title: Symptoms and Immune Markers in Plasmodium/Dengue Virus Co-infection Compared with Mono-infection with Either in Peru.
abstract: BACKGROUND
  Malaria and dengue are two of the most common vector-borne diseases in the world, but co-infection is rarely described, and immunologic comparisons of co-infection with mono-infection are lacking.
  
  
  RESULTS
  We collected symptom histories and blood specimens from subjects in a febrile illness surveillance study conducted in Iquitos and Puerto Maldonado, Peru, between 2002-2011. Nineteen symptoms and 18 immune markers at presentation were compared among those with co-infection with Plasmodium/dengue virus (DENV), Plasmodium mono-infection, and DENV mono-infection. Seventeen subjects were identified as having Plasmodium/DENV co-infection and were retrospectively matched with 51 DENV mono-infected and 44 Plasmodium mono-infected subjects. Those with Plasmodium mono-infection had higher levels of IL-4, IL-6, IL-10, IL-12, IL-13, IL-17A, IFN-γ, and MIP1-α/CCL3 compared with DENV mono-infection or co-infection; those with Plasmodium mono-infection had more cough than those with DENV mono-infection. Subjects with DENV mono-infection had higher levels of TGF-β1 and more myalgia than those with Plasmodium mono-infection. No symptom was more common and no immune marker level was higher in the co-infected group, which had similar findings to the DENV mono-infected subjects.
  
  
  CONCLUSIONS
  Compared with mono-infection with either pathogen, Plasmodium/DENV co-infection was not associated with worse disease and resembled DENV mono-infection in both symptom frequency and immune marker level.
authors.affiliation: Virology Department, U.S. Naval Medical Research Unit No. 6, Lima and Iquitos, Peru.|The President's Malaria Initiative, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.|Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
authors.forename: Eric S
authors.initials: ES
authors.lastname: Halsey
authors.affiliation: Parasitology Department, U.S. Naval Medical Research Unit No. 6, Lima, Peru.
authors.forename: G Christian
authors.initials: GC
authors.lastname: Baldeviano
authors.affiliation: Parasitology Department, U.S. Naval Medical Research Unit No. 6, Lima, Peru.
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Edgel
authors.affiliation: Virology Department, U.S. Naval Medical Research Unit No. 6, Lima and Iquitos, Peru.
authors.forename: Stalin
authors.initials: S
authors.lastname: Vilcarromero
authors.affiliation: Infectious Diseases Department, Hospital de Apoyo, DISA-Loreto, Iquitos, Peru.
authors.forename: Moises
authors.initials: M
authors.lastname: Sihuincha
authors.affiliation: Parasitology Department, U.S. Naval Medical Research Unit No. 6, Lima, Peru.|School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru.
authors.forename: Andres G
authors.initials: AG
authors.lastname: Lescano
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood*; D002648:Child; D060085:Coinfection / Q000473:pathology*; D003371:Cough / Q000473:pathology; D016207:Cytokines / Q000097:blood; D003715:Dengue / Q000150:complications* / Q000473:pathology*; D005260:Female; D006801:Humans; D008288:Malaria / Q000150:complications* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D063806:Myalgia / Q000473:pathology; D010568:Peru; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D015415:Biomarkers; D016207:Cytokines