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Science 8 December 2006:
Vol. 314. no. 5805, pp. 1603 - 1606
DOI: 10.1126/science.1132338
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Reports

Dual Infection with HIV and Malaria Fuels the Spread of Both Diseases in Sub-Saharan Africa

Laith J. Abu-Raddad,1,2* Padmaja Patnaik,3 James G. Kublin4,5*

Mounting evidence has revealed pathological interactions between HIV and malaria in dually infected patients, but the public health implications of the interplay have remained unclear. A transient almost one-log elevation in HIV viral load occurs during febrile malaria episodes; in addition, susceptibility to malaria is enhanced in HIV-infected patients. A mathematical model applied to a setting in Kenya with an adult population of roughly 200,000 estimated that, since 1980, the disease interaction may have been responsible for 8,500 excess HIV infections and 980,000 excess malaria episodes. Co-infection might also have facilitated the geographic expansion of malaria in areas where HIV prevalence is high. Hence, transient and repeated increases in HIV viral load resulting from recurrent co-infection with malaria may be an important factor in promoting the spread of HIV in sub-Saharan Africa.

1 Statistical Center for HIV/AIDS Research and Prevention, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA.
2 Center for Studies in Demography and Ecology, University of Washington, Seattle, WA98195, USA.
3 Department of Epidemiology, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
4 International Health Program, University of Washington, Seattle, WA 98195, USA.
5 Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA.

* To whom correspondence should be addressed. E-mail: laith{at}scharp.org (L.J.A.); jkublin{at}fhcrc.org (J.G.K.)

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Science. ISSN 0036-8075 (print), 1095-9203 (online)