Stiffler Deborah M, Oyieko Janet, Kifude Carolyne M, Rockabrand David M, Luckhart Shirley, Stewart V Ann
Department of Preventive Medicine and Biostatistics, Division of Tropical Public Health, Uniformed Services University of the Health Sciences, Bethesda, MD, United States.
Basic Science Laboratory, US Army Medical Research Directorate-Africa/Kenya Medical Research Institute, Kisumu, Kenya.
Front Cell Infect Microbiol. 2021 Feb 5;10:600106. doi: 10.3389/fcimb.2020.600106. eCollection 2020.
As morbidity and mortality due to malaria continue to decline, the identification of individuals with a high likelihood of transmitting malaria is needed to further reduce the prevalence of malaria. In areas of holoendemic malaria transmission, asymptomatically infected adults may be infected with transmissible gametocytes. The impact of HIV-1 on gametocyte carriage is unknown, but co-infection may lead to an increase in gametocytemia. In this study, a panel of qPCR assays was used to quantify gametocyte stage-specific transcripts present in dried blood spots obtained from asymptomatic adults seeking voluntary HIV testing in Kombewa, Kenya. A total of 1,116 -specific -positive samples were tested and 20.5% of these individuals had detectable gametocyte-specific transcripts. Individuals also infected with HIV-1 were 1.82 times more likely to be gametocyte positive (P<0.0001) and had significantly higher gametocyte copy numbers when compared to HIV-negative individuals. Additionally, HIV-1 positivity was associated with higher gametocyte prevalence in men and increased gametocyte carriage with age. Overall, these data suggest that HIV-positive individuals may have an increased risk of transmitting malaria parasites in regions with endemic malaria transmission and therefore should be at a higher priority for treatment with gametocidal antimalarial drugs.
随着疟疾导致的发病率和死亡率持续下降，为进一步降低疟疾流行率，需要识别出具有高疟疾传播可能性的个体。在疟疾高度流行传播地区，无症状感染的成年人可能感染有可传播的配子体。HIV-1对配子体携带的影响尚不清楚，但合并感染可能导致配子体血症增加。在本研究中，一组定量聚合酶链反应（qPCR）检测用于量化从肯尼亚孔贝瓦自愿接受HIV检测的无症状成年人所提供的干血斑中存在的配子体阶段特异性转录本。总共检测了1116份特异性阳性样本，其中20.5%的个体具有可检测到的配子体特异性转录本。与HIV阴性个体相比，同时感染HIV-1的个体配子体呈阳性的可能性高1.82倍（P<0.0001），且配子体拷贝数显著更高。此外，HIV-1阳性与男性中更高的配子体流行率以及随年龄增长的配子体携带增加有关。总体而言，这些数据表明，在疟疾地方性传播地区，HIV阳性个体可能有更高的传播疟原虫风险，因此应优先使用杀配子体抗疟药物进行治疗。
