Implications of asymptomatic malaria infections on hematologic parameters in adults living with HIV in malaria-endemic regions with varying transmission intensities

• DOI: 10.1016/j.ijid.2023.09.018
• Publication Date: 2023-10-01T14:16:02Z
• Authors: Edwin Kamau; Risper Maisiba; Nicole Dear; Allahna Esber; Ajay P. Parikh; Michael Iroezindu; Emmanuel Bahemana; Hannah Kibuuka; John Owuoth; Jonah Maswai; Benjamin Opot; Raphael O. Okoth; Farid Abdi; Maureen Mwalo; Dennis Juma; Ben Andagalu; Hoseah M. Akala; Neha Shah; Trevor A. Crowell; Jessica Cowden; Christina S. Polyak; Julie A. Ake
• Keywords: Male; Adult; Coinfection; HIV; Nigeria; HIV Infections; Anemia; Infectious and parasitic diseases; RC109-216; Middle Aged; 16. Peace & justice; Kenya; Thrombocytopenia; 3. Good health; Malaria; Asymptomatic malaria; Cohort Studies; Hematologic abnormalities; Prevalence; Humans; Uganda; Female; Asymptomatic Infections

HIV and malaria coinfection impacts disease management and clinical outcomes. This study investigated hematologic abnormalities in malaria-asymptomatic people living with HIV (PLHIV) in regions with differing malaria transmission.Study participants were enrolled in the African Cohort Study: two sites in Kenya, one in Uganda, and one in Nigeria. Data was collected at enrollment and every 6 months. Logistic regression estimated odds ratios for associations between HIV/malaria status and anemia, thrombocytopenia, and leucopenia.Samples from 1587 participants with one or more visits comprising 1471 (92.7%) from PLHIV and 116 (7.3%) without HIV were analyzed. Parasite point prevalence significantly differed across the study sites (P <0.001). PLHIV had higher odds of anemia, with males at lower odds compared to females; the odds of anemia decreased with age, reaching significance in those ≥50 years old. Participants in Kisumu, Kenya had higher odds of anemia compared to other sites. PLHIV had higher odds of leucopenia, but malaria co-infection was not associated with worsened leucopenia. The odds of thrombocytopenia were decreased in HIV/malaria co-infection compared to the uninfected group.Hematological parameters are important indicators of health and disease. In PLHIV with asymptomatic malaria co-infection enrolled across four geographic sites in three African countries, abnormalities in hematologic parameters differ in different malaria transmission settings and are region-specific.