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.