Institute for Infectious and Tropical Diseases, University of Brescia. Brescia, Italy.
Mediterr J Hematol Infect Dis. 2012;4(1):e2012032. doi: 10.4084/MJHID.2012.032. Epub 2012 May 7.
Malaria and HIV/AIDS are among the principal causes of morbidity and mortality worldwide, particularly in resource-limited settings such as sub-Saharan Africa. Despite the international community's efforts to reduce incidence and prevalence of these diseases, they remain a global public health problem. Clinical manifestations of malaria may be more severe in HIV infected patients, which have higher risks of severe malaria and malaria related death. Co-infected pregnant women, children and international travelers from non-malaria endemic countries are at higher risk of clinical complications. However, there is a paucity and conflicting data regarding malaria and HIV co-infection, particularly on how HIV infection can modify the response to antimalarial drugs and about drug-interactions between antiretroviral agents and artemisinin-based combined regimens. Moreover, consulting HIV-infected international travelers and physicians specialized in HIV care and travel medicine should prescribe an adequate chemoprophylaxis in patients travelling towards malaria endemic areas and pay attention on interactions between antiretrovirals and antimalarial prophylaxis drugs in order to prevent clinical complications of this co-infection.This review aims to evaluate the available international literature on malaria and HIV co-infection in adults providing a critical comprehensive review of nowadays knowledge.
疟疾和艾滋病是全世界发病率和死亡率的主要原因之一,特别是在资源有限的环境中,如撒哈拉以南非洲。尽管国际社会努力降低这些疾病的发病率和患病率,但它们仍然是全球公共卫生问题。在感染艾滋病毒的患者中,疟疾的临床表现可能更为严重,他们罹患重症疟疾和疟疾相关死亡的风险更高。合并感染的孕妇、儿童和来自非疟疾流行国家的国际旅行者更有可能出现临床并发症。然而,关于疟疾和艾滋病毒合并感染的数据很少且相互矛盾,特别是关于艾滋病毒感染如何改变对抗疟药物的反应,以及抗逆转录病毒药物和基于青蒿素的联合疗法之间的药物相互作用。此外,咨询感染艾滋病毒的国际旅行者以及专门从事艾滋病毒护理和旅行医学的医生,应在前往疟疾流行地区的患者中开具适当的化学预防药物,并注意抗逆转录病毒药物和抗疟预防药物之间的相互作用,以预防这种合并感染的临床并发症。这篇综述旨在评估有关成人疟疾和艾滋病合并感染的现有国际文献,对当今的知识进行批判性的综合评价。