Abstract
BackgroundAreas endemic for malaria and Hepatitis B virus (HBV) infection largely overlap geographically. A recent study has suggested the existence of an interaction between the two pathogens in symptomatic co-infected individuals on the South-American continent. We examined this issue in a hyperendemic area for both pathogens in sub-Saharan Africa.Methodology and FindingsPre-transfusion samples from a retrospective cohort of 154 blood transfusion recipients were screened for both serological and molecular markers of HBV and Plasmodium genomes using species-specific nested PCR and quantitative real-time PCR. Thirty-seven individuals met exclusion criteria and were subsequently eliminated from further analysis. Of 117 participants, 90% of recipients exhibited evidence of exposure to HBV, 42% with HBsAg and/or HBV DNA and 48% anti-HBc reactive without detectable HBV DNA. Plasmodium genome prevalence by NAT was 50%. Parasitemic individuals were significantly younger than non-parasitemic individuals (P = 0.04). Parasitemia level was not significantly lower in individuals with HBV DNA positive infections compared to those with HBV DNA negative exposures. HBV DNA load was not significantly different in parasitemic and non-parasitemic individuals.ConclusionThe data presented suggests that, in sub-Saharan Africa, asymptomatic co-infections with these two ubiquitous pathogens do not appear to significantly affect each other and evolve independently.
Highlights
Despite being the focus of extensive research in recent years malaria remains a significant cause of morbidity worldwide, with 1 million deaths a year in sub-Saharan Africa (SSA) alone [1]
Samples Whole blood samples were collected pre-transfusion from a cohort of 154 Ghanaian transfusion recipients hospitalized in the departments of Medicine and Obstetrics and Gynaecology, at the Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana as part of the Blood & Organ Transmitted Infectious Agents (BOTIA) sample repository [18]
Hepatitis B virus (HBV) Prevalence Pre-transfusion samples were collected from 154 blood recipients attending KATH in Kumasi, Ghana and tested for serological and molecular markers to determine HBV infection status
Summary
Despite being the focus of extensive research in recent years malaria remains a significant cause of morbidity worldwide, with 1 million deaths a year in sub-Saharan Africa (SSA) alone [1]. In addition to this burden, SSA has a high prevalence of other clinically significant pathogens, including Hepatitis B virus (HBV) and Human Immunodeficiency virus (HIV) [2,3,4]. There are numerous areas of SSA where the endemicity of both malaria and HBV overlap [5,6,7] With both infections sharing an intra-hepatic stage in their life cycles, interactions between the two pathogens have been hypothesized to occur at both immunological and cellular levels. We examined this issue in a hyperendemic area for both pathogens in sub-Saharan Africa
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