Bulletin of the World Health Organization

Co-infections of HIV/AIDS and Malaria should be a concern.

Article: News Story: 2004;82:544-5

Dear Editor, I refer to a news item published in WHO Bulletin Vol. 82, No7 July 2004, 479-558. The agenda was about HIV/AIDS, hunger and the Malaria, which was discussed by an international panel of economists in Copenhagen consensus conference at Denmark in the month of May, identified as individual determinants for suffering of resource-poor countries. Therefore, Malaria, HIV/AIDS and hunger were identified as the most urgent problems to tackle in the developing countries. However, in the light of discussion, can we focus the possibility and consequences of co-infections of AIDS and Malaria?

There are several reports about co-infections of HIV/AIDS and Tuberculosis, which is a well-known fact. Also, it has been reported that the co-infection between Malaria and HIV-1 is the commonest infections in sub-Saharan Africa and, to a lesser extent, in other developing countries as well. It has been estimated that 22 million Africans are infected with HIV-1, and around 500 million are suffering from malaria annually (1,2,).We do not have actual statistics in Asian developing countries; probably the infections of HIV/AIDS and Malaria in same person is prevailing in Asian developing countries. Eventually it is a public health issue because the interaction between these two infections is possible, because of depressed immunity would easily allow any sort of parasitic invasion.

On a population basis, an increased prevalence of malaria and increased parasite density in HIV-infected individuals in Sub-Saharan countries could lead to increased malaria transmission affecting both HIV-positive and -negative individuals (3). It might increase the risk of clinical malaria in HIV-positive subjects. However there is a possibility of Association between HIV and Malaria, because there is a progressive cellular immunosuppression, and any resulting impairment in immune response to malaria might be associated with failure to prevent infection or to suppress parasitemia and clinical disease. HIV infection and malaria prasitemia in pregnancy is documented in a series of studies of HIV –1 infected pregnant woman in Malawi (4).

Whether mosquitoes would transmit HIV is still not known definitely and the question of co-infection, both the issues are of public health concern, which need to be addressed properly by policy-makers.


  • UNAIDS (Joint United Nations Programme on HIV/AIDS). AIDS epidemic update: December 1998. UNAIDS, Geneva, 1998, UNAIDS/98.35.
  • Centre for Disease Control. World malaria situation in 1994. Part III. Wkly Epidemiol Rec 1997 Seo 19; 72(38):285-90
  • Moore JM, Ayisi J, Nahlen BL, Misore A, Lal AA, Udhayakumar V. Immunity to placental malaria. II. Placental antigen-specific cytokine responses are impaired in human immunodeficiency virus-infected women. J Infect Dis. 2000 Sep;182(3):960-4.
  • Bloland PB, Wirima JJ, Steketee RW, Chilima B, Hightower A, Breman JG. Maternal HIV infection and infant mortality in Malawi: evidence for increased mortality due to placental malaria infection. AIDS. 1995 Jul;9(7):721-6.

Prof. Chitta Ranjan Choudhury. Coordinator, International Programme for Tropical Oral Health, Poole Hospital NHS Department of MF Surgery, & IHCS, Bournemouth University, Longfleet Road, Poole, Dorset BH15 2JB, England, UK. Professor & Director, Centre for Oral Disease Prevention & Control, Department of Oral Biology, AB Shetty Memorial Institute of Dental Sciences, Deralakatte, Mangalore 574 160, India. (email: Chitta_choudhury@yahoo.com)