Inter Press Service Examines HIV/Malaria Coinfection

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Inter Press Serviceon Tuesday examined issues surrounding HIV/malaria coinfection,particularly in Mozambique. Research during the past five years hassuggested that severe malaria can further suppress the immune system ofan HIV-positive person, according to Albert Kilian, a senior technicaladviser for Malaria Consortium.

"Patients suffer more often and more severely from malaria once theirimmune system starts to decline, and they will respond less quickly totreatment," he said. A pregnant HIV-positive woman who also has malariais "likely to have more severe malaria symptoms and runs the risk ofdeveloping life-threatening anemia," Kilian said, adding that malariaadds to the risk of having a low-birthweight infant. Although there is"no solid evidence yet," some researchers believe that malaria alsomight increase HIV viral loads and the risk of mother-to-child HIVtransmission, Kilian said.

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He added that anemia, which is common amongchildren who have malaria more than once, also has been associated withincreased mortality among HIV-positive children. It is possible forpeople living with HIV to minimize their vulnerability to malaria,Kilian said, adding that they should take prophylactic treatment usingco-trimoxazol and antiretroviral drugs, if appropriate.

There are significant challenges to controlling the spread of HIV and malaria in Mozambique. According to Inter Press Service,Mozambique has an adult HIV prevalence of 16.6%, and malaria is endemicand transmitted throughout the year. Cases of the disease peak towardthe end of the rainy season, which usually starts in September and endsby May. Addressing HIV/malaria coinfection is an additional challenge,primarily because of widespread poverty and a lack of access to basichealth service. "Many people living with HIV/AIDS die of malaria,especially in the rural areas," Cesar Mufanequico, national director ofthe Mozambican Treatment Access Movement, said.

Although the governmentdistributes no-cost insecticde-treated nets to pregnant women andchildren younger than age five, Mufanequico said he wants thedistribution of no-cost ITNs to HIV-positive people increased as well."Many people living with HIV/AIDS die of malaria, especially in therural areas," he said, adding, "Most do not have nets. We talk aboutfighting HIV/AIDS together with malaria and tuberculosis, but inpractice, we often treat them separately" (Ayisi, Inter Press Service, 7/17).
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