Slutsker Laurence, Marston Barbara J
Malaria Branch, Division of Parasitic Diseases, National Center for Zoonotic, Vectorborne, and Enteric Diseases (proposed), Centers for Disease Control and Prevention, Department of Health and Human Services, Atlanta, Georgia 30341, USA.
Curr Opin Infect Dis. 2007 Feb;20(1):3-10. doi: 10.1097/QCO.0b013e328012c5cd.
This review summarizes accumulating evidence of interactions between HIV and malaria and implications related to prevention and treatment of coinfection.
HIV-infected persons are at increased risk for clinical malaria; the risk is greatest when immune suppression is advanced. Adults with advanced HIV may be at risk for failure of malaria treatment, especially with sulfa-based therapies. Malaria is associated with increases in HIV viral load that, while modest, may impact HIV progression or the risk of HIV transmission. Cotrimoxazole prophylaxis greatly reduces the risk of malaria in people with HIV; the risk can be further reduced with antiretroviral treatment and the use of insecticide treated mosquito nets. Increased numbers of doses of intermittent preventive treatment during pregnancy can reduce the risk of placental malaria in women with HIV.
Interactions between malaria and HIV have important public health implications. People with HIV should use cotrimoxazole and insecticide treated mosquito nets. Malaria prevention is particularly important for pregnant women with HIV, although more information is needed about the best combination of strategies for prevention. In people with HIV, malaria diagnoses should be confirmed, highly effective drugs should be used for treatment, and possible drug interactions should be considered.
本综述总结了关于HIV与疟疾相互作用的越来越多的证据以及与合并感染的预防和治疗相关的影响。
HIV感染者患临床疟疾的风险增加；当免疫抑制严重时风险最大。晚期HIV感染的成年人可能有疟疾治疗失败的风险，尤其是使用基于磺胺类的疗法时。疟疾与HIV病毒载量增加有关，虽然增幅不大，但可能影响HIV的进展或传播风险。复方新诺明预防可大大降低HIV感染者患疟疾的风险；抗逆转录病毒治疗和使用经杀虫剂处理的蚊帐可进一步降低该风险。孕期增加间歇性预防治疗的剂量可降低HIV感染女性患胎盘疟疾的风险。
疟疾与HIV之间的相互作用具有重要的公共卫生意义。HIV感染者应使用复方新诺明和经杀虫剂处理的蚊帐。疟疾预防对感染HIV的孕妇尤为重要，尽管需要更多关于最佳预防策略组合的信息。对于HIV感染者，应确诊疟疾，使用高效药物进行治疗，并考虑可能的药物相互作用。
