Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC 27599, USA.
Am J Trop Med Hyg. 2012 Dec;87(6):1022-7. doi: 10.4269/ajtmh.2012.12-0392. Epub 2012 Oct 8.
Human immunodeficiency virus (HIV) is common in pregnant women in many malaria-endemic regions and may increase risk of placental parasitemia. Placental malaria is more common in primigravidae than multigravidae, but the relationship between HIV and malaria across gravidities is not well characterized. We recruited pregnant Malawian women during the second trimester and followed them until delivery. Parasitemia was assessed at enrollment, follow-up visits, and delivery, when placental blood was sampled. There was no difference in risk of parasitemia between HIV-positive and HIV-negative primigravidae. Among multigravidae, HIV-infected women had greater than twice the risk of parasitemia as HIV-uninfected women throughout follow-up. Human immunodeficiency virus was also associated with more frequent peripheral parasitemia in multigravidae but not primigravidae. Both HIV and primigravid status were independently associated with higher peripheral and placental parasite densities. Although risk of parasitemia is lower in multigravidae than primigravidae, the HIV effect on risk of malaria is more pronounced in multigravidae.
人类免疫缺陷病毒（HIV）在许多疟疾流行地区的孕妇中很常见，可能会增加胎盘疟原虫感染的风险。初产妇比经产妇更容易发生胎盘疟疾，但 HIV 和疟疾在妊娠次数之间的关系尚未得到很好的描述。我们在妊娠中期招募了马拉维孕妇，并对她们进行了随访，直到分娩。在入组时、随访时和分娩时抽取胎盘血样进行寄生虫血症评估。HIV 阳性和 HIV 阴性初产妇之间寄生虫血症的风险没有差异。在经产妇中，HIV 感染的妇女在整个随访期间发生寄生虫血症的风险是 HIV 未感染妇女的两倍多。HIV 还与经产妇外周寄生虫血症的发生频率增加有关，但与初产妇无关。HIV 和初产妇状态都与更高的外周和胎盘寄生虫密度独立相关。尽管经产妇的寄生虫血症风险低于初产妇，但 HIV 对疟疾风险的影响在经产妇中更为明显。
