Martin-Blondel G, Barry M, Porte L, Busato F, Massip P, Benoit-Vical F, Berry A, Marchou B
Service des maladies infectieuses et tropicales, hôpital Purpan, place du Docteur-Baylac, TSA 40031, 31059 Toulouse cedex 09, France.
Med Mal Infect. 2007 Oct;37(10):629-36. doi: 10.1016/j.medmal.2007.03.018. Epub 2007 Jul 12.
Malaria and HIV are two major public health issues, especially in sub-Saharan Africa. The impact of HIV infection on malaria depends on the patient's immune status: immunodepression level but also immunity against Plasmodium. HIV infection increases the incidence of clinical malaria, inversely correlated with the degree of immunodepression, but the severity and mortality are increased only in areas of unstable malaria. In severe malaria the level of parasitemia is similar in HIV-positive and HIV-negative patients. During pregnancy, HIV infection increases the incidence of clinical malaria, maternal morbidity, and fetal and neonatal morbi-mortality. Sulfa-based therapies reduce the risk of malaria, most importantly in pregnancy. HIV infection increases the risk of treatment failure, mainly with sulfa-based therapies, due to re-infection or parasitic recrudescence. Further studies are needed to determine the pathophysiological interactions between HIV infection and malaria.
疟疾和艾滋病毒是两个主要的公共卫生问题，在撒哈拉以南非洲地区尤为如此。艾滋病毒感染对疟疾的影响取决于患者的免疫状态：免疫抑制水平以及对疟原虫的免疫力。艾滋病毒感染会增加临床疟疾的发病率，这与免疫抑制程度呈负相关，但只有在疟疾不稳定地区，其严重程度和死亡率才会增加。在重症疟疾中，艾滋病毒阳性和阴性患者的疟原虫血症水平相似。在怀孕期间，艾滋病毒感染会增加临床疟疾的发病率、孕产妇发病率以及胎儿和新生儿的发病死亡率。磺胺类疗法可降低疟疾风险，在孕期尤为重要。由于再次感染或寄生虫复发，艾滋病毒感染会增加治疗失败的风险，主要是使用磺胺类疗法时。需要进一步研究以确定艾滋病毒感染与疟疾之间的病理生理相互作用。
