Prolonged elevation of viral loads in HIV-1-infected children in a region of intense malaria transmission in Northern Uganda: a prospective cohort study
2010

Impact of Malaria on HIV-1 Viral Loads in Children

Sample size: 135 publication Evidence: moderate

Author Information

Author(s): Kiyingi Herbert Samuel, Egwang Thomas Gordon, Nannyonga Maria

Primary Institution: St. Raphael of St. Francis Nsambya Hospital/Elizabeth Glaser Pediatric AIDS Foundation Collaboration

Hypothesis

P. falciparum infections increase HIV-1 viral loads in children living with AIDS.

Conclusion

Malaria is associated with increased HIV-1 viral loads in children, with some levels remaining elevated weeks after treatment.

Supporting Evidence

  • Malaria increased HIV-1 viral load significantly in children living with AIDS.
  • Low parasitemia transiently increased viral load by 0.42 log.
  • Higher parasitemia resulted in a mean increase in viral load of 0.53 log.
  • Viral loads returned to baseline levels after treatment in most cases.
  • Children with high parasitemia had significantly elevated viral loads even after treatment.

Takeaway

When kids with HIV get malaria, their HIV levels can go up a lot, even after they get treated for malaria.

Methodology

135 HIV-1 positive children were followed for one year to measure HIV-1 viral loads at three time points: baseline, during malaria, and post-malaria.

Potential Biases

Potential bias due to exclusion of children with other infections and the variability in age among participants.

Limitations

The study was limited by the use of cotrimoxazole prophylaxis, potential non-compliance with treatment, and the inability to assess subclinical malaria.

Participant Demographics

135 HIV-1 positive children aged 1.5 to 12 years, with 60% female and 45% under 5 years old.

Statistical Information

P-Value

0.0002

Confidence Interval

95% CI 0.29-0.78

Statistical Significance

p<0.0001

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