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Co-Endemicity of Plasmodium falciparum and HIV-Infections in Treated Patients is Uncorrelated in Benin City, Nigeria

Frederick, Olusegun Akinbo, Richard Omoregie, Luke Dixon, Kyle Brown, Richard Wilson, Mastanna Eraifej, Sabrina Peoples, Adam Curtis, Skyler Battle, Dymekea Bellamy, Lea Shyneque, Rocetia Robinson, DC Ghislaine Mayer and Johanna Marie Porter-Kelley

The Human immunodeficiency virus (HIV) and malaria are two of the world’s most formidable pathogens. Coinfection has been shown to amplify the effects of both diseases with HIV infection enhancing the severity of malaria. Previous work in our laboratory has shown that individuals infected with malaria and HIV who are taking anti-retrovirals have the Plasmodium parasite in their bloodstream suggesting that the lack of anti-malarials in their drug regimen resulted in Plasmodium infection. In this study, we set out to determine the status of Plasmodium infection in a cohort of patients taking both anti-malarial and anti-retroviral drugs. Blood samples were collected from patients of the Edo district of Nigeria in Benin City co-infected with Plasmodium and HIV. We have found that 31 out of the 317 (9.78%) HIV patients on HAART and ACT had Plasmodium in their blood based on microscopic counts. Surprisingly, using the polymerase chain reaction (PCR), the prevalence was at 25.6% for Plasmodium. In addition, we have identified by PCR that Plasmodium falciparum is the only species infecting these patients. Furthermore, no significant relationship was found to exist between CD4+ T-cell counts and malarial infections (CD4 count<200 cells/µL (7.20%)) nor was the malaria parasite density significantly associated with CD4 count<200 cells/µL (P=0.595) in this study population in Benin City, Nigeria. These results suggest that other factors are involved in this complex interaction.

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