Effects of malaria infection in human immunodeficiency virus type 1-infected Ugandan children
BACKGROUND: Malaria causes severe morbidity and mortality in many areas of Africa where HIV-1 infection is also prevalent. Immunosuppression is associated with both diseases but most reports do not find significant interactions between them.
METHODS: A collaborative study of HIV-1 infection in Ugandan women and their infants was established between the Ministry of Health, Makerere University, Kampala, and Case Western Reserve University in 1988. Four hundred fifty-eight infants, including 77 HIV-1-infected, 232 seroreverter and 125 control children born to HIV-1-negative mothers and 24 of indeterminate status were followed closely from birth for 4 years. Data on these infants were reviewed with respect to episodes of general illness and infections, suspected and confirmed episodes of malaria, onset and frequency of malaria, use of chloroquine and occurrence of selected illnesses after episodes of febrile illnesses. Thick and thin blood smears for malaria were obtained from children with fever.
RESULTS: There was no association between occurrence of febrile illnesses and childrens' HIV-1 category. The relative rates of occurrence were 1.0 (95% confidence interval (CI), 0.8 to 1.2) and 1.1 (95% CI 0.9 to 1.4) for the HIV seroreverter and control children compared with the HIV-infected children. Although there was no association (P = 0.83) between HIV-1 status and a smear being taken during a febrile episode, there was an increase in smears positive for malaria parasitemia among seroreverter (risk ratio, 1.5; 95% CI 1.1 to 1.9) and control infants (risk ratio, 1.6; 95% CI 1.2 to 2.2) compared with HIV-1-infected infants. The level of parasitemia was similar in each group. A greater proportion of malaria episodes among the HIV-infected group than among the control groups resulted in hospitalizations (P = 0.001) and blood transfusions (P = 0.02). There was a positive association between time to clinical AIDS and absence of malaria (adjusted for follow-up age) in infected children (P = 0.02). Use of chloroquine was similarly high in each HIV-1 category (80%).
CONCLUSIONS: In this group of HIV-infected children there was no significant increase in malarial episodes as compared with their HIV-negative controls. The results suggest a possibility that malaria may offer some protection against HIV-1 progression or that chloroquine used to treat malaria may have a direct effect against the HIV-1 virus.
| Medienart: |
Artikel |
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| Erscheinungsjahr: |
1997 |
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| Erschienen: |
1997 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:16 |
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| Enthalten in: |
The Pediatric infectious disease journal - 16(1997), 9 vom: 01. Sept., Seite 876-81 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Kalyesubula, I [VerfasserIn] |
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| Anmerkungen: |
Date Completed 03.11.1997 Date Revised 18.08.2019 published: Print Citation Status MEDLINE |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM013007580 |
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|---|---|---|---|
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| 008 | 231221s1997 xx ||||| 00| ||eng c | ||
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| 035 | |a (DE-627)NLM013007580 | ||
| 035 | |a (NLM)9306483 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Kalyesubula, I |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Effects of malaria infection in human immunodeficiency virus type 1-infected Ugandan children |
| 264 | 1 | |c 1997 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ohne Hilfsmittel zu benutzen |b n |2 rdamedia | ||
| 338 | |a Band |b nc |2 rdacarrier | ||
| 500 | |a Date Completed 03.11.1997 | ||
| 500 | |a Date Revised 18.08.2019 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: Malaria causes severe morbidity and mortality in many areas of Africa where HIV-1 infection is also prevalent. Immunosuppression is associated with both diseases but most reports do not find significant interactions between them | ||
