Important note: Information in this article was accurate in 2006. The state of the art may have changed since the publication date.
Important note: Information in this article was accurate in 2006. The state of the art may have changed since the publication date.
Reuters NewMedia - December 7, 2006
The way the two diseases interact greatly expands the prevalence of both among people in sub-Saharan Africa, a team of scientists said in a study in the journal Science.
Malaria, a mosquito-borne disease caused by a parasite, greatly boosts viral load -- the amount of human immunodeficiency virus in the blood of infected people -- making them more likely to infect a sex partner with HIV, they stated.
"Higher viral load causes more HIV transmission, and malaria causes high HIV viral load," said lead study author Laith Abu-Raddad of the Fred Hutchinson Cancer Research Center in Seattle and the University of Washington.
Abu-Raddad, an AIDS researcher, estimated that malaria has helped HIV infect hundreds of thousands and perhaps millions of people in sub-Saharan Africa. AIDS was first identified a quarter century ago.
At the same time, HIV fuels malaria's spread because HIV-infected people are more susceptible to malaria as a result of HIV ravaging the immune system, the body's natural defenses, the researchers said.
AIDS and malaria are concentrated in sub-Saharan Africa. Abu-Raddad said scientists were puzzled when they realized that the risky sexual behavior by people in the region was not by itself sufficient to explain the swift spread of HIV, so other factors must be involved.
They focused their work on Kisumu, a Kenyan city by Lake Victoria where HIV and malaria are both common. They said 5 percent of HIV infections can be blamed on the increased HIV viral load due to malaria, and 10 percent of adult malaria cases can be blamed on HIV.
Since 1980, 8,500 more people got HIV infections, and there were 980,000 more episodes of malaria (a person can get it more than once) in a city whose adult population is 200,000, the study found.
PUBLIC HEALTH EFFORTS
The findings have implications for public health efforts, Abu-Raddad said, showing the importance for authorities to tackle these diseases together.
Of the 39.5 million people worldwide infected with HIV, 24.7 are in the poor countries of sub-Saharan Africa. About 2.1 million of the world's 2.9 million AIDS deaths in the past year were in this region.
Malaria kills more than a million people annually, mostly young children in sub-Saharan Africa.
The researchers produced their results with a mathematical model using HIV and malaria infection data gathered in Malawi by James Kublin of the Hutchinson Center. This enabled them to quantify for the first time the synergy between malaria on HIV and its toll on people.
Scientists previously determined that a lack of male circumcision and the incidence of genital herpes also were facilitating the spread of HIV. Abu-Raddad noted that circumcised men are much less likely to get HIV, and that genital herpes opens a door for HIV to infect a person.
Abu-Raddad said malaria now can be considered a third serious factor facilitating the spread of HIV.
The two diseases drive one another even though they have different modes of transmission -- malaria by mosquito and HIV predominantly by sexual intercourse, Abu-Raddad noted.
Abu-Raddad said once an HIV person gets malaria, his or her viral load goes up and stays higher for six to eight weeks, making the person far more infectious to others.
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