Roberds Ashleigh, Ferraro Emily, 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.
Department of Preventive Medicine and Biostatistics, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, United States.
Front Cell Infect Microbiol. 2021 Apr 12;11:656938. doi: 10.3389/fcimb.2021.656938. eCollection 2021.
Malaria/HIV-1 co-infection has become a significant public health problem in the tropics where there is geographical overlap of the two diseases. It is well described that co-infection impacts clinical progression of both diseases; however, less is known about the impact of co-infection on disease transmission. Malaria transmission is dependent upon multiple critical factors, one of which is the presence and viability of the sexual-stage gametocyte. In this review, we summarize evidence surrounding gametocyte production in and the development factors and the consequential impact that HIV-1 has on malaria parasite transmission. Epidemiological and clinical evidence surrounding anemia, immune dysregulation, and chemotherapy as it pertains to co-infection and gametocyte transmission are reviewed. We discuss significant gaps in understanding that are often due to the biological complexities of both diseases as well as the lack of entomological data necessary to define transmission success. In particular, we highlight special epidemiological populations, such as co-infected asymptomatic gametocyte carriers, and the unique role these populations have in a future focused on malaria elimination and eradication.
疟疾与HIV-1合并感染已成为热带地区一个重大的公共卫生问题，这两种疾病在这些地区存在地域重叠。已有充分描述表明，合并感染会影响这两种疾病的临床进展；然而，关于合并感染对疾病传播的影响却知之甚少。疟疾传播取决于多个关键因素，其中之一是有性阶段配子体的存在和活力。在本综述中，我们总结了有关HIV-1对疟原虫传播的配子体产生、发育因素及相应影响的证据。我们还综述了与合并感染和配子体传播相关的贫血、免疫失调及化疗的流行病学和临床证据。我们讨论了理解上存在的重大差距，这往往是由于这两种疾病的生物学复杂性以及缺乏定义传播成功所需的昆虫学数据所致。特别是，我们强调了特殊的流行病学人群，如合并感染的无症状配子体携带者，以及这些人群在未来致力于消除和根除疟疾方面所起的独特作用。
