title: Evaluation of some haemostatic parameters in falciparum malaria and HIV co-infection.
abstract: BACKGROUND
  Studies from sub-Saharan Africa where malaria is endemic have observed high incidences of malaria and HIV co-infection. It has long been accepted that malaria causes alterations in haemostatic parameters and that HIV is associated with a wide range of haematological changes. We assessed the effect of the overlap of these infections on routine haemostatic parameters.
  
  
  METHODS
  The study involved 337 subjects grouped according to their HIV and malaria status: Group 1 'Asymptomatic HIV seropositive, Plasmodium falciparum positive' (n = 61); Group 2 'Asymptomatic HIV seropositive, P. falciparum negative' (n = 73); Group 3 'Symptomatic HIV seropositive, P. falciparum positive' (n = 49); Group 4 'Symptomatic HIV positive P. falciparum negative' (n = 56); Group 5 'Control HIV negative, P. falciparum positive' (n = 52) and Group 6 'Control HIV negative, P. falciparum negative' (n = 46). Blood samples were taken for HIV testing, diagnosis of falciparum malaria and malaria parasite density counts. Citrated samples were used within one hour of collection for prothrombin time (PT) and activated partial thromboplastin time (APTT). CD4+T cell counts, platelet count and haematocrit (Hct) were also performed.
  
  
  RESULTS
  Our results demonstrate greater alterations in APTT, PT and platelet count with prolongation of APTT, PT and lower platelet counts in HIV and malaria co-infection. In spite of this, the co-infected subjects with mild to moderate parasitaemia did not show a bleeding tendency; however, the risk is higher in severe malaria.
  
  
  CONCLUSIONS
  These results suggest that co-infected subjects with severe malaria have a higher risk of bleeding and would require greater monitoring.
authors.affiliation: a Medical Laboratory Science Department , Nnamdi Azikiwe University , Nnewi , Nigeria.
authors.forename: Rebecca C
authors.initials: RC
authors.lastname: Chukwuanukwu
authors.affiliation: b Medical Laboratory Science Department , University of Nigeria , Enugu , Nigeria.
authors.forename: Ernest O
authors.initials: EO
authors.lastname: Ukaejiofo
authors.affiliation: c Institute of Human Virology Unit , Nnamdi Azikiwe University Teaching Hospital , Nnewi , Nigeria.
authors.forename: Prince U
authors.initials: PU
authors.lastname: Ele
authors.affiliation: a Medical Laboratory Science Department , Nnamdi Azikiwe University , Nnewi , Nigeria.
authors.forename: Charles C
authors.initials: CC
authors.lastname: Onyenekwe
authors.affiliation: d Surgery Department , Nnamdi Azikiwe University/Teaching Hospital , Nnewi , Nigeria.
authors.forename: Titus O
authors.initials: TO
authors.lastname: Chukwuanukwu
authors.affiliation: a Medical Laboratory Science Department , Nnamdi Azikiwe University , Nnewi , Nigeria.
authors.forename: Martin O
authors.initials: MO
authors.lastname: Ifeanyichukwu
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D018791:CD4 Lymphocyte Count; D060085:Coinfection / Q000097:blood* / Q000382:microbiology / Q000821:virology; D015897:Comorbidity; D005260:Female; D015658:HIV Infections / Q000097:blood* / Q000453:epidemiology / Q000821:virology; D006679:HIV Seropositivity / Q000097:blood* / Q000453:epidemiology / Q000821:virology; D015497:HIV-1 / Q000502:physiology; D015498:HIV-2 / Q000502:physiology; D006400:Hematocrit; D054884:Host-Pathogen Interactions; D006801:Humans; D015994:Incidence; D016778:Malaria, Falciparum / Q000097:blood* / Q000453:epidemiology / Q000469:parasitology; D008297:Male; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D010314:Partial Thromboplastin Time; D010963:Plasmodium falciparum / Q000502:physiology; D010976:Platelet Count; D011517:Prothrombin Time; D055815:Young Adult
keywords: Coagulation; HIV; HIV/malaria co-infection; asymptomatic; malaria; symptomatic