Yaffe I
Med Hypotheses. 2001 Oct;57(4):419-22. doi: 10.1054/mehy.2001.1299.
The presented hypothesis suggests that chronic latent malaria infection prepares the niche where the otherwise feeble HIV coinfection can thrive and cause AIDS. It is suggested that the roots of the HIV outbreak and AIDS pandemic lay in the urbanization processes in Africa that resulted in the eradication of the Anopheles vector from previously endemic areas, which changed the immunological status of the inhabitants there as they lost their natural immunity to malaria. Since malarial parasites may persist in the lymphatic network for a lifetime and reduce T cell proliferation while adhering to immature dendritic cells, the loss of this natural immunity made the African population, which was chronically affected with scanty parasitemia, vulnerable to opportunistic infections, HIV among them. The specific transmission modes of latent malaria infection elucidate why AIDS flares up in Africa and spreads there evenly in the population, while in the West it expands rather slowly and is restricted mainly to homosexuals and blood recipients.
提出的假说表明，慢性潜伏性疟疾感染为原本微弱的HIV合并感染创造了能够蓬勃发展并导致艾滋病的环境。有人认为，HIV爆发和艾滋病流行的根源在于非洲的城市化进程，这导致按蚊媒介从以前的流行地区被根除，改变了当地居民的免疫状态，因为他们失去了对疟疾的天然免疫力。由于疟原虫可能在淋巴网络中终生存在，并在粘附于未成熟树突状细胞时减少T细胞增殖，这种天然免疫力的丧失使长期受微量寄生虫血症影响的非洲人群易患机会性感染，其中包括HIV。潜伏性疟疾感染的特定传播方式解释了为什么艾滋病在非洲爆发并在人群中均匀传播，而在西方它传播得相当缓慢，并且主要局限于同性恋者和输血者。
