Subclinical Plasmodium falciparum infection and HIV-1 viral load.

Studies indicate that Plasmodium falciparum infection increases HIV replication in adults. Although malaria-related illness and death are more common in children and HIV-1 generally progresses faster in children than in adults to our knowledge the effect of intermittent malaria on HIV-1 viral load has not been directly explored in children. To investigate this issue we monitored HIV-positive infants from a 1996-2001 birth cohort study in Kisumu Kenya a P. falciparum-holoendemic area. Study design and methods have been described elsewhere. Twenty-four children that were perinatally infected with HIV were included in this substudy. During monthly visits during the childs first 2 years of life malaria and HIV incidence were recorded. Both children with malaria-positive blood smears and those with fever but no smear result available were treated with sulfadoxine-pyrimethamine according to national guidelines. At the time of this substudy none of the study participants were taking antiretroviral drugs. (excerpt)