The impact of HIV-1 on the malaria parasite biomass in adults in sub-Saharan Africa contributes to the emergence of antimalarial drug resistance

Van geertruyden, Jean-Pierre; Menten, Joris; Colebunders, Robert; Korenromp, Eline; D'Alessandro, Umberto

doi:10.1186/1475-2875-7-134

Table 2 Overview of African studies on geometric mean parasite densities during uncomplicated symptomatic malaria, by HIV-1 status of the patient

From: The impact of HIV-1 on the malaria parasite biomass in adults in sub-Saharan Africa contributes to the emergence of antimalarial drug resistance

Study	Setting	Median age (range)	# patients (or malaria episodes, if indicated)	Parasite density, HIV-positive vs. HIV negative patients			Parasite density in HIV-infected: immune-suppressed vs. not immune-suppressed*
CHILDREN	HIGH ENDEMICITY			Values	% change	P-value	Values	% change	P-value
Shaffer [45]	Zaire, 1988	3.3 y	166 (6 HIV+)	93 325 vs 8 913/μL	947%	0.04	---
Mermin, 2004 [46]	Uganda, 2001–3	0–5 y	NR	154 vs 61/200 WBC	152%	0.03	---
Kamya, 2006 [47]	Uganda, 2002–4	3 y	1802	28 186 vs 20 076/μL	40%	NS	---
Otieno, 2006 [19]	Kenya, 2003–4	11 m	317	48 356 vs 47 245/μL	2%	NS	---
Greenberg, 2001 [17]	DRC, 1986–8	5–21 m	271 episodes	4 173 vs 3 854/μL	8%	NS	AIDS vs. HIV positive: 11256 vs 2394/μL	370%	0.068
Taha, 1994 [48]	Malawi, 1989	0–18 m	564 episodes	---		NS	---
Colebunders, 1990 [49]	Zaire, 1986–7	7 y	59	3 210 vs 4 170/μL	-23%	NS	---
Muller, 1990 [50]	Uganda, 1989	11 m	75	---		NS	---
ADULTS	HIGH ENDEMICITY
Mermin, 2004 [46]	Uganda, 2001–3	34 y	90 episodes	---		NS	<200 vs. ≥ 200 CD4/μL: 60 vs. 24/200 WBC	185%	0.02
French [21]	Uganda, 1995–98	31 y	153 episodes	---			Association low CD4 ↔ high parasite density		0.0001
Kamya, 2006 [47]	Uganda, 2002–4	28 y	163	20 537 vs 15 174/μL	35%	NS	---
Laufer, 2006 [22]	Malawi, 2002–3	31.7 y	203	---			Association low CD4 ↔ high parasite density		0.005
Van geertruyden, 2006 [37]	Zambia, 2003–5	27 y (15–50)	971	8 715 vs 8 538/μL	2%	NS	<300 vs. ≥ 300 CD4/μL: 10 093 vs. 7328/μL	37%	0.03
Shah, 2006 [38]	Kenya, 2002–4	Adults	619	11 732 vs 9 516/μL	22%	NS	<200 vs ≥ 200CD4/μL: 22 515 vs. 8232/μL	173%,	<0.005
Francesconi, 2001 [18]	Uganda, 2000	25 y	170	---		NS	---
Whitworth, 2000 [1]	Uganda, 1990–98	35 y	559 episodes	---		NS	Association low CD4 ↔ high parasite density		0.02
Simooya [51]	Zambia, 1988	>12 y	170	---		0.10	---
Muller, 1990 [50]	Uganda, 1989	26 y	200	---		NS	---
CHILDREN	LOW ENDEMICITY
Kalyesubula, 1997 [18]	Uganda, 1988	0–4 y	635 episodes	---		NS	---
Grimwade, 2003 [52]	South Africa, 2000	7 y	663	---		NS	---
ADULTS	LOW ENDEMICITY
Atzori, 1993 [2]	Tanzania, 1991	18–41 y	300	---		NS	---
Grimwade, 2004 [16]	South Africa, 2000	30 y	613	16.7% vs 12.5%*	34%	036	---
Birku, 2002 [36]	Ethiopia, 2000	31 y	19	27 486 vs 32 892/μL	-16%	NS	---

Abbreviations: NS = non-significant; --- = Not reported; m = months; y = years; RR = relative risk; WBC = white blood cells. *All studies except for [23] measured CD4 count during malaria episodes, which, due to the temporary decrease in CD4 caused by symptomatic malaria [24], probably inflated the CD4 threshold below which HIV-related immune-suppression starts to increase malaria incidence.

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ISSN: 1475-2875

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