Malaria an opportunistic infection in HIV/AIDS patients? - A Nigerian experience

HIV and malaria interact at the level of the host's susceptibility to infection, but little is known about the effect of HIV on malaria infection in Nigeria.

This study estimated the prevalence of malaria parasitaemia and its relationship with HIV immunodeficiency.

This cross-sectional study was conducted in two hospitals in Abuja, Nigeria between October 2012 and March 2013 among 600 respondents, comprising 200 HIV-negative controls, 200 HIV-positive patients on antiretroviral therapy (ART), and 200 HIV-positive patients not on ART. Malaria parasites, malaria density and absolute CD4 counts were carried out on all three groups. Participants with CD4 counts below 350 cells/mm³ were considered immunocompromised and likely to develop opportunistic infections.

Most study participants were aged 21-40 years (65.2%). The mean CD4 counts of HIV-positive patients not on ART (300 ± 211 cells/mm³) and those on ART (354 cells/mm³) were significantly lower than among controls (834 cells/mm³) (p < 0.001). Malaria prevalence was not statistically different between the controls (44.5%), patients on ART (40.5%), and those not on ART (39.5%) (p = 0.562). Compared to 7% immunodeficiency among controls, 56% of patients on ART and 65.5% of those not on ART had a CD4 count < 350 cells/mm³ (p < 0.001). The prevalence of malaria parasitaemia among immunodeficient individuals (42.4%) was similar to prevalence among those with CD4 counts > 350 cells/mm³ (40.8%; p = 0.695).

These findings suggest that malaria parasitaemia is not an opportunistic infection among HIV-positive individuals in Nigeria.