Martin-Blondel G, Soumah M, Camara B, Chabrol A, Porte L, Delobel P, Cuzin L, Berry A, Massip P, Marchou B
Service des maladies infectieuses et tropicales, hôpital Purpan, place du Docteur-Baylac, TSA 40031, 31059 Toulouse cedex 9, France.
Med Mal Infect. 2010 May;40(5):256-67. doi: 10.1016/j.medmal.2009.10.008. Epub 2009 Nov 29.
Malaria and HIV are two major public health issues, especially in sub-Saharan Africa. HIV infection increases the incidence of clinical malaria, inversely correlated with the degree of immunodepression. The effect of malaria on HIV infection is not as well established. Malaria, when fever and parasitemia are high, may be associated with transient increases in HIV viral load. The effect of subclinical malaria on HIV viral load is uncertain. During pregnancy, placental malaria is associated with higher plasma and placental HIV viral loads, independently of the severity of immunodeficiency. However, the clinical impact of these transient increases of HIV viral load remains unknown. Although some data suggests that malaria might enhance sexual and mother-to-child transmissions, no clinical study has confirmed this. Nevertheless pregnant women and children with malaria-induced anemia are also exposed to HIV through blood transfusions. Integrated HIV and malaria control programs in the regions where both infections overlap are necessary.
疟疾和艾滋病是两大主要的公共卫生问题,在撒哈拉以南非洲地区尤为突出。艾滋病毒感染会增加临床疟疾的发病率,且与免疫抑制程度呈负相关。疟疾对艾滋病毒感染的影响尚不明确。当发热和寄生虫血症严重时,疟疾可能与艾滋病毒病毒载量的短暂升高有关。亚临床疟疾对艾滋病毒病毒载量的影响尚不确定。在孕期,胎盘疟疾与血浆及胎盘艾滋病毒病毒载量升高有关,与免疫缺陷的严重程度无关。然而,这些艾滋病毒病毒载量短暂升高的临床影响仍不明确。尽管一些数据表明疟疾可能会增加性传播及母婴传播,但尚无临床研究证实这一点。不过,因疟疾导致贫血的孕妇和儿童也会通过输血接触到艾滋病毒。在这两种感染重叠的地区,有必要实施综合的艾滋病毒和疟疾防控项目。