Implications of asymptomatic malaria infections on hematologic parameters in adults living with HIV in malaria-endemic regions with varying transmission intensities

Int J Infect Dis. 2023 Dec:137:82-89. doi: 10.1016/j.ijid.2023.09.018. Epub 2023 Oct 1.

Abstract

Objectives: HIV and malaria coinfection impacts disease management and clinical outcomes. This study investigated hematologic abnormalities in malaria-asymptomatic people living with HIV (PLHIV) in regions with differing malaria transmission.

Methods: Study participants were enrolled in the African Cohort Study: two sites in Kenya, one in Uganda, and one in Nigeria. Data was collected at enrollment and every 6 months. Logistic regression estimated odds ratios for associations between HIV/malaria status and anemia, thrombocytopenia, and leucopenia.

Results: Samples from 1587 participants with one or more visits comprising 1471 (92.7%) from PLHIV and 116 (7.3%) without HIV were analyzed. Parasite point prevalence significantly differed across the study sites (P <0.001). PLHIV had higher odds of anemia, with males at lower odds compared to females; the odds of anemia decreased with age, reaching significance in those ≥50 years old. Participants in Kisumu, Kenya had higher odds of anemia compared to other sites. PLHIV had higher odds of leucopenia, but malaria co-infection was not associated with worsened leucopenia. The odds of thrombocytopenia were decreased in HIV/malaria co-infection compared to the uninfected group.

Conclusion: Hematological parameters are important indicators of health and disease. In PLHIV with asymptomatic malaria co-infection enrolled across four geographic sites in three African countries, abnormalities in hematologic parameters differ in different malaria transmission settings and are region-specific.

Keywords: Asymptomatic malaria; HIV; Hematologic abnormalities; Kenya; Nigeria; Uganda.

MeSH terms

  • Adult
  • Anemia* / epidemiology
  • Asymptomatic Infections / epidemiology
  • Cohort Studies
  • Coinfection* / complications
  • Coinfection* / epidemiology
  • Female
  • HIV Infections* / complications
  • HIV Infections* / epidemiology
  • Humans
  • Kenya / epidemiology
  • Malaria* / complications
  • Malaria* / epidemiology
  • Male
  • Middle Aged
  • Prevalence
  • Thrombocytopenia*