Hasang Wina, Dembo Edson G, Wijesinghe Rushika, Molyneux Malcolm E, Kublin James G, Rogerson Stephen
Department of Medicine, Royal Melbourne Hospital, University of Melbourne Victorian Infectious Diseases Service, Royal Melbourne Hospital, Parkville, Victoria, Australia.
Malawi-Liverpool-Wellcome Trust Clinical Research Programme, University of Malawi College of Medicine, Blantyre.
J Infect Dis. 2014 Nov 1;210(9):1407-14. doi: 10.1093/infdis/jiu262. Epub 2014 May 3.
Coinfection with human immunodeficiency virus (HIV) may increase susceptibility to malaria by compromising naturally acquired immunity.
In 339 adults (64% HIV infected), we measured antibodies to Plasmodium falciparum variant surface antigens (VSA) and antibodies that opsonise infected erythrocytes using parasite lines FCR3, E8B, and R29, and antibodies to merozoite antigens AMA-1 and MSP2. We determined the relationship between malaria antibodies, HIV infection, markers of immune compromise, and risk of incident parasitemia.
HIV-infected adults had significantly lower mean levels of opsonizing antibody to all parasite lines (P < .0001), and lower levels of antibody to AMA-1 (P = .01) and MSP2 (P < .0001). Levels of immunoglobulin G (IgG) to VSA were not affected by HIV status. Opsonising antibody titres against some isolates were positively correlated with CD4 count. There were negative associations between human immunodeficiency virus type 1 (HIV-1) viral load and opsonizing antibodies to FCR3 (P = .04), and levels of IgG to AMA-1 (P ≤ .03) and MSP2-3D7 (P = .05). Lower opsonizing antibody levels on enrollment were seen in those who became parasitemic during follow-up, independent of HIV infection (P ≤ .04 for each line).
HIV-1 infection decreases opsonizing antibodies to VSA, and antibody to merozoite antigens. Opsonizing antibodies were associated with lack of parasitemia during follow up, suggesting a role in protection.
人类免疫缺陷病毒（HIV）合并感染可能通过损害自然获得性免疫而增加对疟疾的易感性。
在339名成年人（64%感染HIV）中，我们使用寄生虫株FCR3、E8B和R29测量了针对恶性疟原虫变异表面抗原（VSA）的抗体以及调理感染红细胞的抗体，以及针对裂殖子抗原AMA-1和MSP2的抗体。我们确定了疟疾抗体、HIV感染、免疫功能受损标志物与新发寄生虫血症风险之间的关系。
HIV感染的成年人针对所有寄生虫株的调理抗体平均水平显著较低（P < .0001），针对AMA-1（P = .01）和MSP2（P < .0001）的抗体水平也较低。针对VSA的免疫球蛋白G（IgG）水平不受HIV状态的影响。针对某些分离株的调理抗体滴度与CD4计数呈正相关。1型人类免疫缺陷病毒（HIV-1）病毒载量与针对FCR3的调理抗体（P = .04）、针对AMA-1的IgG水平（P ≤ .03）和针对MSP2-3D7的IgG水平（P = .05）之间存在负相关。在随访期间发生寄生虫血症的患者中，入组时的调理抗体水平较低，与HIV感染无关（每种寄生虫株P ≤ .04）。
HIV-1感染会降低针对VSA的调理抗体以及针对裂殖子抗原的抗体。调理抗体与随访期间无寄生虫血症相关，提示其在保护方面发挥作用。
