Abstract
BackgroundDual epidemics of the malaria parasite Plasmodium and HIV-1 in sub-Saharan Africa and Asia present a significant risk for co-infection in these overlapping endemic regions. Recent studies of HIV/Plasmodium falciparum co-infection have reported significant interactions of these pathogens, including more rapid CD4+ T cell loss, increased viral load, increased immunosuppression, and increased episodes of clinical malaria. Here, we describe a novel rhesus macaque model for co-infection that supports and expands upon findings in human co-infection studies and can be used to identify interactions between these two pathogens.Methodology/Principal FindingsFive rhesus macaques were infected with P. cynomolgi and, following three parasite relapses, with SIV. Compared to macaques infected with SIV alone, co-infected animals had, as a group, decreased survival time and more rapid declines in markers for SIV progression, including peripheral CD4+ T cells and CD4+/CD8+ T cell ratios. The naïve CD4+ T cell pool of the co-infected animals was depleted more rapidly than animals infected with SIV alone. The co-infected animals also failed to generate proliferative responses to parasitemia by CD4+ and CD8+ T cells as well as B cells while also having a less robust anti-parasite and altered anti-SIV antibody response.Conclusions/SignificanceThese data suggest that infection with both SIV and Plasmodium enhances SIV-induced disease progression and impairs the anti-Plasmodium immune response. These data support findings in HIV/Plasmodium co-infection studies. This animal model can be used to further define impacts of lentivirus and Plasmodium co-infection and guide public health and therapeutic interventions.
Highlights
Human immunodeficiency virus type 1 (HIV) and Plasmodium, the malaria parasite, each present immense disease burdens worldwide
HIV infection appears to increase the risk of both malaria parasite infection and the development of clinical malaria [3,4,5,6,7,8,9,10], and this risk rises with HIV-induced immunosuppression [4,6,7,8,9]
The pattern of co-infection we have chosen to model is adults living in regions of the world, such as Southeast Asia, that have a high incidence of new HIV-1 infections and are endemic for P. vivax malaria
Summary
Human immunodeficiency virus type 1 (HIV) and Plasmodium, the malaria parasite, each present immense disease burdens worldwide. P. falciparum infection appears to have an impact on the HIV infection through a transient increase in HIV viral load [11,12] and a more rapid CD4+ T cell decline [13]. A recent report by Abu-Raddad and colleagues described dual HIV/Plasmodium infection in Kisumu, Kenya (pop 200,000) enhanced the spread of both pathogens, leading to an increase of, from 1980 to 2005, approximately one million episodes of clinical malaria and 8,500 cases of HIV infection [10]. Dual epidemics of the malaria parasite Plasmodium and HIV-1 in sub-Saharan Africa and Asia present a significant risk for co-infection in these overlapping endemic regions. Recent studies of HIV/Plasmodium falciparum coinfection have reported significant interactions of these pathogens, including more rapid CD4+ T cell loss, increased viral load, increased immunosuppression, and increased episodes of clinical malaria. We describe a novel rhesus macaque model for co-infection that supports and expands upon findings in human co-infection studies and can be used to identify interactions between these two pathogens
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