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Volume 13, Number 2—February 2007

Letter

Subclinical Plasmodium falciparum Infection and HIV-1 Viral Load

Kimberly C. Brouwer*Comments to Author , Lisa B. Mirel*, Chunfu Yang*, Renu B. Lal*, Margarette S. Kolczak*, Anne M. Van Eijk†, John Ayisi†, Juliana A. Otieno‡, Bernard L. Nahlen*§, Richard Steketee*, Ya Ping Shi*†, and Altaf A. Lal*
Author affiliations: *Centers for Disease Control and Prevention, Atlanta, Georgia, USA; †Kenya Medical Research Institute, Kisumu, Kenya; ‡New Nyanza Provincial General Hospital, Kisumu, Kenya; §World Health Organization, Geneva, Switzerland;

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Table

Associations with log HIV-1 viral load in infants*

FactorNo.†Predicted beta (SE)p value
Baseline viral load
Log viral load per mL1460.65 (0.09)<0.01
Documented fever
Temperature >37°C23−0.02 (0.11)0.85
Previous visit documented fever
Temperature >37°C180.07 (0.14)0.62
Vaccination within 2 weeks of visit
Yes150.14 (0.14)0.34
Vaccination within 2 weeks of previous visit
Yes180.09 (0.12)0.46
Pneumonia
Present220.01 (0.13)0.93
Anemia
Hemoglobin <8 g/dL25−0.25 (0.16)0.15
Anemia during previous visit
Hemoglobin <8 g/dL270.01 (0.13)0.95
Antimalarial drugs received/since previous visit
Antimalarial drugs given590.02 (0.10)0.84
Malaria status current visit
Parasitemia positive39−0.07 (0.10)0.05
Malaria status previous visit
Parasitemia positive53−0.14 (0.09)0.14
Malaria status and antimalarial drug use received/since previous visit<0.01
Treated parasitemia46−0.11 (0.09)0.25
Did not treat parasitemia7−0.002 (0.17)0.99
Treated, no parasitemia130.28 (0.10)<0.01
Did not treat, no parasitemia80Reference
Malaria dynamics (previous vs. current visit)0.36
Cleared infection‡ (+ –)29−0.20 (0.11)0.09
Reinfection/persistence (+ +)24−0.16 (0.15)0.28
New infection (– +)15−0.18 (0.14)0.20
No malaria‡ (– –)78Reference
Age, mo
4–973–0.39 (0.13)<0.01
10–2473Reference

*Statistically significant associations (p<0.05) are indicated in boldface.
†Total sample size was 146 follow-up visits. Number of visits with the indicated characteristic are listed to the right. Sample size was 145 for pneumonia and anemia and 144 for anemia during previous visit.
‡After multiple comparisons (Tukey-Kramer) between groups in a model of the effect of malaria on log HIV viral load adjusted for age and baseline viral load, no statistically significant differences were found although clearing an infection versus no malaria had a p value of 0.10.

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