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HIV/Malaria Co-Infection Nearly Doubles HIV Viral Load, Increases Chance of Transmission, Study Says

January 24, 2005

The HIV viral load levels of an HIV-positive person nearly doubles when he or she becomes co-infected with malaria, increasing the likelihood that the person could transmit the virus to someone else, according to a study published in the Jan. 15 issue of the journal Lancet, the United Kingdom's SciDev.Net reports. Dr. James Kublin, a clinical researcher at the Fred Hutchinson Cancer Research Center in Seattle, and colleagues studied the HIV viral loads of 367 people in Malawi's Thyolo District, 148 of whom contracted malaria during the study. Researchers attempted to collect viral load data on all 148 HIV/malaria co-infected people, but the team was able to gather sufficient data from only 77 of the participants, according to SciDev.Net. Among the co-infected participants, HIV concentration on average was double what it had been before malaria infection, increasing from an average of 96,215 copies of HIV per milliliter of blood to 168,901 copies per milliliter. However, eight to nine weeks after being treated for malaria, the median HIV viral load in the patients returned to levels similar to those recorded before malaria infection. The study concludes that the increase in HIV viral load when contracting malaria could be sustained long enough to increase the risk of HIV transmission to other people, SciDev.Net reports.

Reaction and Recommendations
In an accompanying Lancet opinion piece, James Whitworth of the London School Hygiene and Tropical Medicine and Kirsten Hewitt of the Health Protection Agency Centre For Infections write that "better integration of health services" for HIV and malaria is "crucial" if even a small increase in the likelihood of HIV transmission occurs when a person contracts malaria, according to SciDev.Net/AllAfrica.com. Whitworth and Hewitt write that viral loads reported in the study might equate to about a 50% increase in the likelihood of HIV transmission, according to SciDev.Net. However, Neil French of the Malawi-Liverpool Wellcome Trust laboratories said discovering the "exact interaction" between HIV and malaria would be difficult because of ethical concerns given that potential study participants would be required to abstain from treatment for both diseases, according to SciDev.Net. French recommended that disease control programs "come together to provide a comprehensive package of care," including providing bed nets to HIV-positive people to reduce the chance of contracting malaria, SciDev.Net reports (Shetty, SciDev.Net, 1/20).

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