Clinical profile of malaria and HIV co-infection

Tudu K.M., Bariha M.K., Mohapatra M.K. et al International Journal of Advances in Medicine (2020) C2
This study, conducted by Tudu et al. (2020), explores the clinical characteristics and outcomes of patients with concurrent malaria and HIV infection, a combination that is relatively understudied in India. The research was carried out at the Department of Medicine, VIMSAR, Odisha, over a one-year period and included patients who presented with fever lasting up to seven days. Out of 340 patients diagnosed with malaria, 52 (15.29%) were found to also be HIV-positive. The patients were divided into three groups: Group A with malaria and HIV co-infection, Group B with HIV mono-infection, and Group C with malaria mono-infection. The clinical presentation in co-infected patients resembled that of HIV more closely than malaria. Common symptoms in the co-infected group included fever (82.7%), vomiting (72.3%), anemia (72.3%), headache (65.4%), and aspiration pneumonia (57.7%). Laboratory findings revealed that a significant number of co-infected patients had hemoglobin levels below 7 g/dL and CD4 cell counts under 200 cells/μL, indicating advanced immunosuppression. All patients received antimalarial treatment with injectable artesunate and antiretroviral therapy (ART). Despite appropriate treatment, the outcome for co-infected patients was comparatively worse: while 48 out of 52 recovered, 6 patients died, mainly due to complications such as anemia, acute kidney injury, and aspiration pneumonia. In conclusion, the study highlights that although malaria-HIV co-infection is not highly prevalent, it is associated with severe clinical outcomes. Routine screening for both infections in febrile patients is recommended to ensure timely diagnosis and treatment.