The impact of HIV-associated immunosuppression on the Plasmodium falciparum chloroquine resistance transporter gene (PfCRT) of HIV patients in Akure, Nigeria

Iyabo Adepeju Simon-Oke,Adeola Olanireti Ade-Alao,Foluso Ologundudu

doi:10.1186/s42269-020-00401-0

Abstract

BackgroundThe study evaluated the prevalence of malaria and Plasmodium falciparum chloroquine resistance transporter gene (PfCRT) in HIV patients attending Specialist Hospital, Akure. This study was carried out between April and June 2019. Three hundred and seventeen (317) patients attending the antiretroviral clinic (ART) were involved, out of which 89 (28.08%) were males and 228 (71.92%) were females. HIV test was done using the Unigold® HIV test kit, malaria test was done using thick and thin blood smear, CD4 test was done using the Partec® CD4 counter and PCR was used to detect the presence of plasmodium falciparum mutant gene. The data obtained from this analysis was subjected to Pearson’s Chi-square test.ResultsThe overall result showed low prevalence of malaria (23.03%) in the sampled patients. Highest malaria prevalence (31.0%) was recorded in HIV patients with CD4 count between 200–500 cells/μl of blood, with the males recording 24.7% malaria prevalence. The age group 20–29 years recorded the highest prevalence of 27.3%. A higher prevalence 91.1% of PfCRT gene in HIV-positive and (40.0%) in HIV-negative patients was recorded with 100% prevalence in patients with CD4 count ≤ 200. This shows that the low prevalence of malaria recorded in this study could be credited to good health-seeking attitude of HIV patients and the upscale of HIV care and treatment centres.ConclusionThe high prevalence of PfCRT gene shows that treatment of malaria with chloroquine is still being practised despite the availability of artemisinin-based combination therapy (ACTs) as the recommended regimen for malaria treatment.

Highlights

The study evaluated the prevalence of malaria and Plasmodium falciparum chloroquine resistance transporter gene (PfCRT) in Human immunodeficiency virus (HIV) patients attending Specialist Hospital, Akure
UNAIDS (2011) reported that in 2010, around 34 million individuals were living with HIV/Acquired immunodeficiency virus (AIDS) of which 2.7 million are new infections, and the highest burden is in sub-Saharan Africa, where an expected populace of 22.9 million (68%) of HIV-infected individuals live (WHO 2011)
Prevalence of malaria parasite according to HIV status A total number of 317 blood samples were collected from already confirmed HIV-positive patients attending the hospital, of which 73 (23.03%) patients tested positive for the presence of malaria parasite while 244 (76.97%) tested negative

Summary

Introduction

The study evaluated the prevalence of malaria and Plasmodium falciparum chloroquine resistance transporter gene (PfCRT) in HIV patients attending Specialist Hospital, Akure. Malaria and HIV are two of the most widely recognised and significant public health issues facing developing nations and the most well-known infection in sub-Saharan Africa (McInnes and Rushton 2010). UNAIDS (2011) reported that in 2010, around 34 million individuals were living with HIV/AIDS of which 2.7 million are new infections, and the highest burden is in sub-Saharan Africa, where an expected populace of 22.9 million (68%) of HIV-infected individuals live (WHO 2011). In Africa, an estimated 40 million individuals are infected with HIV, resulting in a yearly mortality of more than 3 million (McInnes and Rushton 2010), though more than 500 million clinical P. falciparum infections happen each year, with an excess of a million malaria-related cases (Okara et al 2010). A natural clarification for these interactions lies in the cellbased invulnerable reactions to HIV and malaria fever (Olayemi et al 2012)

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Conclusion