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Malaria in HIV/AIDS Patients at Different CD4+ T Cell Levels in Limbe, Cameroon

Helen K Kimbi, Doris T Njoh, Kenneth JN Ndamukong and Leopold G Lehman

HIV infection has resulted in an increased risk of severe malaria and death, because the odds of parasitaemia and risk of malaria fever increase with decreasing CD4+ T cell count and increasing viral load. A cross-sectional study was conducted on 203 HIV/AIDS patients to determine the pattern of malaria infection, anaemic status and the outcome of ARV therapy vis-à-vis malaria treatment at different CD4+ T cell levels of the patient. Participants were HIV patients aged ≥ 20 years attending the HIV treatment centre of Limbe Regional Hospital, Cameroon. Clinical manifestations of malaria in patients were determined using a structured questionnaire. Their CD4+ T cell count and haemoglobin level were determined using the FACS count method. Malaria prevalence and density were determined from Giemsa-stained blood films. Clinical manifestations of malaria increased with decreasing CD4+ T cell counts. There was a negative correlation between malaria severity and decreasing CD4+ T cell counts. A significantly greater proportion (p<0.01) of patients had moderate anaemia. Cases of anaemia increased significantly (p<0.001) with decreasing CD4+ T cell counts. Declining immunity increases vulnerability to malaria infection and highly active ARV combination therapy has great potential to reduce HIV-related malaria.