Advertisement

SKIP ADVERTISEMENT

Global Health

Children With H.I.V. More Likely to Die of Malaria

A mother and her child who has cerebral malaria and is in a coma at Queen Elizabeth Central Hospital in Malawi.Credit...Jim Peck/Michigan State University

Children infected with H.I.V. appear much more likely than those who are not to die with severe malaria, a new study has found. It may make sense to give these children malaria drugs protectively, the authors said.

The research, which looked at 3,000 Malawian children who went into comas with cerebral malaria and included autopsies on more than 100 who had died, partly resolves a question that has long puzzled H.I.V. specialists. Does H.I.V. make malaria more lethal, as it is well-known to do with other diseases — notably tuberculosis?

About three million African children have H.I.V., and malaria and TB are also widespread across the continent. In some hot, wet regions, children may get malaria several times a year.

The study, led by researchers from Montefiore Health System/Albert Einstein College of Medicine in New York and from Michigan State, was published online in the journal mBio.

It has always been difficult to find a large pool of children with both diseases to study, said Dr. Kami Kim, an infectious disease specialist at the medical school and one of the study’s authors.

Most severe malaria occurs in children, because adults develop partial immunity after surviving multiple bouts. But most African children born with H.I.V. die before age 2, often before their disease is even diagnosed.

“No one really looked at the situation thoroughly,” Dr. Kim said.

In the early years of the H.I.V. epidemic, scientists assumed that there was no connection between the virus and malaria, because adults with H.I.V. usually did not die of malaria more often than those without it. (The possible exception was pregnant women, who are already more susceptible to malaria.)

Dr. Kim and her colleagues found that about 20 percent of the children autopsied after malaria deaths were also infected with H.I.V., a far higher rate than that seen in Malawian children over all.

Small blood vessels in their brains were more thickly clogged with platelets and white blood cells than the brain capillaries of children who had malaria alone, the researchers also found.

H.I.V. clearly made it more likely that children with malaria would develop the inflammation and blood clotting that could lead to death, Dr. Kim said.

Doctors should consider ways to protect H.I.V.-infected children against getting malaria, she added, and any child who is infected with both should probably be given anti-inflammatory and anti-clotting drugs.

A version of this article appears in print on  , Section D, Page 3 of the New York edition with the headline: Malaria Is More Lethal for Children With H.I.V.. Order Reprints | Today’s Paper | Subscribe

Advertisement

SKIP ADVERTISEMENT