| 520 | |a METHODS: A collaborative study of HIV-1 infection in Ugandan women and their infants was established between the Ministry of Health, Makerere University, Kampala, and Case Western Reserve University in 1988. Four hundred fifty-eight infants, including 77 HIV-1-infected, 232 seroreverter and 125 control children born to HIV-1-negative mothers and 24 of indeterminate status were followed closely from birth for 4 years. Data on these infants were reviewed with respect to episodes of general illness and infections, suspected and confirmed episodes of malaria, onset and frequency of malaria, use of chloroquine and occurrence of selected illnesses after episodes of febrile illnesses. Thick and thin blood smears for malaria were obtained from children with fever | ||
| 520 | |a RESULTS: There was no association between occurrence of febrile illnesses and childrens' HIV-1 category. The relative rates of occurrence were 1.0 (95% confidence interval (CI), 0.8 to 1.2) and 1.1 (95% CI 0.9 to 1.4) for the HIV seroreverter and control children compared with the HIV-infected children. Although there was no association (P = 0.83) between HIV-1 status and a smear being taken during a febrile episode, there was an increase in smears positive for malaria parasitemia among seroreverter (risk ratio, 1.5; 95% CI 1.1 to 1.9) and control infants (risk ratio, 1.6; 95% CI 1.2 to 2.2) compared with HIV-1-infected infants. The level of parasitemia was similar in each group. A greater proportion of malaria episodes among the HIV-infected group than among the control groups resulted in hospitalizations (P = 0.001) and blood transfusions (P = 0.02). There was a positive association between time to clinical AIDS and absence of malaria (adjusted for follow-up age) in infected children (P = 0.02). Use of chloroquine was similarly high in each HIV-1 category (80%) | ||
| 520 | |a CONCLUSIONS: In this group of HIV-infected children there was no significant increase in malarial episodes as compared with their HIV-negative controls. The results suggest a possibility that malaria may offer some protection against HIV-1 progression or that chloroquine used to treat malaria may have a direct effect against the HIV-1 virus | ||
| 650 | 4 | |a Clinical Trial | |
| 650 | 4 | |a Controlled Clinical Trial | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, U.S. Gov't, P.H.S. | |
| 650 | 4 | |a Acquired Immunodeficiency Syndrome | |
| 650 | 4 | |a Africa | |
| 650 | 4 | |a Africa South Of The Sahara | |
| 650 | 4 | |a Age Factors | |
| 650 | 4 | |a Biology | |
| 650 | 4 | |a Child | |
| 650 | 4 | |a Demographic Factors | |
| 650 | 4 | |a Developing Countries | |
| 650 | 4 | |a Diseases | |
| 650 | 4 | |a Eastern Africa | |
| 650 | 4 | |a English Speaking Africa | |
| 650 | 4 | |a Hiv Infections | |
| 650 | 4 | |a Immunity | |
| 650 | 4 | |a Immunological Effects | |
| 650 | 4 | |a Incidence | |
| 650 | 4 | |a Infant | |
| 650 | 4 | |a Malaria | |
| 650 | 4 | |a Measurement | |
| 650 | 4 | |a Parasitic Diseases | |
| 650 | 4 | |a Physiology | |
| 650 | 4 | |a Population | |
| 650 | 4 | |a Population Characteristics | |
| 650 | 4 | |a Prospective Studies | |
| 650 | 4 | |a Research Methodology | |
| 650 | 4 | |a Research Report | |
| 650 | 4 | |a Studies | |
| 650 | 4 | |a Uganda | |
| 650 | 4 | |a Viral Diseases | |
| 650 | 4 | |a Youth | |
| 700 | 1 | |a Musoke-Mudido, P |e verfasserin |4 aut | |
| 700 | 1 | |a Marum, L |e verfasserin |4 aut | |
| 700 | 1 | |a Bagenda, D |e verfasserin |4 aut | |
| 700 | 1 | |a Aceng, E |e verfasserin |4 aut | |
| 700 | 1 | |a Ndugwa, C |e verfasserin |4 aut | |
| 700 | 1 | |a Olness, K |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t The Pediatric infectious disease journal |d 1991 |g 16(1997), 9 vom: 01. Sept., Seite 876-81 |w (DE-627)NLM012615706 |x 1532-0987 |7 nnns |
| 773 | 1 | 8 | |g volume:16 |g year:1997 |g number:9 |g day:01 |g month:09 |g pages:876-81 |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 16 |j 1997 |e 9 |b 01 |c 09 |h 876-81 | ||