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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Increased severe anemia in HIV-1-exposed and HIV-1-positive infants and children during acute malaria
AIDS, Volume 20, No. 2, Year 2006
Notification
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Description
Objective: Since the primary hematological complication in both pediatric HIV-1 and malaria is anemia, co-infection with these pathogens may promote life-threatening severe malarial anemia (SMA). The primary objective of the study was to determine if HIV-1 exposure [HIV-1 (exp)] and/or HIV-1 infection [HIV-1(+)] increased the prevalence of SMA in children with acute malaria. Design: The effect of HIV-1 exposure and HIV-1 infection on the prevalence of SMA (hemoglobin < 6.0 g/dl), parasitemia (parasites/μl), and high-density parasitemia (HDP, ≥ 10 000 parasites/μl) was investigated in children ≤ 2 years of age presenting at hospital with acute Plasmodium falciparum malaria in a rural holoendemic malaria transmission area of western Kenya. Methods: Upon enrollment, a complete hematological and clinical evaluation was performed on all children. Malaria parasitemia was determined and children with acute P. falciparum malaria were evaluated for HIV-1 exposure and infection by two rapid serological antibody tests and HIV-1 DNA PCR, respectively. Results: Relative to HIV-1(-) group (n = 194), the HIV-1 (exp) (n = 100) and HIV-1(+) (n = 23) groups had lower hemoglobin concentrations (P < 0.001 and P < 0.001, respectively), while parasitemia and HDP were equivalent between the three groups. Multivariate analyses demonstrated that the risk of SMA was elevated in HIV-1(exp) children (odds ratio, 2.17; 95% confidence interval, 1.25-3.78; P < 0.01) and HIV-1(+) children (odds ratio, 8.71; 95% confidence interval, 3.37-22.51; P < 0.0001). The multivariate model further revealed that HIV-1 exposure or infection were not significantly associated with HDP. Conclusions: Results presented here demonstrate that both HIV-1 exposure and HIV-1 infection are associated with increased prevalence of SMA during acute P. falciparum infection, independent of parasite density. © 2006 Lippincott Williams & Wilkins.
Authors & Co-Authors
Otieno, Richard O.
Kenya, Maseno
Maseno University
United States, Pittsburgh
University of Pittsburgh
Ouma, Collins
United States, Pittsburgh
University of Pittsburgh
Kenya, Nairobi
Kenyatta University
Ong'Echa, John Michael O.
United States, Pittsburgh
University of Pittsburgh
Keller, Christopher C.
United States, Pittsburgh
University of Pittsburgh Graduate School of Public Health
Were, Tom
United States, Pittsburgh
University of Pittsburgh
Kenya, Nairobi
Kenyatta University
Waindi, Eliud Nyandago
Kenya, Maseno
Maseno University
Michaels, Marian G.
United States, Pittsburgh
Upmc Children’s Hospital of Pittsburgh
Day, Richard D.
United States, Pittsburgh
University of Pittsburgh Graduate School of Public Health
Vulule, John M.
Kenya, Nairobi
Kenya Medical Research Institute
Perkins, Douglas Jay
United States, Pittsburgh
University of Pittsburgh
United States, Pittsburgh
University of Pittsburgh Graduate School of Public Health
Statistics
Citations: 150
Authors: 10
Affiliations: 6
Identifiers
Doi:
10.1097/01.aids.0000200533.56490.b7
Research Areas
Genetics And Genomics
Health System And Policy
Infectious Diseases
Maternal And Child Health
Study Design
Cross Sectional Study
Case-Control Study
Study Locations
Kenya