The interaction between HIV and malaria is increasing the prevalence of both diseases in sub-Saharan Africa, according to a study published in the Dec. 8 issue of the journal Science, the Washington Post reports (Washington Post, 12/8). Laith Abu-Raddad of the University of Washington and the Fred Hutchinson Cancer Research Center and colleagues using a mathematical model examined HIV and malaria coinfection data gathered in Malawi by James Kublin, a study co-author from FHCRC, Reuters reports. The model enabled the researchers to quantify the "synergy" between HIV and malaria, which kills more than 1 million people annually, in sub-Saharan Africa, according to Reuters (Dunham, Reuters, 12/7). According to the AP/Houston Chronicle, HIV transmission occurs most easily when a person has high viral load. The study -- funded in part by the University of Washington Center for AIDS and STD and FHCRC -- found that malaria causes a sevenfold increase in viral load that lasts six to eight weeks. In addition, the study found that HIV-positive people are more susceptible to malaria because their immune systems are weakened. In regions where both diseases are common, HIV might be responsible for almost 10% of malaria cases, and malaria might be responsible for about 5% of HIV cases, according to Abu-Raddad. The researchers focused their work in Kisumu, Kenya, where they applied the mathematical model to determine that 8,500 additional HIV cases and 980,000 extra malaria cases during a 20-year period were the result of coinfection, Abu-Raddad said (Neergaard, AP/Houston Chronicle, 12/7).

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"While HIV/AIDS is predominantly spreading through sexual intercourse, this biological cofactor induced by malaria has contributed considerably to the spread of HIV by increasing HIV transmission probability per sexual act," Abu-Raddad said (AFP/Yahoo! News, 12/8). He added that malaria could be considered a third serious factor in the spread of HIV, in addition to lack of male circumcision and the presence of genital herpes (Reuters, 12/7). In addition, "the weakening of the immune system by HIV infection has fueled a rise" in adult malaria cases and "may have facilitated the expansion of malaria in Africa," Kublin said (AFP/Yahoo! News, 12/8). According to Anthony Fauci, director of NIH's National Institute of Allergy and Infectious Diseases, the study is "an important paper." He added, "We really need to be much more serious about what we do about malaria at the same time we're serious about what we do about HIV." Malaria programs "assume a much, much greater imperative when you realize not only are you going to have an impact on one disease, but you might impact another disease," Fauci said. Kublin said that malaria prevention programs need to target HIV-positive people and that it is necessary to expand access to antiretroviral treatment (AP/Houston Chronicle, 12/7).

The study is available online.

NPR's "Morning Edition" on Friday reported on the study. The segment includes comments from Abu-Raddad; Richard Feachem, executive director of the Global Fund To Fight AIDS, Tuberculosis and Malaria; Kublin; and James Whitworth, head of international health programs at the Wellcome Trust (Knox, "Morning Edition," NPR, 12/8). Audio of the segment is available online.

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