Plasmodium falciparum malaria and perinatally acquired human immunodeficiency virus type 1 infection in Kinshasa, Zaire: a prospective, longitudinal cohort study of 587 children

Article Abstract:

The immune deficiency caused by HIV (human immunodeficiency virus) infection predominantly affects the cellular immune system. That is, the opportunistic infections which are most common among patients with AIDS are those which are normally kept in check by cells of the immune system and not those controlled by antibodies. Since infection with Plasmodium falciparum, the malaria organism, is largely controlled by the cellular immune system, there is concern that malaria will become both more frequent and more severe in parts of the world such as Africa that are affected by both malaria and AIDS. Furthermore, malaria is known to depress parts of the cellular immune system, so it is possible that not only might malaria become more severe as a result of AIDS, but also that the progression of AIDS might be accelerated by the simultaneous presence of malaria. A large, prospective study is necessary to resolve such questions, and just such a study has now been completed in the country of Zaire, Africa. A total of 260 children born to women infected with HIV type 1 and 327 children born to uninfected women were monitored, starting from age 5 to 9 months, for the next 13 months. During this follow-up period, 271 cases of malaria were identified, but no differences were found between the two groups. Malaria was neither more severe nor more common among the children born to women positive for HIV, and this was true regardless of whether the children reverted to negative, that is were not infected themselves, or remained positive. Similarly, the frequency and severity of malaria did not depend on whether the HIV-infected children developed symptoms of AIDS or not. Furthermore, infection with Plasmodium falciparum was not found to influence the rate of progression of infection with HIV type 1. These results suggest that concerns about interaction between HIV infection and infection with the malaria organism are unfounded. (Consumer Summary produced by Reliance Medical Information, Inc.)

Cases, Observations, HIV infection in children, Pediatric HIV infections, Plasmodium falciparum, Immunological tolerance, Immunologic tolerance

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Pulmonary tuberculosis in HIV-infected patients in Zaire: a controlled trial of treatment for either 6 or 12 months

Article Abstract:

Treating HIV-infected patients with tuberculosis for 12 months instead of six months may reduce the rate of relapse but it does not appear to improve survival rates. A six-month course of anti-tuberculosis drugs may be adequate in developing countries when resources are scarce. A total of 335 HIV-positive patients and 188 HIV-negative patients with tuberculosis took rifampin, isoniazid and pyrazinamide every day for two months and then twice a week for four months. Of 240 HIV-positive patients with no evidence of tuberculosis after six months of treatment, 121 took rifampicin and isoniazid for six more months and 119 took a placebo. At 12 and 24 months, survival rates were similar in both groups. However, there were nine relapses in the patients taking placebo, compared to one relapse in those taking anti-tuberculosis drugs. In Zaire, where the study took place, a higher relapse rate is acceptable because most family members have already been exposed to tuberculosis.

Health aspects, Drug therapy, HIV patients, Tuberculosis, Africans

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Perinatal transmission of the human immunodeficiency virus type 1 to infants of seropositive women in Zaire

Article Abstract:

Regardless of economic class, babies in urban Zaire were worse off medically if their mothers had AIDS. The experiment compared the babies born to women with and without antibodies to the AIDS virus in their blood, the presence of which indicates that a person has become infected with the AIDS virus, whether or not they have started to show any symptoms of AIDS. The babies of the women with the AIDS virus were more frequently premature, had lower birth weights and were more likely to die during their first month. A year after birth, twenty percent of the infants with the AIDS virus had died, as opposed to only four percent of the infants without the AIDS virus. About eight percent of the infants still alive had AIDS.

Analysis, Patient outcomes, Mortality, Maternal-fetal exchange, Complications and side effects, Hospitals, HIV (Viruses), HIV, Infants, Infant mortality, Disease transmission, Congo (Kinshasa), Zaire

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