Malaria in immuno-suppressed individuals on antiretroviral therapy (ART) in north-central Nigeria

Abstract

The immune deficiency caused by HIV infection reduces the immune response to malaria parasitaemia and therefore leads to an increased frequency of clinical attacks of malaria. The burden of malaria in HIV-infected adults on antiretroviral therapy (ART) was determined and the association between immunological status of these HIV-infected individuals with malaria parasite was investigated. One hundred and twenty blood samples were collected from HIV infected adult volunteers on ART in Abuja and its surrounding communities. Demographic information as well as weight of participants were obtained. Blood samples were subjected to thick and thin blood films for malaria parasites and CD4 cell count quantification. Hematological parameters such as PCV, WBC and differential counts were also obtained from these blood samples. Malaria was diagnosed in 51 (42.5%) out of the 120 volunteers. Lower CD4 cell counts were associated with increased rate of malaria which was 44.1% at CD4 cell count of ≤ 200 cells/μL and 40.4% at >200 cells/μL (p<0.05). Hematological parameters also showed significant relationship at p<0.05. Severely immuno-suppressed HIV infected patients are at greater risk of malaria infection, hence the need for a more aggressive malaria control measures especially among these group of individuals.

Keywords: HIV; immuno-suppressed; ART; malaria