Interactions between malaria and human immunodeficiency virus anno 2014.

Area of Science:

• Tropical medicine
• Infectious diseases
• Immunology

Background:

• Interactions between human immunodeficiency virus (HIV) and tropical pathogens like malaria are a significant concern in tropical regions.
• HIV-related immunosuppression increases malaria infection, burden, treatment failure, and complications.
• Emerging antiretroviral therapies (ART) and antimalarials necessitate understanding their combined effects on efficacy and toxicity.

Purpose of the Study:

• To review the complex interactions between HIV and malaria, focusing on treatment and prevention strategies.
• To evaluate the impact of current HIV interventions on malaria outcomes.
• To provide guidance on malaria management in HIV-infected populations.

Main Methods:

• Literature review of studies investigating HIV-malaria interactions.
• Analysis of clinical and epidemiological data on coinfection.
• Assessment of drug interactions between antiretrovirals and antimalarials.

Main Results:

• HIV immunosuppression correlates with increased malaria severity and treatment failure.
• Co-trimoxazole prophylaxis demonstrates potent antimalarial properties.
• Certain antiretrovirals (e.g., protease inhibitors, ritonavir-boosted lopinavir) show synergistic effects with antimalarials, improving outcomes without increased toxicity.
• Efavirenz combined with amodiaquine-artesunate may increase toxicity.

Conclusions:

• Current standards of care for malaria prevention and treatment in HIV-infected individuals are largely similar to the general population.
• Widespread use of insecticide-treated bed nets, co-trimoxazole prophylaxis, and ART significantly reduces malaria morbidity in HIV patients.
• Confirmatory malaria diagnosis is essential in HIV-infected individuals receiving these interventions to guide appropriate treatment with artemisinin-based combination therapies.