Hepatitis C Virus Infection May Lead to Slower Emergence of P. falciparum in Blood

International audienceBACKGROUND: Areas endemic for Plasmodium falciparum, hepatitis B virus (HBV) and hepatitis C virus (HCV) overlap in many parts of sub-Saharan Africa. HBV and HCV infections develop in the liver, where takes place the first development stage of P. falciparum before its further spread in blood. The complex mechanisms involved in the development of hepatitis may potentially influence the development of the liver stage of malaria parasites. Understanding the molecular mechanisms of these interactions could provide new pathophysiological insights for treatment strategies in Malaria. METHODOLOGY: We studied a cohort of 319 individuals living in a village where the three infections are prevalent. The patients were initially given a curative antimalarial treatment and were then monitored for the emergence of asexual P. falciparum forms in blood, fortnightly for one year, by microscopy and polymerase chain reaction. PRINCIPAL FINDINGS: At inclusion, 65 (20.4%) subjects had detectable malaria parasites in blood, 36 (11.3%) were HBV chronic carriers, and 61 (18.9%) were HCV chronic carriers. During follow-up, asexual P. falciparum forms were detected in the blood of 203 patients. The median time to P. falciparum emergence in blood was respectively 140 and 120 days in HBV- and HBV+ individuals, and 135 and 224 days in HCV- and HCV+ individuals. HCV carriage was associated with delayed emergence of asexual P. falciparum forms in blood relative to patients without HCV infection. CONCLUSIONS: This pilot study represents first tentative evidence of a potential epidemiological interaction between HBV, HCV and P. falciparum infections. Age is an important confounding factor in this setting however multivariate analysis points to an interaction between P. falciparum and HCV at the hepatic level with a slower emergence of P. falciparum in HCV chronic carriers. More in depth analysis are necessary to unravel the basis of hepatic interactions between these two pathogens, which could help in identifying new therapeutic approaches against malaria

Cardiac Events in World-class Athletes: An Internet-based Study.

This study aimed at assessing the prevalence of adverse cardiac events, as identified in the media, in world-class athletes according to their sex and sports discipline. All female and male' athletes, from 30 individual Olympic sports, ranked in the international yearly top 10 between 2006-2018, were included. The name of each of them was associated in a Google search with selected key terms related to heart disease and/or acute cardiac events after their inclusion date. Global and sex-specific adverse cardiac event hazard function λ were calculated for each sport. Global and sex-specific prevalence of cardiac events were calculated, then compared (Fisher's exact test) between all sports. From the 2471 athletes included, 15 cases of cardiac events (prevalence 0.61%) were reported; 2 sudden cardiac deaths (0.08%) occurred in male athletes. The other events were related to arrhythmic events (n = 13), mainly supra-ventricular arrhythmias (n = 9). All surviving athletes were able to continue their career, mostly after ablation procedure. Male endurance athletes accounted for 7 events among which 3 events occurred among short-distance triathletes. Events among women were comparatively rare (n = 4), and all were observed among short-distance triathletes. A relatively unexpected high prevalence of cardiac events in endurance elite athletes, was observed as compared to other sports, mainly in short-distance male and female triathletes. This raises the question of particular cardiovascular constraints in this discipline, and underlines the urge of international longitudinal follow-up studies in these kinds of athletes