在 HIV-1 低流行人群中，没有证据表明 HIV-1 与疟疾之间存在关联。
No evidence of association between HIV-1 and malaria in populations with low HIV-1 prevalence.
机构信息
Department of Biology, University of Kentucky, Lexington, Kentucky, United States of America.
出版信息
PLoS One. 2011;6(8):e23458. doi: 10.1371/journal.pone.0023458. Epub 2011 Aug 12.
BACKGROUND
The geographic overlap between HIV-1 and malaria has generated much interest in their potential interactions. A variety of studies have evidenced a complex HIV-malaria interaction within individuals and populations that may have dramatic effects, but the causes and implications of this co-infection at the population level are still unclear. In a previous publication, we showed that the prevalence of malaria caused by the parasite Plasmodium falciparum is associated with HIV infection in eastern sub-Saharan Africa. To complement our knowledge of the HIV-malaria co-infection, the objective of this work was to assess the relationship between malaria and HIV prevalence in the western region of sub-Saharan Africa.
METHODOLOGY/PRINCIPAL FINDINGS: Population-based cross-sectional data were obtained from the HIV/AIDS Demographic and Health Surveys conducted in Burkina Faso, Ghana, Guinea, Mali, Liberia and Cameroon, and the malaria atlas project. Using generalized linear mixed models, we assessed the relationship between HIV-1 and Plasmodium falciparum parasite rate (PfPR) adjusting for important socio-economic and biological cofactors. We found no evidence that individuals living in areas with stable malaria transmission (PfPR>0.46) have higher odds of being HIV-positive than individuals who live in areas with PfPR≤0.46 in western sub-Saharan Africa (estimated odds ratio 1.14, 95% confidence interval 0.86-1.50). In contrast, the results suggested that PfPR was associated with being infected with HIV in Cameroon (estimated odds ratio 1.56, 95% confidence interval 1.23-2.00).
CONCLUSION/SIGNIFICANCE: Contrary to our previous research on eastern sub-Saharan Africa, this study did not identify an association between PfPR and infection with HIV in western sub-Saharan Africa, which suggests that malaria might not play an important role in the spread of HIV in populations where the HIV prevalence is low. Our work highlights the importance of understanding the epidemiologic effect of co-infection and the relevant factors involved in this relationship for the implementation of effective control strategies.
背景
HIV-1 和疟疾的地理重叠引起了人们对它们之间潜在相互作用的极大兴趣。各种研究都证明了个体和人群中 HIV-疟疾的相互作用非常复杂，这种相互作用可能会产生巨大影响，但在人群层面上，这种合并感染的原因和影响仍不清楚。在之前的一篇论文中，我们发现寄生虫疟原虫引起的疟疾流行率与东非撒哈拉以南地区的 HIV 感染有关。为了补充我们对 HIV-疟疾合并感染的认识，本研究的目的是评估撒哈拉以南非洲西部地区疟疾和 HIV 流行率之间的关系。
方法/主要发现：我们从布基纳法索、加纳、几内亚、马里、利比里亚和喀麦隆的艾滋病毒/艾滋病人口与健康调查以及疟疾地图集项目中获得了基于人群的横断面数据。使用广义线性混合模型，我们调整了重要的社会经济和生物学协变量，评估了 HIV-1 和恶性疟原虫寄生虫率（PfPR）之间的关系。我们没有发现证据表明生活在稳定疟疾传播地区（PfPR>0.46）的个体比生活在 PfPR≤0.46地区的个体更有可能感染 HIV，这与撒哈拉以南非洲西部的情况相反（估计比值比为 1.14，95%置信区间为 0.86-1.50）。相比之下，结果表明 PfPR 与喀麦隆的 HIV 感染有关（估计比值比为 1.56，95%置信区间为 1.23-2.00）。
结论/意义：与我们之前对东非撒哈拉以南地区的研究相反，本研究没有发现 PfPR 与西撒哈拉以南非洲的 HIV 感染之间存在关联，这表明在 HIV 流行率较低的人群中，疟疾可能不会在 HIV 的传播中发挥重要作用。我们的工作强调了理解合并感染的流行病学效应以及这种关系中涉及的相关因素对于实施有效控制策略的重要性。
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