porto, Alameda Prof. Hernâni Monteiro, 4200, Porto, Portugal. maria.lurdes.uci@gmail.com.|Nephrology Research and Development Unit, Instituto de Engenharia Biomédica, I3S, Instituto de Investigação e Inovação em Saúde, University of Porto, 4200-319, Porto, Portugal. maria.lurdes.uci@gmail.com.
authors.forename: Lurdes
authors.initials: L
authors.lastname: Santos
mesh_terms: D000328:Adult; D000810:Angola; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D000962:Antimalarials / Q000627:therapeutic use; D060085:Coinfection / Q000175:diagnosis* / Q000188:drug therapy / Q000469:parasitology / Q000821:virology; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000469:parasitology; D006801:Humans; D016778:Malaria, Falciparum / Q000175:diagnosis* / Q000188:drug therapy / Q000469:parasitology; D008297:Male; D008875:Middle Aged; D009073:Mozambique; D011174:Portugal; D014195:Travel; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D044966:Anti-Retroviral Agents; D000962:Antimalarials