Egwang, Thomas

Kiyingi, Herbert

Nannyonga, Maria

Retrovirology

English

PubMed

Herbert Kiyingi

Thomas Egwang

Maria Nannyonga

Crossref

POSTER PRESENTATION Open Access
Prolonged elevation of viral loads in
HIV-1-infected children in a region of intense
malaria transmission in Northern Uganda
Herbert Kiyingi1,2*, Thomas Egwang1, Maria Nannyonga2
From 16th International Symposium on HIV and Emerging Infectious Diseases
Marseille, France. 24-26 March 2010
Background
Introduction
Malaria and HIV-1 infection cause significant morbidity
and mortality in children in sub-Saharan Africa. Recur-
rent malaria infection increases HIV-1 viral load in adults
and increases the rate of progression of HIV-1 infection
to AIDS. The effect of malaria on viral loads in Children
living with AIDS (CLWA) is not clearly known.
Objective
To assess the effect of malaria on HIV-1 viral loads in
CLWA.
Methods
One hundred thirty five afebrile HIV-1 positive children
having negative blood slides for malaria were recruited
at Apac Hospital and followed up for one year. They
were monitored for development of P. falciparum
malaria, which was treated with CQ+SP and the chil-
dren followed up for 28 days. HIV-1 viral loads were
measured over three time-points: at enrolment (no
malaria), during an episode of malaria, and at a visit
about 8 weeks (range 6-19 weeks) after the malaria visit
when the child had neither parasites nor any intervening
malaria episodes (post-malaria). Primary analyses were
restricted to children who on follow up had HIV-1 viral
loads measured at the three relevant time-points.
Results
Baseline characteristics, Table 1.
Malaria increased HIV-1 viral load significantly in
CLWA. Low parasitaemia <= 5/HPF transiently
increased viral load by 0.42 log (95% CI 0.29-0.78, p =
0.0002), higher than that reported in adults. These
patients’ viral loads returned to levels similar to those at
baseline after treatment. In 13 patients with high parasi-
taemia (10-20/HPF), the mean increase in viral load was
0.53 log (0.14 to 0.51), p < 0.0001, remaining signifi-
cantly higher than at baseline after treatment ie. mean
difference (signed-rank test) in viral load “before” and
“after” malaria was significant.
Discussion
P. falciparum malaria increased HIV-1 viral loads in
children, with some viral loads remaining elevated sev-
eral weeks after antimalarial treatment. Prolonged post-
treatment elevation has important implications for the
clinical course and the potential for transmission in
sexually active adults.
Author details
1medbiotech Laboratories, Kampala, Uganda. 2Nsambya Hospital, Kampala,
Uganda.
Published: 11 May 2010
doi:10.1186/1742-4690-7-S1-P72
Cite this article as: Kiyingi et al.: Prolonged elevation of viral loads in
HIV-1-infected children in a region of intense malaria transmission in
Northern Uganda. Retrovirology 2010 7(Suppl 1):P72.* Correspondence: herbertskiyingi@hotmail.com
1medbiotech Laboratories, Kampala, Uganda
Table 1
SEX MALE/FEMALE 41.1%/58.9%
AGE (yrs) (1.5-5)/(6-12) 44.7%/55.3%
WHO CLASSIFICATION
1, 2, 3, 4
n = 30, 55,
48, 02
percentage = 22.2%,
40.7%, 35.6%, 1.48%
HAEMOGLOBIN median, IQR 10.5 9.8 - 13.8
Kiyingi et al. Retrovirology 2010, 7(Suppl 1):P72
http://www.retrovirology.com/content/7/S1/P72
© 2010 Kiyingi et al; licensee BioMed Central Ltd.


Prolonged elevation of viral loads in HIV-1-infected children in a region of intense malaria transmission in Northern Uganda

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Prolonged elevation of viral loads in HIV-1-infected children in a region of intense malaria transmission in Northern Uganda

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