Impact of HIV-1 infection on the hematological recovery after clinical malaria

• Published in: Journal of acquired immune deficiency syndromes (1999) Vol. 50; no. 2; p. 200
• Main Authors: Van Geertruyden, Jean-Pierre, Mulenga, Modest, Chalwe, Victor, Michael, Nambozi, Moerman, Filip, Mukwamataba, Doreen, Colebunders, Robert, D'alessandro, Umberto
• Format: Journal Article
• Language: English
• Published: United States 01.02.2009
• Subjects: Anemia - blood; Anemia - parasitology; Animals; Antimalarials - therapeutic use; Female; Hemoglobins - analysis; HIV Infections - complications; HIV Infections - immunology; HIV Infections - virology; HIV-1; Humans; Malaria, Falciparum - complications; Malaria, Falciparum - drug therapy; Malaria, Falciparum - parasitology; Male; Multivariate Analysis; Plasmodium falciparum; Risk Factors; Treatment Outcome; Zambia; Zambia
• ISSN: 1525-4135
• DOI: 10.1097/QAI.0b013e3181900159

Anemia is the most frequent cytopenia in HIV-infected individuals and is often associated with malaria. To assess the impact of HIV-1 on the hematological recovery after a clinical malaria episode. In Ndola, Zambia, a region with high malaria and HIV prevalence, hemoglobin (Hb) was measured in 634 malaria patients 14 and 45 days after antimalarial treatment. Risk factors for hematological recovery were analyzed in a multivariate linear regression model. At enrollment, HIV-1-infected malaria patients had lower Hb compared with HIV-1 uninfected (122.7 vs 136.0 g/L; P < 0.001). In both groups, mean Hb was significantly lower at day 14 posttreatment than day 0 (P < 0.0001) and significantly higher at day 45 than at day 14 (HIV-1 negative: P = 0.0001; HIV-1 infected: P = 0.005). HIV-1 was a risk factor for a larger Hb decrease until day 14 (P < 0.001) and slower recovery until day 45 (P = 0.048). When considering the whole 45-day follow-up period, mean Hb increased in the HIV-1-negative group (+3.54 g/L; 95% confidence interval: 1.37 to 5.70; P = 0.001) but not in the HIV-1-infected group (-0.72 g/L; 95% confidence interval: -3.85 to +2.40; P = 0.64). HIV-1 infection as such (P < 0.0001), not CD4 cell count (P = 0.46), was an independent risk factor for a slower hematological recovery. HIV-1-infected malaria patients had a slower hematological recovery after successful parasite clearance. Malaria preventive measures should be targeted to this high-risk group.